Top

Published in:

01-11-2017

Outcomes after laparoscopic ventral hernia repair: does the number of previous recurrences matter? A prospective study

Authors: Joaquín Picazo-Yeste, Carlos Moreno-Sanz, Cristina Sedano-Vizcaíno, Antonio Morandeira-Rivas, Francisco Sánchez-De Pedro

Published in: Surgical Endoscopy | Issue 11/2017

Abstract

Background

It is not yet clearly known whether laparoscopic ventral hernia repair (LVHR) is superior to the open approach in recurrent hernias. The aim of this study is to determine the safety and efficacy of laparoscopic technique for ventral hernias and investigate whether these outcomes are affected by the number of previous failed repairs.

Methods

Data from 124 consecutive patients who underwent LVHR using a standardized technique between September 2007 and June 2014 were collected prospectively. In all repairs, a composite prosthesis was tailored to overlap the defect by at least 5 cm and fixed with a double crown of spiral tacks. Clinical follow-up visits were performed at 1 week, 1, 6, and 12 months, and yearly thereafter. Patients were classified in 3 groups (0, 1, and ≥ 2) according to the number of previous hernia repairs for further statistical analysis.

Results

Long-term surveillance was available in 116 (93%) patients. Of these, 96 (82.8%) were recurrent hernias. There were 2 (1.7%) conversions, both in recurrent cases, and in 3 (2.6%) patients a hybrid access was used. Mean operating time was 55 min. There was an overall postoperative complication rate of 16%, with no mortality. During a mean follow-up of 30 (range 20–90) months, 3 (2.6%) recurrences were diagnosed 6, 8, and 9 months after surgery, respectively. A univariate analysis related to demographic, clinical, and perioperative variables did not find any significant relationship between the number of previous recurrences and operating time, conversion rate, hospital length of stay, overall morbidity, or recurrence.

Conclusions

This study suggests that laparoscopic approach in recurrent incisional hernias is a safe and feasible alternative to open techniques. Furthermore, our experience supports the idea that LVHR may be the best option for recurrent cases in properly selected patients, independently of the number of previous recurrences.

Mudge M, Hughes LE (1985) Incisional hernia: a 10-year prospective study of incidence and attitudes. Br J Surg 72:70–71CrossRefPubMed

Perrone JM, Soper NJ, Eagon C, Klingensmith ME, Aft RL, Frisella MM, Brunt LM (2005) Perioperative outcomes and complications of laparoscopic ventral hernia repair. Surgery 138:708–716CrossRefPubMed

LeBlanc KA, Booth WV (1993) Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endosc 3:39–41PubMed

DeMaría EJ, Moss JM, Sugerman HJ (2000) laparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prostethic patch repair of ventral hernia. Prospective comparison to open prefascial polypropylene mesh repair. Surg Endosc 14:326–329CrossRefPubMed

Carbajo MA, Martin del Olmo JC, Blanco JI, De la Cuesta C, Toledano M, Martin F, Vaquero C, Inglada L (1999) Laparoscopic treatment vs open surgery in the solution of major incisional and abdominal wall hernias with mesh. Surg Endosc 13:250–252CrossRefPubMed

Holzman MD, Purut CM, Reintgen K, Eubanks S, Pappas TN (1997) Laparoscopic ventral and incisional hernioplasty. Surg Endosc 11:32–35CrossRefPubMed

Ramshaw BJ, Esartia P, Schwab J, Mason EM, Wilson RA, Duncan TD, Miller J, Lucas GW, Promes J (1999) Comparison of laparoscopic and open ventral herniorrhaphy. Am Surg 65:827–831PubMed

Goodney PP, Birkmeyer CM, Birkmeyer JD (2002) Short-term outcomes of laparoscopic and open ventral hernia repair. Arch Surg 137:1161–1165CrossRefPubMed

Moreau PE, Helmy N, Vons C (2012) Laparoscopic treatment of incisional hernia. State of art in 2012. J Visc Surg 149:40–48CrossRef

10.

Heniford BT, Park A, Ramshaw BJ, Voeller G (2003) Laparoscopic repair of ventral hernias. Nine years´experience with 850 consecutive cases. Ann Surg 238:391–400PubMedPubMedCentral

11.

Moreno-Egea A, Carrillo-Alcazar A, Aguayo-Albasini JL (2012) Is the outcome of laparoscopic incisional hernia affected by defect size? A prospetive study. Am J Surg 203:87–94CrossRefPubMed

12.

Verbo A, Petito L, Manno A, Coco C, Mattana C, Lurati M, Pedretti G, Rizzo G, Sermoneta D, Lodoli C, Nunziata J, D´Ugo D (2007) Laparoscopic approach to recurrent incisional hernia repair: a 3-year experience. J Laparoendosc Adv Surg Tech A 17:591–595CrossRefPubMed

13.

Uranues S, Salehi B, Bergamaschi R (2008) Adverse events, quality of life, and recurrence rates after laparoscopic adhesiolysis and recurrent incisional hernia mesh repair in patients with previous failed repairs. J Am Coll Surg 207:663–669CrossRefPubMed

14.

Sturt NJ, Liao CC, Engledow AH, Menzies D, Motson RW (2011) Results of laparoscopic repair of primary and recurrent incisional hernias at a single UK institution. Surg Laparosc Endosc Percutan Tech 21:86–89CrossRefPubMed

15.

Hwang CS, Witchterman KA, Alfrey EJ (2009) Laparoscopic ventral hernia repair is safer tan the open repair: analysis of the NSQIP data. J Surg Res 156:213–216CrossRefPubMed

16.

Burger J, Luijendijk R, Hop W, Halm J, Verdaasdonk E, Jeekel J (2004) Long-term follow up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:578–583PubMedPubMedCentral

17.

Jenkins ED, Yom VH, Melman L, Pierce RA, Schuessler RB, Frisella MM, Christopher Eagon J, Michael Brunt L, Matthews BD (2010) Clinical predictors of operative complexity in laparoscopic ventral hernia repair: a prospective study. Surg Endosc 24:1872–1877CrossRefPubMed

18.

Rosen M, Brody F, Ponsky J, Walsh RM, Rosenblatt S, Duperier F, Fanning A, Siperstein A (2003) Recurrence after laparoscopic ventral hernia repair. Surg Endosc 17:123–128CrossRefPubMed

19.

Bencini L, Sanchez LJ, Boffi B, Farsi M, Scatizzi M, Moretti R (2003) Incisional hernia repair. Retrospective comparison of laparoscopic and open techniques. Surg Endosc 17:1546–1551CrossRefPubMed

20.

Itani K, Hur K, Kim L, Anthony T, Berger D, Reda D, Neumayer L (2010) Comparison of laparoscopic and open repair with mesh for the treatment of ventral incisional hernia: a randomized trial. Arch Surg 145:322–328CrossRefPubMed

21.

Hesselink VJ, Luijendijk RW, de Wilt JH, Heide R, Jeekel J (1993) An evaluation of risk factors in incisional hernia recurrence. Surg Gynecol Obstet 176:228–234PubMed

22.

Forbes SS, Eskicioglu C, McLeod RS, Okrainec A (2009) Meta-analysis of randomized controlled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh. Br J Surg 96:851–858CrossRefPubMed

23.

Sajid MS, Bokhari SA, Mallick AS, Cheek E, Baig MK (2009) Laparoscopic versus open repair of incisional/ventral hernia: a meta-analysis. Am J Surg 197:64–72CrossRefPubMed

24.

Kapischke M, Schulz T, Schipper T, Tensfeldt J, Caliebe A (2008) Open versus laparoscopic incisional hernia repair: something different from a meta-analysis. Surg Endosc 22:2251–2260CrossRefPubMed

25.

Sauerland S, Walgenbach M, Habermalz B, Seiler CM, Miserez M (2011) Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst Rev (3):CD007781

26.

Carlson MA, Frantzides CT, Shostrom VK, Laguna LE (2008) Minimally invasive ventral herniorrhaphy: an analysis of 6266 published cases. Hernia 12:9–22CrossRefPubMed

27.

Constanza MJ, Heniford BT, Arca MJ, Mayes JT, Gagner M (1998) Laparoscopic repair of recurrent ventral hernias. Am Surg 64:1121–1125. Discussion:1126–1127

28.

Varghese TK, Denham DW, Dawes LG, Murayama KM, Prystowsky JB, Joehl RJ (2002) Laparoscospic ventral hernia repair: an institutional experience. J Surg Res 105:115–118CrossRefPubMed

29.

McKinlay RD, Park A (2004) Laparoscopic ventral incisional hernia repair: a more effective alternative to conventional repair of recurrent incisional hernia. J Gastrointest Surg 8:670–674CrossRefPubMed

30.

Wassenaar EB, Schoenmaeckers EJ, Raymakers JT, Rakic S (2009) Recurrences after laparoscopic repair of ventral and incisional hernias: lessons learned from 505 repairs. Surg Endosc 23:825–832CrossRefPubMed

31.

Sharma A, Mehrotra M, Khullar R, Soni V, Baijal M, Chowbey PK (2011) Laparoscopic ventral/incisional hernia repair: a single centre experience of 1242 patients over a period of 13 years. Hernia 15:131–139CrossRefPubMed

32.

Earle D, Roth S, Saber A, Haggerty S, Bradley JF III, Fanelli R, Price R, Richardson WS, Stefanidis D, SAGES Guidelines Committee (2016) SAGES guidelines for laparoscopic ventral hernia repair. Surg Endosc 30:3163–3183CrossRefPubMed

33.

Treviño JM, Franklin ME Jr, Berghoff KR, Glass JL, Jaramillo EJ (2006) Preliminary results of a two-layered prosthetic repair for recurrent inguinal and ventral hernias combining open and laparoscopic techniques. Hernia 10:253–257CrossRefPubMed

34.

Griniatsos J, Eugenia Y, Anastasios T, Christos T, Theodoros D (2009) A hybrid technique for recurrent incisional hernia repair. Surg Laparosc Endosc Percutan Tech 19:177–180CrossRef

35.

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

36.

Rogmark P, Petersson U, Bringman S, Eklund A, Ezra E, Sevonius D, Smedberg S, Osterberg J, Montgomery A (2013) Short-term outcomes for open and laparoscopic midline incisional hernia repair: a randomized multicenter controlled trial: the ProLOVE (prospective randomized trial on open versus laparoscopic operation of ventral eventrations) trial. Ann Surg 258:37–45CrossRefPubMed

37.

Eker HH, Hansson BM, Buunen M, Janssen IM, Pierik RE, Hop WC, Bonjer HJ, Jeekel J, Lange JF (2013) Laparoscopic vs. open incisional hernia repair: a randomized clinical trial. JAMA Surg 148:259–263CrossRefPubMed

38.

Chelala E, Thoma M, Tatete B, Lemye AC, Dessily M, Alle JL (2007) The suturing concept for laparoscopic mesh fixation in ventral and incisional hernia repair: mid-term analysis of 400 cases. Surg Endosc 21:391–395CrossRefPubMed

39.

Picazo-Yeste J, Morandeira-Rivas A, Moreno-Sanz C (2013) Multilayer myofascial mesh repair for giant midline incisional hernias: a novel advantageous combination of old and new techniques. J Gastrointest Surg 17:1665–1672CrossRefPubMed

Title: Outcomes after laparoscopic ventral hernia repair: does the number of previous recurrences matter? A prospective study
Authors: Joaquín Picazo-Yeste
Carlos Moreno-Sanz
Cristina Sedano-Vizcaíno
Antonio Morandeira-Rivas
Francisco Sánchez-De Pedro
Publication date: 01-11-2017
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 11/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-017-5510-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Outcomes after laparoscopic ventral hernia repair: does the number of previous recurrences matter? A prospective study

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 11/2017

Primary fascial closure during laparoscopic ventral hernia repair does not reduce 30-day wound complications

Anorectal complications after robotic intersphincteric resection for low rectal cancer

Troubleshooting common endoscopic malfunctions: a study integrating a preoperative checklist and troubleshooting guide into surgical resident training

Is there a role for near-infrared technology in laparoscopic resection of pancreatic neuroendocrine tumors? Results of the COLPAN “colour-and-resect the pancreas” study

The use of expanding ports in laparo-endoscopic single-site surgery may cause more pain: a meta-analysis of randomized clinical trials

A plea for thoracoscopic resection of solitary pulmonary nodule in cancer patients