Pregnancy following laparoscopic mesh repair of ventral abdominal wall hernia.
BACKGROUND
There are no data on laparoscopic repair of ventral and incisional hernias (LRVIH) in fertile women who intend to have further pregnancies. A unique series is described of 8 women who got pregnant and gave birth after LRVIH.


METHODS
Medical records of  875 consecutive patients who underwent LRVIH were reviewed. Women who gave birth after LRVIH were identified. At follow-up, patients answered a questionnaire on pain, discomfort, recurrence, and problems during pregnancy and delivery and underwent a physical examination.


RESULTS
Eight patients were identified; all agreed to inclusion. Four women received LRVIH for incisional hernia; 4 were operated on for primary ventral hernia. Median age at LRVIH was 29 years (range, 24 to 34). No postoperative complications occurred. Median time between LRVIH and delivery was 22.5  months (range, 12 to 44). Median follow-up after delivery was 23.5 months (range, 2 to 40). Five patients experienced a tearing pain in the area of hernia repair during the last months of pregnancy. This pain was not continually present and disappeared after delivery in all patients. All infants  were born healthy at full term. Seven patients had a vaginal birth and one had a caesarean delivery. There were no major complications during pregnancy or delivery. At control examination, all patients were asymptomatic and, with one exception, without signs of recurrence. One patient had  a swelling in the repaired area indicating either recurrence or mesh bulging. Being asymptomatic, she refused any further diagnostics.


CONCLUSIONS
LRVIH in fertile women who intend to have further pregnancies is an acceptable therapeutical option that causes no significant problems  during pregnancy or delivery.
Department of Surgery, Hospital Group Twente (ZGT), Almelo, The Netherlands. eschoenmaeckers@gmail.com
Ernst
E
Schoenmaeckers
Vincent
V
Stirler
Johan
J
Raymakers
Srdjan
S
Rakic
D000328:Adult; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D011184:Postoperative Period; D011247:Pregnancy; D011256:Pregnancy Outcome; D013526:Surgical Mesh; D055815:Young Adult