title: Laparoscopic repair of complicated umbilical hernia with Strattice Laparoscopic™ reconstructive tissue matrix.
abstract: BACKGROUND
  Complex hernias continue to present a challenge. Surgical techniques for repair are carefully considered to reduce risk for complications. Laparoscopic repairs improve postoperative infection rates, and placement of biologic mesh decreases mesh infection rates. However, laparoscopic repairs using biologic mesh is generally challenging due to difficulty with maneuverability.
  
  
  METHODS
  We present a case of a complex ventral hernia that was laparoscopically repaired using a new FDA cleared laparoscopic biologic graft. The patient had multiple comorbidities, including obesity, hepatitis C, endocarditis secondary to IV drug use, tobacco smoking, bilateral inguinal hernia, and recurrent umbilical hernia. The recurrent hernia was larger, irreducible, and discolored compared to original defect. The patient underwent laparoscopic repair with primary closure and reinforcement with Strattice™ Tissue Matrix Laparoscopic (LifeCell Corporation, Branchburg, NJ). At nine months postoperative, the patient had no evidence of recurrence, infection, or chronic pain, demonstrating early success from the surgical management.
  
  
  CONCLUSIONS
  Presence of multiple comorbidities and incarcerated recurrent hernia increase risk for complications during and/or after hernia repair. Considering these factors, laparoscopic repair with Strattice Laparoscopic and defect closure was a reasonable technique for repair.
  
  
  CONCLUSIONS
  Laparoscopic suture repair reinforced with biologic dermal tissue matrix was successfully performed during a complex hernia repair.
authors.affiliation: University of Nevada School of Medicine, Department of Surgery, 2040 W. Charleston Blvd. Ste. #601, Las Vegas, NV 89102, United States. Electronic address: stsuda@medicine.nevada.edu.
authors.forename: Shawn
authors.initials: S
authors.lastname: Tsuda
keywords: Incarcerated hernia; Laparoscopic hernia repair; Recurrent hernia; Strattice; Umbilical hernia