Compared to the open technique, laparoscopic ventral hernia repair (LVHR) has lower rates of complications, recurrence, greater patient acceptance, and shorter hospital stay. Although the choice of mesh material is still evolving, concern about the formation of intraperitoneal adhesions to the viscera has limited the use of polypropylene (PP) for laparoscopic ventral hernia repair. The objective of this study is to investigate the safety and efficacy of PP during LVHR.
METHODS AND PROCEDURES:
Between 2002 and 2006, we performed LVHR in 141 consecutive patients (84 male, 57 Female) using intraperitoneal PP. Three trocars were used and the PP mesh was fixed to the abdominal wall with two rows of titanium staples overlapping the hernia defect by 3-5 cm. Data concerning the age and sex of patients, operative time, length of hospital stay, short and long term complications were collected.
Of the 141 patients 134 pts (95%) were discharged on the day of surgery. Mean age was 58.7 years (range, 29-91 years), Mean operative time was 63 minutes (range, 34-124 minutes), and the mean follow-up period was 40 months (range, 12-68 months). The postoperative complications included: Wound infection n=4(2.8%), transient partial small bowel obstruction which resolved in all cases without operative management n=4(2.8%), port site hernia n=3(2.1%), and seroma n=1(0.7%). Overall recurrence rate was n=6(4.2%). There were no conversions to an open procedure.
These outcomes are comparable with the largest LVHR studies reported and demonstrate that the use of intraperitoneal PP is safe and effective with no increase in morbidity.
Program Number: P347