Laparoscopic Tension-Free Repair of Anterior Abdominal Wall Incisional and Ventral Hernias with an Intraperitoneal Gore-Tex ® Mesh: Prospective Study and Review of the Literature

Abstract

Background

: Recurrence rates after repair of incisional and ventral hernias range from 18% to 52%. Prosthetic open repair has decreased this rate, but the wide fascial dissection it requires increases the complication rate. Laparoscopic repair is a safe and effective alternative.

Patients and Methods

: A prospective study was performed including 86 patients (63 women and 23 men) with a mean age of 54 years (range 29-79 years) having incisional or ventral hernias who underwent laparoscopic repair in our institution between July 1994 and October 2001. The majority of the patients were obese with a mean body mass index of 31.7 kg/m². The abdominal wall defect size ranged from 2 × 1 cm to 20 × 13 cm. In all cases, a Gore-Tex^® mesh (Dual Mesh, W.L. Gore & Associates, Flagstaff, AZ, USA) was used in sizes ranging from 10 × 15 cm to 20 × 30 cm.

Results

: Nineteen repairs were performed for recurrent hernias (12 incisional and 7 ventral). The mean operative time was 110.3 minutes (range 50-240 minutes). There was one open conversion (1.2%), one intraoperative complication (1.2%), and no deaths. There were no wound or mesh infections. Immediate postoperative complications occurred in 9 patients (10.6%) and late complications occurred in 16 patients (18.8%). The average hospital stay was 4.8 days (range 2-19 days). During a mean follow-up of 37 months (range 6-73 months), there were 6 hernia recurrences (7%).

Conclusion

: Laparoscopic repair of incisional hernia and ventral hernia appears to be safe, especially with the use of Gore-Tex mesh, and is proving to be effective as it decreases pain, complications, hospital stay, and recurrences.