title: Laparoscopic incisional hernia repair after solid-organ transplantation.
abstract: BACKGROUND
  Incisional hernias are a frequent problem after liver transplantation. Mesh repair techniques including laparoscopic repair have been employed in order to address this problem. We have introduced intraperitoneal onlay mesh repair (IPOM) in 2008 because of advantages that had been reported in the literature. To perform a structured comparison of methods and outcomes, we compared patients who have been treated with IPOM and those who have been treated conventionally.
  
  
  METHODS
  We included 29 consecutive patients (15 IPOM, 14 conventional hernia repair [CHR] who have been analyzed and have been examined clinically and sonographically during their follow-up.
  
  
  RESULTS
  Recurrence rate was 6% (IPOM) and 50% (CHR), complication rate was 33% (IPOM) and 21% (CHR), mean hospital stay was 7.2 (IPOM) and 9.7 (CHR) days. None of the 29 patients had an impaired wound healing or infectious complications. Of the 29 patients, 10 received sirolimus for immunosuppression, which was switched preoperatively to a calcineurin inhibitor.
  
  
  CONCLUSIONS
  IPOM results in a shorter hospital stay. The complication rate with IPOM was higher compared with CHR, recurrence rate was considerably lower. The role of perioperative sirolimus switch needs to be interpreted with caution, but should be further investigated because of potential advantages with respect to fewer wound healing complications.
authors.affiliation: Department of General, Visceral and Vascular Surgery, Friedrich-Schiller-University, Jena, Germany. Hubert.Scheuerlein@med.uni-jena.de
authors.forename: H
authors.initials: H
authors.lastname: Scheuerlein
authors.forename: F
authors.initials: F
authors.lastname: Rauchfuss
authors.forename: A
authors.initials: A
authors.lastname: Gharbi
authors.forename: M
authors.initials: M
authors.lastname: Heise
authors.forename: U
authors.initials: U
authors.lastname: Settmacher
mesh_terms: D065095:Calcineurin Inhibitors; D005260:Female; D006547:Hernia / Q000209:etiology; D059685:Herniorrhaphy; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D012008:Recurrence; D020123:Sirolimus / Q000008:administration & dosage
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D020123:Sirolimus