Single Port Access (spa) Ventral Hernia Repair: Initial Report of 15 Cases

Laparoscopic ventral hernia repair has been demonstrated to be an acceptable and successful technique. Aside from similar, albeit decreased complications compared to open hernia repair, the laparoscopic technique adds the additional complication of port site hernia to its follow up criteria. We originally described a two port repair technique in 2002. Now, we have applied the recently developed Single Port Access Technique to Ventral Hernia Repair.

The charts of 15 patients undergoing primary and recurrent ventral hernias employing the Single Port Access technique were reviewed. The SPA technique was applied by making a 1.0 cm incision remote to the hernia location in the abdominal wall. After entry with a clear 5mm trocar into the abdomen was safely ensured, skin and soft tissue flaps were raised off the fascia laterally from the central trocar. One or two 5mm low profile trocars were inserted though the same skin incision. Adhesiolysis was then performed with one or two instruments per the severity of the adhesions. Once completed, the mesh (allowing a 3 to 5 cm overlap) was inserted through one of the trocar sites in the skin incision. If the fascial defect needed to be enlarged, then a 10mm trocar was placed to fill the enlarged defect and prevent gas leak. The mesh had a centrally placed suture for securing its position to the abdominal wall. This suture was grasped with a suture grasping device inserted through the center of the abdominal wall defect(s). The mesh was then tacked to the abdominal wall. The fascial defects were closed as well as the skin incision.

All procedures were completed via the Single Port Access technique. Operative time was comparable to prior two port ventral hernia repairs done by the same surgeon (PGC). EBL and LOS were similar. Mesh size placed ranged from 81 to 252 cm2. Several types of polypropylene based mesh were used. There have been no wound infections or port site hernias in follow-up of 2 – 17 months. There have been no recurrent hernias of the primary site.

We have successfully demonstrated the applicability of Single Port Access (SPA) surgery to ventral hernia repair. In our initial series, we performed this procedure on smaller hernias but have now begun applying it to larger repairs. The results have been comparable to standard multiport laparoscopic ventral hernia repairs.

Session: Podium Presentation

Program Number: S094

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