[Treatment of non-midline ventral hernia: experience in an abdominal wall unit and literature review].
BACKGROUND
Lateral ventral hernia is an interesting surgical problem. However, few data are available on this entity.


OBJECTIVE
To review current knowledge of lateral ventral hernia and present our experience of this entity in a multidisciplinary abdominal wall unit.


METHODS
A.


METHODS
a search of Spanish (Cirugía Española) and international literature was performed through MEDLINE using the key words "lateral incisional/ventral hernia". B. Clinical study: a series of 53 patients who underwent endoscopic surgery for non-midline ventral hernia were prospectively studied. Clinical parameters, postoperative complications and the recurrence rate were evaluated. The mean follow-up was 64 months (range, 12-120 months).


RESULTS
A.


METHODS
we found a ratio between chapters on inguinal hernia and ventral hernia of 3.8:1 and a complete absence of chapters on lateral ventral hernia. Only two articles specifically dealt with ventral hernia. B. Clinical study: the most frequent location was lumbar (34%), followed by iliac and subcostal. A total of 37.7% of patients could be treated without admission and the remaining patients had a mean length of hospital stay of 2.7 days. Hematoma (17%) predominated in iliac ventral hernias and pain was transitory in two patients with lumbar ventral hernia. There were two early recurrences due to incorrect mesh fixation in subcostal and lumbar ventral hernias.


CONCLUSIONS
Non-midline ventral hernia is a little known entity. Future treatment should be individualized in each patient and should be based on common classification of the type of defect to correctly evaluate the results. The laparoscopic route provides competitive results in selected patients.
Moreno-Egea
Alfredo
A
Unidad de Pared Abdominal, Departamento de Cirugía, Hospital J.M. Morales Meseguer, Murcia, España. moreno-egea@ono.com
Guzmán
Pablo
P
Morales
Germán
G
Carrillo
Andrés
A
Aguayo
José Luis
JL
D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D011183:Postoperative Complications / Q000453:epidemiology; D013526:Surgical Mesh