title: New method of laparoscopic incisional hernia repair with double circumferential transfascial sutures.
abstract: BACKGROUND
  Although, laparoscopic incisional hernia repair (LIHR) provides an alternative method for managing incisional hernias, the ideal procedure for reducing the incidence of postoperative complications remains unclear.
  
  
  METHODS
  We have developed a new method of LIHR that involves a double transfascial suture and does not require the use of spiral tackers. We performed this procedure consecutively in five patients (four males and one female with a mean age of 65.6 years). We describe our new method of LIHR, and present preliminary clinical results.
  
  
  RESULTS
  The mean defect size was 26.2 ± 15.8 cm(2), and the mesh size that was used was 121.7 cm(2) in all cases. An occult hernia was found in one patient during laparoscopic observation. The mean operative time was 198.4 ± 49.3 minutes with a blood loss of 12.2 ± 24.6 mL. Postoperative courses were uneventful with a median postoperative hospitalization period of 8 days. No patient required mesh removal and none developed a recurrent hernia during the median follow-up period of 13 months.
  
  
  CONCLUSIONS
  Although, larger number of patients and longer follow-up will be required to prove the operative adequacy of our new procedure, it appears to represent a feasible option for LIHR.
authors.affiliation: Department of Surgery, Tokai University School of Medicine 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. hmatsui@is.icc.u-tokai.ac.jp
authors.forename: Hideo
authors.initials: H
authors.lastname: Matsui
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Nabeshima
authors.forename: Akiko
authors.initials: A
authors.lastname: Ishii
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ishizu
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Kondoh
authors.forename: Kyoji
authors.initials: K
authors.lastname: Ogoshi
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Makuuchi
mesh_terms: D000368:Aged; D005260:Female; D006547:Hernia / Q000473:pathology; D059685:Herniorrhaphy; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D011183:Postoperative Complications; D013537:Sutures; D016896:Treatment Outcome