Joshua De Marchi1, Florin Remus Sferle2, Dermot Hehir2. 1. Department of Surgery, Midlands Regional Hospital, Tullamore, Republic of Ireland. Joshdemarchi@rcsi.ie. 2. Department of Surgery, Midlands Regional Hospital, Tullamore, Republic of Ireland.
Abstract
BACKGROUND: Symptomatic ventral herniation is a common clinical presentation. The treatment, whether elective or as an emergency, can be difficult and a variety of surgical repairs are utilised. Intraperitoneal onlay mesh (IPOM) involves the placement of a reinforcing prosthesis, usually supported by primary closure of the defect. Intra-abdominal adhesions have been highlighted as a potential complication in utilising this form of mesh placement. Several methods of laparoscopic mesh placement outside of the peritoneal cavity are gaining prominence as potential alternatives to IPOM. AIMS: This study reviews our experience with IPOM in the repair of ventral hernia by a single surgical team. METHODS: A prospectively maintained electronic database of all laparoscopic ventral hernia repair (LVHR) performed within the study period was analysed and reported. Follow-up questionnaires were sent to patients to follow long-term outcomes. RESULTS: One hundred eight patients underwent LVHR over a 7-year period. Demographics demonstrated an obese patient group (BMI 30.89 ± 4.9 kg/m2), with a variety of hernia sizes and morphologies. Hernia recurrence was found in two patients (1.8%). Twenty-nine (26.8%) patients suffered a complication, but only eight (7.4%) of those required intervention beyond pharmacotherapy. Two patients required mesh explantation. CONCLUSIONS: IPOM for the general surgeon is a relatively safe and effective method of repairing ventral hernias, with a low recurrence rate.
BACKGROUND: Symptomatic ventral herniation is a common clinical presentation. The treatment, whether elective or as an emergency, can be difficult and a variety of surgical repairs are utilised. Intraperitoneal onlay mesh (IPOM) involves the placement of a reinforcing prosthesis, usually supported by primary closure of the defect. Intra-abdominal adhesions have been highlighted as a potential complication in utilising this form of mesh placement. Several methods of laparoscopic mesh placement outside of the peritoneal cavity are gaining prominence as potential alternatives to IPOM. AIMS: This study reviews our experience with IPOM in the repair of ventral hernia by a single surgical team. METHODS: A prospectively maintained electronic database of all laparoscopic ventral hernia repair (LVHR) performed within the study period was analysed and reported. Follow-up questionnaires were sent to patients to follow long-term outcomes. RESULTS: One hundred eight patients underwent LVHR over a 7-year period. Demographics demonstrated an obesepatient group (BMI 30.89 ± 4.9 kg/m2), with a variety of hernia sizes and morphologies. Hernia recurrence was found in two patients (1.8%). Twenty-nine (26.8%) patients suffered a complication, but only eight (7.4%) of those required intervention beyond pharmacotherapy. Two patients required mesh explantation. CONCLUSIONS:IPOM for the general surgeon is a relatively safe and effective method of repairing ventral hernias, with a low recurrence rate.
Authors: Peder Rogmark; Ulf Petersson; Sven Bringman; Arne Eklund; Emmanuel Ezra; Dan Sevonius; Sam Smedberg; Johanna Osterberg; Agneta Montgomery Journal: Ann Surg Date: 2013-07 Impact factor: 12.969
Authors: R Bittner; J Bingener-Casey; U Dietz; M Fabian; G S Ferzli; R H Fortelny; F Köckerling; J Kukleta; K Leblanc; D Lomanto; M C Misra; V K Bansal; S Morales-Conde; B Ramshaw; W Reinpold; S Rim; M Rohr; R Schrittwieser; Th Simon; M Smietanski; B Stechemesser; M Timoney; P Chowbey Journal: Surg Endosc Date: 2013-10-11 Impact factor: 4.584
Authors: Andreas Domen; Cedric Stabel; Rami Jawad; Nicolas Duchateau; Erik Fransen; Patrick Vanclooster; Charles de Gheldere Journal: Langenbecks Arch Surg Date: 2020-05-31 Impact factor: 3.445