engleski

Laparoscopic treatment of ventral hernia

INTRODUCTION: Ventral hernia occurs often after abdominal surgery, with incidence of 3 to 13%. After surgical treatment of ventral hernia, recurrence occurs in 15 to 50% cases. Introduction of mesh repairs of ventral hernia in daily surgical routinehas decreased incidence of hernia relapse. Our aim ist to present our results of laparoscopic mesh treatment of ventral hernia. MATHERIAL AND METHODS: In our institution, in the 2004-2009 period, we operated 450 patients with ventral hernia. 264 of these patients had postoperative incisional ventral hernia, 144 had umbilical or epigastric hernia and 42 had parastomal hernia. 58 patients were operated laparoscopicaly by „double crown“ (Carbajo) technique. In laparoscopicaly operated patients, mesh of two types were used: Dual mesh and Surgisis gold. 58 laparoscopicaly operated patients were in average 56.3 years old, 46 had postoperative hernia, 8 had umbilical hernia, 3 diastasis of musculi recti abdominis and 1 had parastomal hernia. The average size of abdominal wall defect was 8.3 cm. RESULTS: The average duration of surgery was 92 minutes. Postoperative hospital stay was in average 4.2 days. In 2/58 cases we had to convert the laparoscopic procedure to an open one. We had two bowel (one small bowel and one large bowel) lesions in our series. 5/58 (8.6%) patients had hernia recurrence. As a late unfavorable result, we count persisting pain and abdominal wall weakness in one patient. We had no mortality in our series of patients. CONCLUSION: Laparoscopic approach is feasible and acceptable and it shows advantages compared to classic open treatment of ventral hernia because of its minimal invasive nature. Total hospital expenses of laparoscopic treatment are becoming more acceptable. Experienced laparoscopic surgical team can be rapidly trained for application of this method. In our hospital laparoscopic method of ventral hernia repair is becoming every day routine.

ventral hernia

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