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01-10-2013 | Review

Closure versus non-closure of hernia defect during laparoscopic ventral hernia repair with mesh

Authors: M. S. Zeichen, H. J. Lujan, W. N. Mata, V. H. Maciel, D. Lee, I. Jorge, G. Plasencia, E. Gomez, A. M. Hernandez

Published in: Hernia | Issue 5/2013

Abstract

Purpose

Laparoscopic ventral hernia repair with mesh versus laparoscopic ventral hernia defect closure with mesh reinforcement. The primary end-point was recurrence.

Methods

Retrospective review of patients who underwent laparoscopic ventral hernia repair for small- and medium-sized hernias between July 2000 and September 2011. These patients were divided: (1) repair with mesh alone (non-closure group) and (2) those with hernia defect closure and mesh reinforcement (closure group). The closure group was further divided by technique: percutaneous versus intracorporeal closure of the defect.

Results

128 patients were studied: 93 patients (72.66 %) in the non-closure group and 35 patients (27.34 %) in the closure group. Follow-up was available in 105 patients (82.03 %) at a mean of 797.2 days (range 7–3,286 days). In the non-closure group there were 14 patients (15.05 %) with postoperative complications and 8 patients (22.86 %) in the closure group, four of which were seromas. Fourteen patients (19.18 %) developed recurrent hernias in the non-closure group with an average time to presentation of 23.17 months (range 5.3–75.3). Two patients (6.25 %) developed recurrent hernias in the percutaneous group with an average time to presentation of 12.95 months (range 9.57–16.33). There have been no recurrences in patients whose defect was closed intracorporeally.

Conclusion

Although our study demonstrated a difference in recurrence rates of 19.18 % in the non-closure group versus 6.25 % in the closure group, the difference did not reach statistical significance. A larger series with longer follow-up may demonstrate clinical significance.

National Center for Health Statistics (1998) Vital and health statistics of the Centers for Disease Control and Prevention. Adv Data 300:7

Millenium Research Group (2009) US markets for soft tissue repair. Millennium Research Group, Inc., Toronto

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

Flum DR, Horvath K, Koepsell T (2003) Have outcomes of incisional hernia repair improved with time? A population-based analysis. Ann Surg 237:129–135PubMedCrossRef

Girotto JA, Chiaramonte M, Menon NG et al (2003) Recalcitrant abdominal wall hernias: long term results of autologous tissue repair. Plast Reconstr Surg 112:106–114PubMedCrossRef

Anthony T, Bergen PC, Kim LT (2000) Factors affecting recurrence following incisonal herniorrhaphy. World J Surg 24:95–101PubMedCrossRef

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

Pierce RA, Spitler JA, Frisella MM et al (2007) Pooled data analysis of laparoscopic versus open ventral hernia repair: 14 years of patient data accrual. Surg Endosc 21:378–386PubMedCrossRef

Heniford BT, Park A, Ramshaw BJ et al (2003) Laparoscopic repair of ventral hernias: nine years’ experience with 850 consecutive hernias. Ann Surg 238:391–399 (discussion 399–400)PubMed

10.

DeMaria EJ, Moss JM, Sugerman HJ (2000) Laparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prosthetic patch repair of ventral hernia: prospective comparison to open prefascial polypropylene mesh repair. Surg Endosc 14:326–329PubMedCrossRef

11.

Olmi S, Scaini GC, Erba L, Croce E (2007) Laparoscopic versus open incisional hernia repair. Surg Endosc 21:555–559PubMedCrossRef

12.

LeBlanc KA (2005) Incisional hernia repair: laparoscopic techniques. World J Surg 29:1073–1079PubMedCrossRef

13.

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. doi:10.1002/14651858.CD007781.pub2

14.

De Vries Reilingh TS, van Geldere D, Langernhorst B et al (2004) Repair of large midline incisional hernias with polypropylene mesh: comparison of three operative techniques. Hernia 8:56–59PubMedCrossRef

15.

Luijendijk RW, Hop WC, van den Tol MP et al (2000) A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343:392–398PubMedCrossRef

16.

Burger JW, Luijendijk RW, Hop WC et al (2004) Long term follow up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:578–583PubMed

17.

DenHartog D, Dur AH, Tuinebreijer WE, et al (2008) Open surgical procedures for incisional hernias. Cochrane Database Syst Rev (3):CD006438

18.

Franklin M, Dorman J, Glass J, Balli J, Gonzalez J (1998) Laparoscopic ventral hernia repair. Surg Laparosc Endosc 8(4):294–299PubMedCrossRef

19.

Franklin ME, Gonzalez JJ, Glass JL, Manjarrez A (2004) Laparoscopic ventral and incisional hernia repair: 11-year experience. Hernia 8:23–27PubMedCrossRef

20.

Chowbey P, Sharma A, Khullar R, Soni V, Baijal M (2003) Laparoscopic ventral hernia repair with extraperitoneal mesh. Surg Laparosc Endosc Percutan Tech 13(2):101–105PubMedCrossRef

21.

Palanivelu C, Jani KV, Senthilnathan P et al (2007) Laparoscopic sutured closure with mesh reinforcement of incisional hernias. Hernia 11:223–228PubMedCrossRef

22.

Palanivelu C, Rangarajan M, Parthasarathi R et al (2008) Laparoscopic repair of suprapubic incisional hernias: suturing and intraperitoneal composite mesh onlay. A retrospective study. Hernia 12(3):251–256PubMedCrossRef

23.

Sharma D, Jindal V, Pathania OP, Thomas S (2010) Novel technique for closure of defect in laparoscopic ventral hernia repair. J Min Access Surg 6(3):86–88CrossRef

24.

Jorge I, Maciel VH, Lujan H (2011) New technique for fascial defect approximation during laparoscopic ventral hernia repair with mesh. Abstract-Emerging Technology Session SAGES Annual Meeting

25.

Agarwal BB, Agarwal S, Mahajan KC (2008) Laparoscopic ventral hernia repair: innovative anatomical closure, mesh insertion without 10 mm transmyofascial port, and atraumatic mesh fixation: a preliminary experience of a new technique. Surg Endosc 23(4):900–905PubMedCrossRef

26.

Clapp ML, Hicks SC, Awad SS, Liang MK (2012) Trans-cutaneous closure of central defects (TCCD) in laparoscopic ventral hernia repairs (LVHR). World J Surg 37(1):42–51

27.

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 21:391–395PubMedCrossRef

28.

Schoenmaeckers E, Wassenaar EB, Raymakers JT, Rakic S (2010) Bulging of the mesh after laparoscopic repair of ventral and incisional hernias. J Society Laparoendosc Surg 14(4):541–546CrossRef

29.

Tse GH, Stutchfield BM, Duckworth AD, de Beaux AC, Tulloh B (2010) Pseudo-recurrence following laparoscopic ventral and incisional hernia repair. Hernia 14(6):583–587PubMedCrossRef

30.

Jagad RB (2008) Laparoscopic ventral hernia repair: a new method for fixation of the mesh with sutures. Surg Laparosc Endosc Percutan Tech 18(3):277–279PubMedCrossRef

31.

Sajid MS, Parampalli U, McFall MR (2012) A meta-analysis comparing tacker mesh fixation with suture mesh fixation in laparoscopic incisional and ventral hernia repair. Hernia 17(2):159–166

Title: Closure versus non-closure of hernia defect during laparoscopic ventral hernia repair with mesh
Authors: M. S. Zeichen
H. J. Lujan
W. N. Mata
V. H. Maciel
D. Lee
I. Jorge
G. Plasencia
E. Gomez
A. M. Hernandez
Publication date: 01-10-2013
Publisher: Springer Paris
Published in: Hernia / Issue 5/2013
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-013-1115-6

At a glance: The STEP trials

Springer Medicine

Closure versus non-closure of hernia defect during laparoscopic ventral hernia repair with mesh

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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