title: Occult ventral hernia defects: a common finding during laparoscopic ventral hernia repair.
abstract: BACKGROUND
  In many incidences, laparoscopic exploration reveals occult ventral hernia defects that were not detected on physical examination. The objective of this study was to describe the frequency of occult ventral hernia defects detected during laparoscopy.
  
  
  METHODS
  Prospectively collected data on 146 consecutive patients who underwent laparoscopic ventral hernia repair were reviewed. The numbers of ventral defects found on preoperative physical examination were compared with those found during the laparoscopic procedure.
  
  
  RESULTS
  Out of 146 laparoscopic ventral hernia repair patients, 70 patients (48%) were found to have occult defects that were not detected on preoperative abdominal examination. Among all the possible variables, only the type of hernia was found to have a significant difference.
  
  
  CONCLUSIONS
  Almost half of the patients with a ventral hernia have clinically occult hernia defects that can be recognized laparoscopically. This indicates the importance of careful inspection of the anterior abdominal wall during the surgical procedure.
authors.affiliation: Department of Surgery, Michigan State University/Kalamazoo Center for Medical Studies, 1000 Oakland Drive, Kalamazoo, MI 49008, USA. saber@kcms.msu.edu
authors.forename: Alan A
authors.initials: AA
authors.lastname: Saber
authors.forename: Arun J
authors.initials: AJ
authors.lastname: Rao
authors.forename: Edward A
authors.initials: EA
authors.lastname: Itawi
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Elgamal
authors.forename: Ruvie L
authors.initials: RL
authors.lastname: Martinez
mesh_terms: D034861:Abdominal Wall / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D005260:Female; D006554:Hernia, Umbilical / Q000473:pathology / Q000601:surgery; D006555:Hernia, Ventral / Q000473:pathology* / Q000517:prevention & control / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome