title: Laparoscopic incisional hernia repair: long term results.
abstract: OBJECTIVE
  The aim of this prospective monocenter study was to evaluate the long-term results of laparoscopic treatment of incisional hernias using intra-peritoneal prosthetic mesh.
  
  
  METHODS
  Seventy-seven patients underwent laparoscopic treatment of incisional hernia between January 2002 and January 2008. All patients were followed for at least five years after surgery. The parameters assessed were hernia recurrences and post-operative pain. In case of doubt as to the diagnosis of recurrence or pain, a CT examination was performed.
  
  
  RESULTS
  Nine patients were excluded: four patients refused to participate in the study and five died of unrelated disease during follow-up. Sixty-eight patients (89.7%) were followed for a mean of 92.3 (± 19.8)months. Mean age of patients was 58 (± 11.3)years. There were no deaths and no conversions. The mean operative time was 104 (± 48)minutes. The morbidity rate was 13.2%. Major complications included one case each of mesh infection, post-operative peritonitis (bowel injury), and surgical site pain requiring revisional surgery. Five patients developed seroma. The mean duration of hospitalization was 4.5 (± 2.3) days. The long-term recurrence rate was 8.8%. The average interval to onset of recurrence was 45.8 (± 31.1)months. Trocar site hernias were observed in three patients. Four patients had post-operative pain requiring long-term medical treatment.
  
  
  CONCLUSIONS
  Laparoscopic incisional hernia repair using intra-peritoneal prosthetic mesh is a safe technique with satisfactory long-term outcome. One major complication occurred: bowel injury. Suture closure of 10mm trocar sites should be routine.
authors.affiliation: Chirurgie digestive, centre hospitalier départemental de Vendée, 85000 La Roche-sur-Yon, France; Chirurgie générale et digestive, Cité Sanitaire, 44600 Saint-Nazaire, France. Electronic address: emeric.abet@chd-vendee.fr.
authors.forename: E
authors.initials: E
authors.lastname: Abet
authors.affiliation: Clinique de chirurgie digestive et endocrinienne, institut des maladies de l'appareil digestif, CHU de Nantes-Hôtel Dieu, 44000 Nantes, France; Chirurgie générale et digestive, Cité Sanitaire, 44600 Saint-Nazaire, France.
authors.forename: E
authors.initials: E
authors.lastname: Duchalais
authors.affiliation: Chirurgie digestive, centre hospitalier départemental de Vendée, 85000 La Roche-sur-Yon, France; Chirurgie générale et digestive, Cité Sanitaire, 44600 Saint-Nazaire, France.
authors.forename: F
authors.initials: F
authors.lastname: Denimal
authors.affiliation: Chirurgie digestive, centre hospitalier départemental de Vendée, 85000 La Roche-sur-Yon, France; Chirurgie générale et digestive, Cité Sanitaire, 44600 Saint-Nazaire, France.
authors.forename: B
authors.initials: B
authors.lastname: de Kerviler
authors.affiliation: Chirurgie digestive, centre hospitalier départemental de Vendée, 85000 La Roche-sur-Yon, France; Chirurgie générale et digestive, Cité Sanitaire, 44600 Saint-Nazaire, France.
authors.forename: M-H
authors.initials: MH
authors.lastname: Jean
authors.affiliation: Chirurgie digestive, centre hospitalier départemental de Vendée, 85000 La Roche-sur-Yon, France; Chirurgie générale et digestive, Cité Sanitaire, 44600 Saint-Nazaire, France.
authors.forename: A-G
authors.initials: AG
authors.lastname: Brau-Weber
authors.affiliation: Chirurgie digestive, centre hospitalier départemental de Vendée, 85000 La Roche-sur-Yon, France; Chirurgie générale et digestive, Cité Sanitaire, 44600 Saint-Nazaire, France.
authors.forename: M
authors.initials: M
authors.lastname: Comy
mesh_terms: D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation; D013526:Surgical Mesh; D016896:Treatment Outcome
keywords: Incisional hernia; Intra-peritoneal prosthetic mesh; Laparoscopic; Long term outcome