Long-term results of laparoscopic repair of incisional hernias using an intraperitoneal composite mesh

Abstract

1) Intra-abdominal composite mesh is good tolerance. 2) The recurrence rate is low and within 1 year of the operation. 3) The long-term morbidity with LIHR is moderate. 4) The risk of intestinal injury is not predictable. 5) Reoperations can be performed with sufficient guarantee using laparoscopy.

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

“…Our results in the augmentation technique, however, coincide better with other studies than that of Flam's and show a lack of linear rise in hernia recurrence rate during the years after surgery, reaching even a steady state after 5 years, as also reported by Moreno Egea ''bridging technique'' [33]. Indeed, 80 % of our recurrent hernias were diagnosed within 3-4 postoperative years.…”

“…The only major complication of bowel perforation related to missed enterotomies, which had to be re-operated, occurred in 3 out of 1326 patients (0.22 %), independently of defect size, similar to what has been reported in Bacari's study [9]. This complication is reported in the literature in up to 2.5 % of cases as ''secondary bowel breakdown'' which leads to delayed perforation [23,[33][34][35][36].…”

“…Mesh reinforcement could be applied during the same surgery if no spillage exists in the abdominal cavity, as done in six cases of our study. In case of spillage, the mesh placement should be considered for a second-stage surgery that would be delayed 6-12 months, similarly to treatment of bowel strangulation in the defect or in the presence of any sign of infected field [5,15,33].…”

Traitement des éventrations par laparoscopie. Quel bilan en 2012 ?

“…Dans trois études [12,18,19], les plaies digestives ont été suturées par voie laparoscopique et l'intervention a été poursuivie (pose de la prothèse) sans complication infectieuse secondaire (n = 13). Dans neuf études, les plaies digestives ont été traitées de principe après conversion (n = 31) [5,6,10,11,16,20,22].…”

“…Le ou les orifices d'éventration libérés ont été fermés par des points séparés dans trois séries (12,07 % ; 505 patients) [9,12,20] et laissés ouverts dans 19 séries (79,3 % ; 5779 patients) [5][6][7][8]10,11,[13][14][15][16][17][18][19][21][22][23][24][25][26].…”