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01-10-2019 | Seroma | Original Article

Laparoscopic management of recurrent ventral hernia: an experience of 222 patients

Authors: S. Dey, R. Parthasarathi, S. C. Sabnis, R. Jain, P. Praveen Raj, P. Senthilnathan, S. Rajapandian, C. Palanivelu

Published in: Hernia | Issue 5/2019

Abstract

Background

To evaluate the predisposing factors and characteristics of recurrent ventral hernia (RVH) along with the feasibility and outcome of laparoscopy in managing RVH.

Methods

This study is a retrospective analysis of all patients with reducible or irreducible, uncomplicated RVH who underwent surgical management from January 2012 to June 2018.

Results

Out of 222 patients, 186 (83.8%) were female, and 36 (16.2%) were male. The mean age was 54.1 ± 10.1 years; an average body mass index was 31 kg/m² (19–47.9). The most common previous abdominal operations among female patients were cesarean sections (43.5%) and abdominal hysterectomy (36.6%). Most of the patients had a history of open mesh repair (43.7%) and open anatomical repair (36.9%). The median time of recurrence was 4 years (1–33 years). The median defect size was 10 cm² (range 2–150 cm²), and 73% defects were in the midline. Total 181 of 222 (81.6%) patients underwent laparoscopic intraperitoneal onlay mesh plus (L-IPOM+), 19 (8.5%) laparoscopic-assisted IPOM+, 17(7.7%) laparoscopic anatomical repair, while remaining 5 (2.3%) patients required open mesh reconstruction. The median size of the composite mesh used was 300 cm² (150–600 cm²). The mean operating time was 145 (30–330) min, and median blood loss was 15 (5–110) ml. The median hospital stay was 3 days, and median follow-up period was 37 months. The post-operative symptomatic seroma rate was 3.1%, and re-recurrence rate was 1.4%.

Conclusion

Obesity, old age, female sex, previous lower abdominal surgeries, and previous open repair of a hernia are factors associated with recurrence. Laparoscopic repair is feasible with excellent outcome in most of the patients.

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Title: Laparoscopic management of recurrent ventral hernia: an experience of 222 patients
Authors: S. Dey
R. Parthasarathi
S. C. Sabnis
R. Jain
P. Praveen Raj
P. Senthilnathan
S. Rajapandian
C. Palanivelu
Publication date: 01-10-2019
Publisher: Springer Paris
Keywords: Seroma
Incisional Hernia
Published in: Hernia / Issue 5/2019
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-019-01912-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Laparoscopic management of recurrent ventral hernia: an experience of 222 patients

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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