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Laparoscopic incisional hernioplasty: experience of 45 cases

INTRODUCTION: Incisional hernia is a frequent complication of laparotomy. Repair by simple suture has high relapse rates, and despite the use of prosthesis, risk of recurrence is still high. In the 1990s, laparoscopic repair of incisional hernia gained popularity. Benefits include reduced risk of complications, less pain and faster return to daily activities. Moreover, it can decrease the recurrence rate. AIM: To present our experience with laparoscopic treatment of incisional hernias. METHODS: Between January 2007 and July 2010, 45 patients underwent laparoscopic repair of incisional hernia. Indications included sufficient space for placement of trocars and adequate overlap of the prosthesis over the hernia defect. Contraindications were severe comorbidities that limited the use of pneumoperitoneum and/or general anesthesia, as well as history of diffuse peritonitis due to high risk of intra-abdominal adhesions. RESULTS: Mean operative time was 76 minutes. There was only one (2.2%) intraoperative complication. There was no conversion. Duration of hospitalization was equal to or less than 24 hours in 38 patients (84.4%). Fifteen patients (33%) had complications. However, 14 were minor complications (11 painless seromas and 3 prolonged pain) and only one major complication (late perforation of cecum). There was only one recurrence (2.2%) after a mean follow up of 24.6 months. CONCLUSIONS: Laparoscopic repair of incisional hernia is safe, feasible and effective. Seems to be associated with lower rates of perioperative complications and length of stay compared to open repair.

Hernia, ventral; Complications


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