title: Laparoscopic treatment of incisional hernia. State of the art in 2012.
abstract: OBJECTIVE
  The objective of this review is to evaluate the results of laparoscopic treatment of ventral hernias using intra-peritoneal prosthetic mesh through a review of published surgical series.
  
  
  METHODS
  All large series of patients treated for an incisional hernia by laparoscopy and published between 2002 and 2011 were identified. The results of controlled randomized series comparing this technique with open surgical repair were analyzed.
  
  
  RESULTS
  Twenty-two series with a total of 7057 patients were analyzed (range 51-1242); the mean Body Mass Index (BMI) was 32 (range: 28.5-46), and the mean size of the hernia defect was 10.6 cm (range: 6-14.9 cm). The mean rate of conversion to open surgical repair was 2.7%. Mean operative duration was 90 ± 33 minutes. Mortality was 0.8%, usually due to an unrecognized intestinal injury (1.6%), which occurred more frequently with second or iterative hernia repairs. Hospital stay averaged 2.5 days. The infection rate was 0.3% and the rate of hernia recurrence was 4.6% (with a mean follow-up of 36 months). No statistically significant differences were found in terms of post-operative complications or hernia recurrence in the randomized studies comparing laparoscopic to open anterior abdominal surgical repair. However, duration of hospital stay was shorter after laparoscopy in some studies.
  
  
  CONCLUSIONS
  Laparoscopic repair of ventral incisional hernia is technically feasible and reliable for large hernia defects, even in obese patients. This approach should be reserved for patients with no history of previous hernia repair in order to avoid the risk of intestinal injury. It appears to allow for a shortened duration of hospitalization.
authors.affiliation: Service de chirurgie digestive et métabolique, AP-HP, Hôpitaux Universitaires de Seine Saint-Denis, Hôpital Jean Verdier, avenue du 14-Juillet, 93143 Bondy cedex, France.
authors.forename: P-E
authors.initials: PE
authors.lastname: Moreau
authors.forename: N
authors.initials: N
authors.lastname: Helmy
authors.forename: C
authors.initials: C
authors.lastname: Vons
mesh_terms: D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy