Long-term outcomes of 1326 laparoscopic incisional and ventral hernia repair with the routine suturing concept: a single institution experience

Abstract

Our long series confirms the unexpected high rate of feasibility in the suturing concept or augmentation technique, and confers additional benefits to the conventional advantages of LIVHR in terms of reducing the overall morbidity, with a low rate of recurrences. Based on our experience and study, the current best indications for a successful LIVHR procedure should be tailored upon the limitations of the defect's width and proper patient selection, to restore adequately the optimal functionality of the abdominal muscles and provide better functional and cosmetic outcomes.

Is fascial defect closure with intraperitoneal onlay mesh superior to standard intraperitoneal onlay mesh for laparoscopic repair of large incisional hernia?

“…In the current study, the incidences of seroma formation after sIPOM and IPOM‐Plus for large IHR were not significantly different (25% vs 14%). Given the expected incidence of seroma formation , IPOM‐Plus resulted in a high occurrence of seroma in the present study. In some cases of IPOM‐Plus, the hernial sac had a transverse diameter that was much wider than that of the fascial defect, and it might not have been sufficiently closed.…”

“…to reduce the incidence of adverse hernia‐related events including recurrence, seroma formation, and mesh bulging . Several reports have indicated the effectiveness of IPOM‐Plus , and a recent systematic review concluded that IPOM‐Plus was more effective than sIPOM .…”

Laparoscopic versus Hybrid Approach for Treatment of Incisional Ventral Hernia

“…The mean operative time in laparoscopic hernioplasties ranges from 85 to 100 min according to other studies [23][24][25] . Adhesiolysis lengthens the duration of operation [8] and this has been observed also in our series as average operative time in LA and HA groups were 128 and 134 min respectively.…”

Outcomes of bridging versus mesh augmentation in laparoscopic repair of small and medium midline ventral hernias

“…There are several modifications of sutures placed on the fascial edges and hernia sac. The most commonly used suturing techniques are the ones proposed by Chelala [27,28], Agrawal [29] and Orenstein [30]. However, none of them meets the criteria recommended for safe abdominal closure with a continuous suture and a suture/wound length (SL:WL) ratio of at least 4:1 [23].…”