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Laparoscopic sutured closure with mesh reinforcement of incisional hernias.

BACKGROUND: This study reports medium-term outcomes of laparoscopic incisional hernia repair.

STUDY DESIGN: Laparoscopic repair was performed on 721 patients with ventral hernia. After adhesiolysis the defect was closed with no. 1 polyamide suture or loop. This was followed by reinforcement with intraperitoneal onlay repair with a bilayered mesh.

RESULTS: Laproscopic repair of ventral hernia was performed on 613 females and 108 males. Of these, 185 (25.7%) were recurrent incisional hernias of which 93 had undergone previous open hernioplasty. The remaining 92 patients had previously undergone sutured repair. The average operating time was 95 min (range 60-115 min). Conversion rate was 1%. The average hospital stay was 2 days (range 1-6 days). The commonest complication was seroma formation at the incisional hernia site. Full-thickness bowel injury occurred in two patients. The mean follow-up period was 4.2 years (range 3 months to 10 years). Recurrence was noted in four (0.55%) patients.

CONCLUSION: Laparoscopic repair is well-tolerated and can be accomplished with minimum morbidity in ventral hernias.

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