Top

Surgical Endoscopy

Published in:

01-06-2010

Laparoscopic incisional hernia repair is feasible and safe after liver transplantation

Authors: Anita Kurmann, Guido Beldi, Stephan A. Vorburger, Christian A. Seiler, Daniel Candinas

Published in: Surgical Endoscopy | Issue 6/2010

Abstract

Background

Incisional hernia is a common complication after liver transplantation. The current study evaluated incidence and risk factors for incisional hernia and compared laparoscopic and open hernia repair in terms of feasibility and outcome.

Methods

A cohort of 225 patients was prospectively investigated. The median follow-up period was 61 months (range, 6–186 months). The study cohort had 31 patients who underwent open repair and 13 who underwent laparoscopic repair.

Results

Incisional hernia, found in 57 patients (25%), had occurred after a median of 17 months (range, 5–138 months). The significant risk factors were male gender (p = 0.001) and body mass index (BMI) greater than 25 kg/m² (p = 0.002). A trend toward a lower recurrence rate (15% vs 35%; p = 0.28) and fewer surgical complications (15% vs 19%; p = 0.99) was found in the laparoscopic group.

Conclusions

Incisional hernia is a frequent complication after liver transplantation. Associated risk factors are male gender and a BMI greater than 25 kg/m². Laparoscopic hernia repair for such patients is feasible and safe.

Gomez R, Hidalgo M, Marques E, Marin L, Loinaz C, Gonzalez I, Garcia I, Moreno E (2001) Incidence and predisposing factors for incisional hernia in patients with liver transplantation. Hernia 5:172–176CrossRefPubMed

Janssen H, Lange R, Erhard J, Malago M, Eigler FW, Broelsch CE (2002) Causative factors, surgical treatment, and outcome of incisional hernia after liver transplantation. Br J Surg 89:1049–1054CrossRefPubMed

Kahn J, Muller H, Iberer F, Kniepeiss D, Duller D, Rehak P, Tscheliessnigg K (2007) Incisional hernia following liver transplantation: incidence and predisposing factors. Clin Transplant 21:423–426CrossRefPubMed

Piazzese E, Montalti R, Beltempo P, Bertelli R, Puviani L, Pacile V, Nardo B, Cavallari A (2004) Incidence, predisposing factors, and results of surgical treatment of incisional hernia after orthotopic liver transplantation. Transplant Proc 36:3097–3098CrossRefPubMed

Shi LW, Verran D, Rao AR, Stewart GJ, McCaughan GW (2003) Incisional hernia following orthotopic liver transplantation. Transplant Proc 35:425–426CrossRefPubMed

Vardanian AJ, Farmer DG, Ghobrial RM, Busuttil RW, Hiatt JR (2006) Incisional hernia after liver transplantation. J Am Coll Surg 203:421–425CrossRefPubMed

Beldi G, Ipaktchi R, Wagner M, Gloor B, Candinas D (2006) Laparoscopic ventral hernia repair is safe and cost effective. Surg Endosc 20:92–95CrossRefPubMed

Lomanto D, Iyer SG, Shabbir A, Cheah WK (2006) Laparoscopic versus open ventral hernia mesh repair: a prospective study. Surg Endosc 20:1030–1035CrossRefPubMed

McGreevy JM, Goodney PP, Birkmeyer CM, Finlayson SR, Laycock WS, Birkmeyer JD (2003) A prospective study comparing the complication rates between laparoscopic and open ventral hernia repairs. Surg Endosc 17:1778–1780CrossRefPubMed

10.

Olmi S, Scaini A, Cesana GC, Erba L, Croce E (2007) Laparoscopic versus open incisional hernia repair: an open randomized controlled study. Surg Endosc 21:555–559CrossRefPubMed

11.

Toso C, Meeberg GA, Bigam DL, Oberholzer J, Shapiro AM, Gutfreund K, Ma MM, Mason AL, Wong WW, Bain VG, Kneteman NM (2007) De novo sirolimus-based immunosuppression after liver transplantation for hepatocellular carcinoma: long-term outcomes and side effects. Transplantation 83:1162–1168CrossRefPubMed

12.

Langer C, Liersch T, Kley C, Flosman M, Suss M, Siemer A, Becker H (2003) Twenty-five years of experience in incisional hernia surgery: a comparative retrospective study of 432 incisional hernia repairs. Chirurg 74:638–645CrossRefPubMed

13.

Sorensen LT, Hemmingsen UB, Kirkeby LT, Kallehave F, Jorgensen LN (2005) Smoking is a risk factor for incisional hernia. Arch Surg 140:119–123CrossRefPubMed

14.

Harold K, Mekeel K, Spitler J, Frisella M, Merritt M, Tessier D, Matthews B (2009) Outcomes analysis of laparoscopic ventral hernia repair in transplant patients. Surg Endosc 23:1835–1838CrossRefPubMed

15.

Mekeel K, Mulligan D, Reddy KS, Moss A, Harold K (2007) Laparoscopic incisional hernia repair after liver transplantation. Liver Transpl 13:1576–1581CrossRefPubMed

16.

Barbaros U, Asoglu O, Seven R, Erbil Y, Dinccag A, Deveci U, Ozarmagan S, Mercan S (2007) The comparison of laparoscopic and open ventral hernia repairs: a prospective randomized study. Hernia 11:51–56CrossRefPubMed

Title: Laparoscopic incisional hernia repair is feasible and safe after liver transplantation
Authors: Anita Kurmann
Guido Beldi
Stephan A. Vorburger
Christian A. Seiler
Daniel Candinas
Publication date: 01-06-2010
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 6/2010
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-009-0799-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic incisional hernia repair is feasible and safe after liver transplantation

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 6/2010

Open versus laparoscopic versus robotic gastrectomy for cancer: need for comparative-effectiveness quality

Early gastric cancer management

Outweighing the benefits and weakness of endoscopic submucosal dissection for early gastric cancer in the west

The RAPID protocol enhances patient recovery after both laparoscopic and open colorectal resections

Transoral thyroid and parathyroid surgery

“Chopstick” surgery: a novel technique improves surgeon performance and eliminates arm collision in robotic single-incision laparoscopic surgery