Laparoscopic ventral hernia repair: advances and limitations.

Laparoscopic ventral hernia repair, a topic of great debate today, has evolved to be a feasible and safe procedure. It has been shown to be as effective as open repair, with a lower recurrence rate. Despite the excellent results of the laparoscopic repair of ventral hernias, numerous controversies are associated with this procedure, such us how to create the pneumoperitoneum, how to perform adhesiolysis, how to manage the hernia sac, the evolution and complications related to postoperative seroma, the type and size of the mesh, and how to insert and fix the mesh. This paper addresses many of these issues and provides data about the advances and limitations associated with laparoscopic ventral hernia repair, together with the description of our results. Also analyzed are future aspects of laparoscopic ventral hernia repair related to prosthetic materials and methods of fixation, especially those regarding bioactive materials and biosurgery.