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Complications of Laparoscopic Incisional and Ventral Hernia Repair

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Management of Abdominal Hernias

Abstract

Ventral hernia repairs are among the most common operations performed by general surgeons throughout the world. In the United States, ∼105,000 ventral abdominal hernias are repaired each year. Incisional hernias, most commonly resulting from a laparotomy, occur after 3–20 % of operations [1–3]. Factors predisposing patients to the formation of an initial ventral hernia include obesity, advanced age, diabetes, steroid use, pulmonary disease, and infectious wound complications. Surgical approaches to ventral hernia repair have been a subject of much research and debate for many years. Existing evidence strongly supports performing tension-free hernia repairs using prosthetic devices in most patients and all hernia sizes [4]. Recurrence rates below 20 % are the norm with the currently popular Rives/Stoppa/Wantz method of the prosthetic repair of a ventral hernia. The key principles of this operation are the use of a large prosthesis as an underlay, wide fascial overlap, and tension-free repair [5, 6]. The Achilles heel of this approach is the possibility of mesh infection and the frequent wound complications, ranging from 12 to 20 % [2]. The minimally invasive approach takes advantage of the wide exposure and accessibility for prosthetic placement while eliminating the large incision, extensive subcutaneous dissection and tissue flaps, the need for drains, and ultimately lowering the incidence of wound complications [7]. Since the first reports of a laparoscopic ventral hernia repair more than 15 years ago, large series as well as randomized studies have been published.

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Authors and Affiliations

  1. AA Northwestern Memorial Hospital, Northwestern University, Chicago, USA

    V. B. Tsirline (Assistant Professor Department of Surgery)

  2. Surgical Specialist at Anne Arundel, Anne Arundel Medical Center Health Sciences Pavilion, Suite 600, Maryland, USA

    I. Belyansky MD

  3. Department of Surgery, Carolinas Laparoscopic and Advanced Surgery Program, Carolinas Medical Center, 1025 Morehead Medical Drive, Suite 300, Charlotte, NC, 28204, USA

    B. Todd Heniford MD

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  1. V. B. Tsirline
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  2. I. Belyansky MD
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Correspondence to B. Todd Heniford MD .

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Editors and Affiliations

  1. , Department of Surgery, Peninsula College of Medicine & Dentistr, N/A, Plymouth, PL4 8AA, Devon, United Kingdom

    Andrew N. Kingsnorth

  2. , Surgeons Group of Baton Rouge, Our Lady of the Lake Physician Group, N/A, Baton Rouge, 70808, Louisiana, USA

    Karl A. LeBlanc

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Tsirline, V.B., Belyansky, I., Heniford, B.T. (2013). Complications of Laparoscopic Incisional and Ventral Hernia Repair. In: Kingsnorth, A., LeBlanc, K. (eds) Management of Abdominal Hernias. Springer, London. https://doi.org/10.1007/978-1-84882-877-3_25

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