Laparoscopic Incisional and Ventral Hernia Mesh Repair

  • Davide LomantoEmail author
  • Hrishikesh P. Salgaonkar


The high recurrence rate of conventional open repair in the treatment of ventral hernias has caused some surgeons to adopt a paradigm shift in the treatment towards laparoscopic approach. Since its introduction in 1993, laparoscopic ventral hernia has offered a minimal invasive approach to repair of ventral and incisional hernias. It borrows many of the tenets of the traditional Rives-Stoppa-Wantz repair and places the mesh in a sublay position, usually placed one layer deeper in the intra-peritoneal position, often on an intact peritoneal layer. With time, several innovations and modifications to the laparoscopic repair have been developed. In this chapter we explore the indications, contra-indications, options of minimally invasive abdominal wall repair and reconstruction and the post-operative care.


Ventral hernia Incisional hernia Laparoscopic surgery IPOM LVHR 


  1. 1.
    Sarela AI, Miner TJ, Karpeh MS, Coit DG, Jaques DP, Brennan MF. Clinical outcomes with laparoscopic stage M1, unresected gastric adenocarcinoma. Ann Surg. 2006;243:189–95.CrossRefGoogle Scholar
  2. 2.
    Sarela AI, Murphy I, Coit DG, Conlon KC. Metastasis to the adrenal gland: the emerging role of laparoscopic surgery. Ann Surg Oncol. 2003;10:1191–6.CrossRefGoogle Scholar
  3. 3.
    Luijendijk RW, Hop WC, van den Tol MP, de Lange DC, Braaksma MM, IJzermans JN, et al. A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med. 2000;343:392–8.CrossRefGoogle Scholar
  4. 4.
    Stoppa RE. The treatment of complicated groin and incisional hernias. World J Surg. 1989;13:545–54.CrossRefGoogle Scholar
  5. 5.
    Wantz GE. Incisional hernioplasty with Mersilene. Surg Gynecol Obstet. 1991;172:129–37.PubMedGoogle Scholar
  6. 6.
    Cassar K, Munro A. Surgical treatment of incisional hernia. Br J Surg. 2002;89:534–45.CrossRefGoogle Scholar
  7. 7.
    Cobb WS, Kercher KW, Heniford BT. Laparoscopic repair of incisional hernias. Laparoscopic surgery: beyond mere feasibility. In: Patel NA, Bergamaschi R, editors. Surgical clinics of North America. Philadelphia: Saunders; 2006. p. 91–103.Google Scholar
  8. 8.
    Flum DR, Horvath K, Koepsell T. Have outcomes of incisional hernia repair improved with time? A population-based analysis. Ann Surg. 2003;237:129–35.CrossRefGoogle Scholar
  9. 9.
    Bittner R, Bingener-Casey J, Dietz U, Fabian M, Ferzli GS, Fortelny RH, Köckerling F, Kukleta J, Leblanc K, Lomanto D, Misra MC, Bansal VK, Morales-Conde S, Ramshaw B, Reinpold W, Rim S, Rohr M, Schrittwieser R, Simon T, Smietanski M, Stechemesser B, Timoney M, Chowbey P, International Endohernia Society (IEHS). Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS)-part 1). Surg Endosc. 2014;28:2–29.CrossRefGoogle Scholar
  10. 10.
    Sauerland S, Walgenbach M, Habermalz B, Seiler CM, Miserez M. Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst Rev. 2011;(3):CD007781.Google Scholar
  11. 11.
    Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg. 2004;240(4):578–83. discussion 583–5.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Aslani N, Brown CJ. Does mesh offer an advantage over tissue in the open repair of umbilical hernias? A systematic review and meta-analysis. Hernia. 2010;14(5):455–62.CrossRefGoogle Scholar
  13. 13.
    Cuccurullo D, Piccoli M, Agresta F, Magnone S, Corcione F, Stancanelli V, Melotti G. Laparoscopic ventral incisional hernia repair: evidence-based guidelines of the first Italian Consensus Conference. Hernia. 2013;17(5):557–66.CrossRefGoogle Scholar
  14. 14.
    Heniford BT, Park A, Ramshaw BJ, Voeller G. Laparoscopic ventral and incisional hernia repair in 407 patient. J Am Coll Surg. 2000;190(6):645–50.CrossRefGoogle Scholar
  15. 15.
    LeBlanc K. Herniorrhaphy with the use of transfascial sutures. In: LeBlanc K, editor. Laparoscopic hernia surgery. London: Arnold; 2003. p. 115–24.CrossRefGoogle Scholar
  16. 16.
    Wassenaar EB, Schoenmaeckers EJ, Raymakers JT, Rakic S. Recurrences after laparoscopic repair of ventral and incisional hernia: lessons learned from 505 repairs. Surg Endosc. 2009;23(4):825–32.CrossRefGoogle Scholar
  17. 17.
    Silecchia G, Campanile FC, Sanchez L, Ceccarelli G, Antinori A, Ansaloni L, Olmi S, Ferrari GC, Cuccurullo D, Baccari P, Agresta F, Vettoretto N, Piccoli M. Laparoscopic ventral/incisional hernia repair: updated guidelines from the EAES and EHS endorsed Consensus Development Conference. Surg Endosc. 2015;29:2463–84.CrossRefGoogle Scholar
  18. 18.
    Palanivelu C, Jani KV, Senthilnathan P, Parthasarathi R, Madhankumar MV, Malladi VK. Laparoscopic sutured closure with mesh reinforcement of incisional hernias. Hernia. 2007;11:223–8.CrossRefGoogle Scholar
  19. 19.
    Chelala, et al. The suturing concept for laparoscopic mesh fixation in ventral and incisional hernias: preliminary results. Hernia. 2003;7:191–6.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Chelala E, Thoma M, Tatete B, Lemye AC, Dessily M, Alle JL. The suturing concept for laparoscopic mesh fixation in ventral and incisional hernia repair: mid-term analysis of 400 cases. Surg Endosc. 2007;21(3):391–5.CrossRefGoogle Scholar
  21. 21.
    Chelala E, Debardemaeker Y, Elias B, Charara F, Dessily M, Allé JL. Eighty-five redo surgeries after 733 laparoscopic treatments for ventral and incisional hernia: adhesion and recurrence analysis. Hernia. 2010;14(2):123–9. Epub 2010 Feb 14.CrossRefGoogle Scholar
  22. 22.
    Agarwal BB, Agarwal S, Mahajan KC. Laparoscopic ventral hernia repair: innovative anatomical closure, mesh insertion without 10-mm transmyofascial port, and atraumatic mesh fixation: a preliminary experience of a new technique. Surg Endosc. 2009;23:900–5. Scholar
  23. 23.
    Sharma D, Jindal V, Pathania OP, Thomas S. Novel technique for closure of defect in laparoscopic ventral hernia repair. J Minim Access Surg. 2010;6(3):86–8.CrossRefGoogle Scholar
  24. 24.
    Orenstein SB, Dumeer JL, Monteagudo J, Poi MJ, Novitsky YW. Outcomes of laparoscopic ventral hernia repair with routine defect closure using “shoelacing” technique. Surg Endosc. 2011;25:1452–7.CrossRefGoogle Scholar
  25. 25.
    Barnes GS, Papasavas PK, O'Mara MS, Urbandt J, Hayetian FD, Gagn DJ, Newton ED, Caushaj PF. Modified extraperitoneal endoscopic separation of parts for abdominal compartment syndrome. Surg Endosc. 2004;18:1636–9.CrossRefGoogle Scholar
  26. 26.
    Griniatsos J, Yiannakopoulou E, Tsechpenakis A, Tsigris C, Diamantis T. A hybrid technique for recurrent incisional hernia repair. Surg Laparosc Endosc Percutan Tech. 2009;19(5):e177–80.CrossRefGoogle Scholar
  27. 27.
    Mathes SJ, Steinwald PM, Foster RD, Hoffman WY, Anthony JP. Complex abdominal wall reconstruction: a comparison of flap and mesh closure. Ann Surg. 2000;232(4):586–96.CrossRefGoogle Scholar
  28. 28.
    Lomanto D, Iyer SG, Shabbir A, Cheah WK. Laparoscopic versus open ventral hernia mesh repair: a prospective study. Surg Endosc. 2006;20:1030–5.CrossRefGoogle Scholar
  29. 29.
    Johnson WH, Fecher AM, McMahon RL, Grant JP, Pryor AD. Versa Step trocar hernia rate in unclosed fascial defects in bariatric patients. Surg Endosc. 2006;20:1584–6.CrossRefGoogle Scholar
  30. 30.
    Bittner R, Bingener-Casey J, Dietz U, Fabian M, Ferzli G, Fortelny R, et al. Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society [IEHS])-Part III. Surg Endosc. 2014;28:380–404. Scholar
  31. 31.
    Forbes SS, Eskicioglu C, McLeod RS, Okrainec A. Meta-analysis of randomized controlled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh. Br J Surg. 2009;96:851–8.CrossRefGoogle Scholar
  32. 32.
    Sajid MS, Bokhari SA, Mallick AS, Cheek E, Baig MK. Laparoscopic versus open repair of incisional/ventral hernia: a meta-analysis. Am J Surg. 2009;197:64–72.CrossRefGoogle Scholar
  33. 33.
    Itani KM, Hur K, Kim LT, Anthony T, Berger DH, Reda D, Neumayer L, for the Veternas Affairs Ventral Incisional Hernia Investigators. Comparison of laparoscopic and open repair with mesh for the treatment of ventral incisional hernia: a randomized trial. Arch Surg. 2010;145:322–8.CrossRefGoogle Scholar
  34. 34.
    Pring CM, Tran V, O’Rourke N, Martin IJ. Laparoscopic versus open ventral hernia repair: a randomized controlled trial. ANZ J Surg. 2008;78:903–6.CrossRefGoogle Scholar
  35. 35.
    Olmi S, Scaini A, Cesana GC, Erba L, Croce E. Laparoscopic versus open incisional hernia repair: an open randomized controlled study. Surg Endosc. 2007;21:555–9.CrossRefGoogle Scholar
  36. 36.
    Mussack T, Ladurner R, Vogel T, Lienemann A, Eder-Willwohl A, Hallfeldt KK. Health-related quality-of-life changes after laparoscopic and open incisional hernia repair: a matched pair analysis. Surg Endosc. 2006;20:410–3.CrossRefGoogle Scholar
  37. 37.
    Hope WW, Lincourt AE, Newcomb WL, Schmelzer TM, Kercher KW, Heniford BT. Comparing quality-of-life outcomes in symptomatic patients undergoing laparoscopic or open ventral hernia repair. J Laparoendosc Adv Surg Tech A. 2008;18:567–71.CrossRefGoogle Scholar

Copyright information

© Springer Nature India Private Limited 2020

Authors and Affiliations

  1. 1.Minimally Invasive Surgical Centre, KTP Advanced Surgical Training CentreYong Loo Lin School of Medicine, National University Health System, National University of SingaporeSingaporeSingapore
  2. 2.Department of SurgeryMinimally Invasive Surgical Centre, National University Health System and Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore

Personalised recommendations