Effect of the endoscopic components separation in large-sized laparoscopic incisional hernia repair. Medium-term follow-up

Abstract

Introduction: Laparoscopic incisional hernia repair is a technique with proven advantages, but with limitations in large defects of the abdominal wall. The objective is the analysis of a short series of patients who underwent SCV, as an adjunct to laparoscopic repair of abdominal wall defects. Material and method: Study by descriptive design of 28 patients registered prospectively and consecutively with defects of the abdominal wall, repaired by laparoscopic plastic type SCV, with clinical follow-up in the medium term. Registered variables: age, sex, type and size of the parietal defect, mesh size used, number of fixations, surgical time, time of the SCV, morbidity, mortality and recurrence. Results: The mean diameter of the eventrogenic defects was 11.4 cm, achieving closure in all cases. There were no intraoperative complications. Postoperative morbidity was recorded in 3 cases: unusual abdominal pain, cardiolo-gical complication and postoperative intestinal obstruction with intestinal resection. There was a recurrence (3.57 %) detected during the follow-up time. Conclusions: The SCV is a useful and effective procedure as an adjunct in the repair of abdominal wall defects. A bilateral sliding of 6 to 8 cm of the abdominal rectus is achieved towards the midline, allowing to reduce the size of the defect and achieve closure, reinforced with a mesh with smaller size than usual, and with low morbidity.