Gideon Sroka, MD, Husam Mady, MD, Ibrahim Matter, MD. Bnai-Zion Medical Center
Introduction: since the introduction of the laparoscopic approach to ventral hernia repair its advantages have been clear but it comes with limitations as well. The purpose of this study is to examine a hybrid approach that uses both open and laparoscopic techniques for ventral hernia repair, and to define the type of defect for which this approach would be most beneficial.
Methods: a case series of all patients who went through a hybrid ventral hernia repair in our department from 01/2015 to 6/2017. Patient selection is related to defect and sac sizes and content. Operation starts in laparoscopic exploration and adhesiolysis, then a limited incision is performed over the defect in order to achieve a safe content reduction, complete sac excision, and defect closure. A return to the laparoscopic approach allows optimal mesh placement and fixation without a need for wide undermining (short video will be presented). Data is presented as as mean±SD.
Results: 18 patients (10:M, 8:F) went through the procedure. All of them had post operative ventral hernia (POVH). Defect size was 5.2±1.6 cm and sac diameter was 8.2±1.9 cm. Operating time was 71±13 min. LOS was 3.5±1.2 days. Two patients had seromas that were treated conservatively. There were no small bowel injeries. Patient satisfaction was high. In 11±9 months of follow up there was no recurrence.
Conclusion: for patients with small to medium size POVH with larger sacs with dense adhesions to their content, a hybrid approach allows achieving all goals of the operation safely, in a minimal invasive way and good functional outcome.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87950
Program Number: P029
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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