Early Experience with Laparoscopic Incisional Hernia Repair

Abstract

Conventional incisional hernia repair, even with a piece of mesh incorporated, has high recurrence and morbidity. Laparoscopic incisional hernia repair was reported in western countries to be a better alternative. The purpose of this study is to report the early experiences of laparoscopic incisional hernia repair among Taiwanese patients. Thirty-seven patients with incisional hernia, twelve were recurrent, received laparoscopic underlay Dualmesh(superscript R) (ePTFE) repair at Cathay General Hospital in past two years with one conversion. The mean area of defect was 50.2 cm^2. Multiple defects were found in 13(35%) patients. Peri-operative complications included dysuria (2), seroma (2), ileus (1), trocar site bleeding (1) and wound infection (1). Post-operative hospitalizations ranged from 3 to 8 (mean; 4.3) days. Post-operative patients' questionnaire revealed less pain experienced during laparoscopic repair by those who had previous open repair. There were no recurrences during a 3 to 21 (mean; 9.1) months follow-up. Based on our initial results, laparoscopic incisional hernia repair is safe and feasible among Taiwanese. Comparing to the open repair, laparoscopic incisional hernia repair has less perioperative complications, debility, and short-term recurrence rate. Long-term recurrence is expected to be lower than conventional repair due to less surgical trauma and the tension-free nature of laparoscopic repair.