Laparoscopic approach to incisional hernia.
BACKGROUND
After more than 8 years of working in the field, we thought it would be interesting to evaluate our experience in the laparoscopic repair of abdominal wall hernias, focusing attention on the lessons learned with time.


METHODS
From January 1994 to November of 2000, a total of 270 patients with abdominal wall hernias were treated in our center using the laparoscopic approach. The data collected and analyzed were preoperative evaluation, operative findings, early and long-term complications, and recurrences.


RESULTS
The mean follow-up time was 44 months, mean surgical time was 85 min, and mean hospital stay was 1.5 days. The average number of abdominal wall defects was 4.8 per patient. There were 9 (3.3%) small bowel perforations. Conversion to open surgery was required in 1 case (0.3%). Minor early postoperative complications occurred in 38 patients (14.07%). Twenty patients (7.4%) developed persistent postoperative abdominal pain. There was 1 case (0.3%) of small bowel incarceration through the mesh border and another case (0.3%) of small bowel leakage due to ischemia and subsequent peritonitis. The relapse rate was 4.4% (12 cases).


CONCLUSIONS
The laparoscopic approach is a valuable option in the management of abdominal wall hernias, but it requires experience in laparoscopic surgery and there is a specific learning curve for the technique.
Carbajo
M A
MA
Servicio de Cirugía General, Hospital de Medina del Campo, Cta. De Peñaranda de Bracamonte, Km. 2, 47400 Medina del Campo, Valladolid, Spain. 983 83 80 07
Martp del Olmo
J C
JC
Blanco
J I
JI
Toledano
M
M
de la Cuesta
C
C
Ferreras
C
C
Vaquero
C
C
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D007421:Intestine, Small / Q000293:injuries; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000209:etiology; D011446:Prospective Studies; D012008:Recurrence