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Laparoscopic Ventral Hernia Repair

M. Tabakov, A. Filipov

Abstract


Introduction: Ventral hernia is a common problem in the routine surgical practice. The development of the laparoscopic technique and technology made the minimally invasive hernia repair possible. Aim: The current study reports a single-institution experience with the laparoscopic ventral hernia repair.Materials and Methods: From January, 2012 till December, 2015, 92 patients with primary or incisional ventral hernias were referred for laparoscopic hernia repair. The operated patients were followed for 24.7 months ±13.2 months (1-48). The demographic parameters of the cohort, operative time, postoperative stay, postoperative pain score along VAS on 24h and 7th postoperative day, intra- and postoperative complications, recurrence rate and conversion rate were recorded. Results: Three patients (3.26%) were converted to an open procedure. The mean age in the treated group was 59 years ±14. 37 (41.6%) are male and 52 (58.4%) - female. 27% of the treated patients were morbidly obese. The mean operative time of the laparoscopic group was 111.17min.±34.08. 24 hours after the procedure the mean VAS pain score was 6.23 and on the 7th postoperative day - 2.23±0.73. Postoperative complications occurred in 24.7% of the cases. One hernia recurrence and two port-site hernias were observed. Thus, the overall hernia recurrence rate was 3.37%. Clinically significant seromas developed in 9 patients (10.1%) and abdominal wall bulging was observed in four. One mesh infection, which mandated mesh removal, ensued. One patient had persistent post-operative pain, which lasted more than six months after the operation. 5 patients underwent a second surgery - 2 hematoma removals, 2 seroma drainages and 1 mesh removal. The 30-day mortality rate in the group is 0%Conclusion: The laparoscopic repair of primary and incisional ventral hernias is technically feasible and safe with a recurrence rate similar or even lower compared to the open procedures. At the same time, the laparoscopic approach benefits from fewer wound complications and all the others virtues of the minimally invasive surgery.

Keywords

Keywords: Laparoscopic ventral hernia repair, IPOM, IPOM plus




DOI: http://dx.doi.org/10.14748/ssm.v48i0.2300

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About The Authors

M. Tabakov

A. Filipov

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