Laparoscopic Component Separation with Bio-prosthetic Reinforcement: A Single Surgeon’s Experience

Ibrahim Daoud, MD, Brian Pellini, MD, Randall Kimball, MD

St. Francis Hospital, Hartford, CT

Introduction: Laparoscopic component separation has the advantages of preserving the abdominal wall vasculature and does not require the formation of skin flaps. These advantages have the potential to reduce post-operative complications. This study reports a single surgeon’s experience with laparoscopic component separation with bioprosthetic reinforcement.

Method: We present a series of 33 laparoscopic component separations with bioprosthetic mesh over a two year period from February 2010 to July 2012. Data collected included demographics, operative time, length of stay and complications

Results: Thirty three patients were included with a median age of 63 (36-83). 90% had preexisting comorbidities (40% ASA 2, 55% ASA 3). 60% had at least one prior ventral hernia repair. The median defect width was 11cm (6-19), and median operating time was 225 minutes (150-325). 80% were bilateral component separations: 91% were completely laparoscopic, 6% were combined, and 4% (n=1) were converted. All mesh was biologic (human acellular or non-crosslinked porcine). The median length of stay was 6 days, with return of bowel function in 5 days. 8 (24%) patients experienced complications , with 1 (3%) infected seroma and 2 (6%) reoperations for failure of the repair.

Conclusions: Our series correlates with with the literature in showing reduced wound complications and similar length of procedure with laparoscopic component separation. Bioprosthetic mesh can be safely used in the repair of ventral hernia using laparoscopic component separation. Long term follow up is necessary to assess the durability of bioprosthetic mesh in these patients. This is one of the largest single surgeon experiences with laparoscopic component separation reported, and one of the first reporting on the routine use of bioprosthetic mesh.

Session: Podium Presentation

Program Number: S025

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