Short-term results of ten hernia defect closure cases during laparoscopic ventral hernia repair

Kanyu Nakano, MD¹, Hitoshi Idani², Shinya Asami¹, Hiro Okawa¹, Masashi Yoshimoto¹, Atene Ito¹, Kazuteru Monden¹, Yohei Kurose¹, Masayoshi Hioki¹, Tatsuhiro Ishii¹, Hiroshi Sadamori¹, Satoshi Ono¹, Norihisa Takakura¹. ¹Fukuyama City Hospital, ²Hiroshima City Hospital

[Background]

We underwent laparoscopic ventral hernia repair for 95 patients in our hospital from April 2002 to September 2015. 27 men and 68 women, average age 71.2 years old. We conduct transfascial suture with non-absorbable thread and tacking fixation under 3 ports. Occult hernia was found in 23 of 95 patients (24.2%). Conversion to an open repair was required in five cases because of massive adhesion into the hernia sac or large hernia. The mean operation time was 123 minutes. The complications were three seromas which needed treatment, bleeding four, two intestinal injury, two ileus, one mesh infection, one severe asthma attack and upper gastrointestinal bleeding, one port-site recurrence, and one liver damage. During a median follow up period of 57 months, recurrence was noted on three patients (3.4%).

[Method]

We conduct the hernia defect closure for 10 patients for the prevention of a seroma, mesh infection, a recurrence and bulging, for hernia orifice transverse diameter 8cm or less from October, 2013.

 [Results]

The patients consisted of 4 men and 6 women with a mean age of 73.0 (46-93) years old. The mean operation time was 144 minutes. We used Parietex Composite mesh for seven cases and Symbotex for two cases. We conducted only a hernia defect closure and did not use mesh for one patient.

There was one case that fixation of the mesh was not possible enough because working space became small after a hernia defect closure. We experienced another case that oral intake did not advance to by the pain of the defect closure site postoperatively. Other than them, the complications with the hernia defect closure were absent. The observation period is short; up to 23 months, but the recurrence does not show it currently.

 [Conclusion]

There is not the major problem about the short-term prognosis about the hernia defect closure, but it is necessary to observe course about the long-term prognosis carefully.