The critical technical aspects of laparoscopic repair of ventral and incisional hernias.

Several authors have revealed the utility of the laparoscopic approach to hernia defects that involve the ventral surface of the abdominal wall. The results of these series have been favorable. These authors all have recognized that appropriate sizing and fixation are important components of this operation. The pitfalls of the laparoscopic repair of incisional hernias are few but are significant. The most important technical considerations are dissection of all adhesions and clear identification of the fascial defect, prosthesis overlap of 3 cm in all directions, and fixation by through and through sutures and spiral tacks. The attention to these factors will diminish the risk of the immediate and long-term complications of the repair of these fascial defects.