Laparoscopic ventral hernioplasty in consecutive unselected group

Abstract

Background: Laparoscopic surgery for ventral/ incisional hernia becomes more and more popular, but the most of studies were done in selected groups of patients. Material and Methods: The report is based on the analysis of all patients with primary and postoperative abdominal hernias from one General surgery department, operated in 2012-2013. There were 50 patients (15 men, 35 women), mean age 53.1+/-9.8 years, average BMI 36.3+/-6.5 kg/m2. Fourteen hernias were primary (defect area 29+/-14 cm2), and 36 - postoperative (defect area 176+/-88 cm2). In all patients laparoscopic IPOM hernioplasty was attempted. The netted polyester prostheses, covered with porcine collagen were used. The prostheses were fixed by titanium tacks and transabdominal ligatures. Result: The average duration of endoscopic operation was 63+/-24 min. There were seven simultaneous operations. In two cases, conversion was required (4%). There was one inadvertent enterotomy (2%), SSI after laparoscopy developed in 2 cases (4%), and also in 2 cases after conversion. Late complications were: 3 persistent seromas (6%), and chronic pain in 2 cases (4%). We found no relapses after average follow-up of 13 months. Conclusion: Laparoscopic IPOM hernioplasty is successful technique for treatment of primary and incisional hernias. No special selection of patients is needed. In unselected population conversion rate is low, with acceptable number of early and late complications, and relapses.