Laparoscopic repair of incisional hernias located on the abdominal borders: a retrospective critical review.
BACKGROUND
The aim of this study was to assess feasibility and results of laparoscopic approach to repair incisional hernias of the abdominal borders, the weakest points of abdominal wall.


METHODS
Since 2002 through 2008 a total of 39 patients with fascial defects of the abdominal borders underwent laparoscopic repair. The defects were suprapubic (n=18), subxiphoidal (n=15), and lateral sided (n=6). The body mass index was >oe=30 Kg/m2 in 19 patients. The parietal defects was measured both externally and from within the peritoneal cavity and 56% of meshes were fixed only by tacks, especially in suprapubic site.


RESULTS
The mean operating time was 161.8+/-25 minutes. There was 1 intraoperative complication, an intestinal injury repaired laparoscopically. Conversion was needed in 1 patient for massive adhesions. Postoperative early surgical complications were 7 (1 seroma). Morbidity in obese and nonobese patients showed no statistically relevant difference (P>0.05). There was no postoperative death. Mean hospital stay was 5.1+/-3 days. The mean follow-up was 37 months and recurrence was observed in 3 cases.


CONCLUSIONS
The onlay laparoscopic approach for repair of incisional hernias of the abdominal borders can warrant good results. Obesity is not a contraindication to laparoscopic repair. Anyway, further experiences are necessary to confirm these results.
Ferrari
Giovanni Carlo
GC
Surgery and Videolaparoscopy Department, Niguarda Hospital, Milan, Italy.
Miranda
Angelo
A
Sansonna
Fabio
F
Magistro
Carmelo
C
Di Lernia
Stefano
S
Maggioni
Dario
D
Franzetti
Maurizio
M
Costanzi
Andrea
A
Pugliese
Raffaele
R
D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies