Management of Mesh and Sutures during Laparoscopic Ventral Hernia Repair: A Lesson Learned from an Experimental Model

Abstract

Conventional surgery repair of incisional hernias requires wide dissection and mesh placement, often with drains (1, 2). It also often involves a lengthy postoperative stay and a delay of several weeks in the return to normal activities. Laparoscopic hernia repair has been used successfully to repair inguinal hernias as well as some ventral hernias, either primary or incisional hernias (3, 4). The laparoscopic approach for ventral hernias is performed by placing a mesh intraperitoneally, covering the defect of the abdominal wall. One of the main concerns of surgeons performing this technique by the laparoscopic approach is the production of adhesions and fistulas by placing the mesh in contact with the bowel, but it is difficult to determine if the adherences are produce to the mesh itself, to the sutures used to fix the mesh to the abdominal wall, to the edges of the mesh, or if they are due to the inflammatory response of the anterior abdominal wall after realising the intrabdominal adherences to the sac of the hernia or to previous scar.