Laparoscopic ventral hernia repair: Does primary repair in addition to placement of mesh decrease recurrence?

Ambar Banerjee, Catherine Beck, Vimal K. Narula, John Linn, Sabrena Noria, Bradley Zagol, Dean J. Mikami

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

Background The advent of laparoscopic ventral hernia repair (LVHR) not only reduced the morbidity associated with open repair but also led to a decrease in the hernia recurrence rate. However, the rate continues to remain significant. Methods A retrospective observational study was conducted on 193 patients who were treated with LVHR by two minimally invasive surgeons in a 24-month period. The patient population was broadly divided into two groups based on the laparoscopic repair of the fascial defect with mesh underlay, or with primary suture repair and mesh underlay (PSR ? MU). Patient demographics, rates of hernia recurrence, and other associated complications were compared between the two groups. Patient variables and the clinical outcomes were analyzed with descriptive statistics and chi-square test. Results One hundred ninety-three consecutive patients underwent LVHR for incisional (n = 136), umbilical (n = 44), epigastric (n = 9), and parastomal (n = 4) hernia. Hernia recurrence was documented in eight patients (4.1%). The mean follow-up period was 10.5 months (range 1-36 months). Incisional hernias accounted for all eight recurrences. The rate of recurrence in those treated with PSR ? MU was 3% (two of 67 cases) in comparison with 4.8% (six of 126 patients) associated with mesh alone. The rate of recurrence in the recurrent hernia group, treated with mesh only, was 10.5% (four of 38 patients) compared with 4.8% (one of 21 patients) in the PSR ? MU group. Conclusions Primary laparoscopic repair along with mesh placement for the management of ventral hernia was found to be effective in selected cases as evidenced by the low rate of recurrence when compared with conventional laparoscopic repair with mesh alone. Further retrospective and prospective studies, with larger patient enrollment, are warranted to confirm the benefit of this technique over traditional repair.

Original languageEnglish (US)
Pages (from-to)1264-1268
Number of pages5
JournalSurgical endoscopy
Volume26
Issue number5
DOIs
StatePublished - May 2012

Keywords

  • Laparoscopic ventral hernia repair
  • Primary repair with mesh
  • Recurrence

ASJC Scopus subject areas

  • Surgery

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    Banerjee, A., Beck, C., Narula, V. K., Linn, J., Noria, S., Zagol, B., & Mikami, D. J. (2012). Laparoscopic ventral hernia repair: Does primary repair in addition to placement of mesh decrease recurrence? Surgical endoscopy, 26(5), 1264-1268. https://doi.org/10.1007/s00464-011-2024-3