Laparoscopic ventral and incisional hernia repair: A preliminary report

Ventral and incisional hernia repairs, which are among the most common abdominal operations, are associated with a high rate of hernia recurrence (50%) and an infection rate of about 10%. The use of tension-free repairs has reduced the recurrence rate but not the infection rate, especially in obese patients. We began to use a laparoscopic approach to ventral hernia repair because this method may reduce the postoperative hospital stay, lessen postoperative pain, and decrease rates of recurrence and infection. From December 1998 to April 1999, we repaired complicated umbilical and incisional hernias in 5 patients. Two patients had concomitant laparoscopic cholecystectomy. The hernias were 8 to 456 cm² in size (mean, 155 cm²). An expanded polytetrafluoroethelyne mesh was used in 3 cases, and a polypropylene mesh was used in 2. The operation time ranged from 3 to 8 days (mean, 5 days). One patient had postoperative herniation of a trocar site and seroma formation. During a follow-up period of 6 to 10 months, there were no infections and no recurrences.