Full laparoscopic incisional hernia repair using a 2-port route technique.
OBJECTIVE
The incidence of incisional hernia repair is increasing each year throughout the world. We created a full laparoscopic herniorrhaphy by means of an easy, reliable, and minimally invasive (two trocars) intraperitoneal onlay technique, using different sizes of a DualMesh (W. L. Gore & Associates; Flagstaff, AZ) with the soft side against the adherence material.


METHODS
A group of patients with an incisional hernia and other ventral hernias underwent a laparoscopic herniorrhaphy using this technique. By combining simple extra- and endocorporeal manipulation, a mesh, prior to being inserted into peritoneal cavity through a trocar port was completed with four sutures between the corner of the mesh and the abdominal wall, so that when pulling the strands outside the abdomen, the furled intraperitoneal mesh being unfurled flat, was lifted from and overlapped the hernial defect at the top of the abdomen spontaneously and exactly. The mesh was anchored by nonabsorbable surtures and endo-Helical Fasteners. The sutures were either tied and the knots buried subcutaneously, or were eventually removed.


RESULTS
It is by employing only two trocars applying this technique to a complete full laparoscopic intraperitoneal onlay of different sizes of a DualMesh incisional and ventral hernia repair. The mesh overlapped all hernial margins nicely and was anchored firmly. Postoperative courses were uneventful, without any complications. During the longest follow-up period of 2 years and 1 month, there was no recurrent evidence of the hernia in this group.


CONCLUSIONS
This technique, which applies to almost every laparoscopic ventral hernia repair procedure for use against an adherence mesh, can help to carry out an ideal, easy, and quick orientation and intraperitoneal anchoring of the mesh.
Dai
Li-Hua
LH
Department of Surgery, The First Hospital of Guangzhou, Guangzhou, China. stswhz@zsu.edu.cn
D034861:Abdominal Wall / Q000601:surgery; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D046449:Hernia, Abdominal / Q000601:surgery*; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D010537:Peritoneum / Q000601:surgery; D011138:Polytetrafluoroethylene; D013526:Surgical Mesh; D017792:Surgical Stapling; D053441:Suture Anchors; D013536:Suture Techniques; D013537:Sutures
D011138:Polytetrafluoroethylene