title: Laparoscopic tension-free abdominal wall repair: impact of mesh size and of different fixation devices in a consecutive series of 120 patients.
abstract: OBJECTIVE
  To assess the impact of mesh size and fixation devices on short-term outcomes in a consecutive series of tension-free laparoscopic abdominal wall repairs.
  
  
  METHODS
  Data for 120 consecutive, unselected patients undergoing tension-free laparoscopic incisional (n=63) or umbilical (n=57) hernia repair were prospectively collected. A multivariate analysis was performed to evaluate variables influencing outcomes.
  
  
  RESULTS
  Persistent seromas were observed in 13 patients (10.83%) and 2 recurrences (1.98%) occurred. Mesh size >300 cm was associated with increased hospital stay [odds ratio (OR) 4.83; 95% confidence interval (CI), 1.5-15.53; P=0.008], increased postoperative day 1 (POD1) pain assessed with visual analog scale (OR 5.51; 95% CI, 1.76-17.2; P=0.003), and the presence of complications (OR 10.4; 95% CI, 1.85-58.96; P=0.007). Body mass index >30 resulted in increased hospital stay (OR 3.05; 95% CI, 1.23-7.57; P=0.01) and increased POD1 visual analog scale (OR 2.28; 95% CI, 1-5.18; P=0.04).
  
  
  CONCLUSIONS
  Mesh size and obesity were the main factors influencing postoperative outcomes.
authors.affiliation: *IRCAD-IHU University of Strasbourg, Strasbourg, Alsace, France †IRCAD-AITS Show Chwan Health Care System, Changhua, Taiwan.
authors.forename: Michele
authors.initials: M
authors.lastname: Diana
authors.forename: Cosimo
authors.initials: C
authors.lastname: Callari
authors.forename: Jacopo
authors.initials: J
authors.lastname: D'Agostino
authors.forename: Hurng-Sheng
authors.initials: HS
authors.lastname: Wu
authors.forename: Didier
authors.initials: D
authors.lastname: Mutter
authors.forename: Jacques
authors.initials: J
authors.lastname: Marescaux
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D005260:Female; D006554:Hernia, Umbilical / Q000601:surgery; D006555:Hernia, Ventral / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D013526:Surgical Mesh / Q000592:standards*; D016896:Treatment Outcome