Abstract
Laparoscopic incisional and ventral hernia repair (LIVHR) has been advocated for short hospital stay, rapid ambulation, and low recurrence rates and has gained increasing popularity. We report here the outcomes of long-term follow-up of LIVHR. The series comprised 100 LIVHR procedures performed between June 2000 and February 2004. LIVHR was performed with the standard three-trocar configuration. Underlay expanded polytetrafluoroethylene mesh was placed in a tension-free manner and bridged the fascia defect with an adequate overlap of at least 4 cm. Enrolled patients were prospectively followed up at return visits. Two conversions due to densely scarred abdomen were inevitable. There were four true recurrences (4%) and three eventrations (loss of prosthetic elasticity) (3%). There was no difference in recurrence rate and eventrations among ventral, incisional, and recurrent incisional hernias. Patients with recurrent incisional hernias reported more seroma formations, and seroma formation was independently associated with adhesiolysis (adjusted odds ratio=4.57). Long-term follow-up of LIVHR was satisfactory both in complications and in recurrences. The efficacy of LIVHR was ascertained and reproducible for Taiwanese patients. The concerns with chronic pain necessitate preoperative counseling with patients indicated or planned for LIVHR.
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