O52 LAP-T MINI LAPAROSCOPIC TECHNIQUE FOR THE REPAIR OF RECURRENT UMBILICAL HERNIA ON PRIMARILY UNTREATED DIASTASIS

Abstract

Abstract Aim “This retrospective analysis on 1000 cases of Diatasis Recti (DR) complicated by single/multiple, primary/recurrent hernias, all treated with the Laparoscopic Abdominoplasty Technique (LAP-T), aims at evaluating the possible correlation of higher recurrence rate and complications when DR is left untreated” Material and Methods “This review on 1000 patients, <65yrs, BMI<30, 3>IRD>12, based on CT Scan/MRI study, showed 235 (23,5%) of them to be recurrent umbilical/midline hernias engaged on untreated RMD, independently from the surgical technique used for primary repair. Re-operation with LAP-T technique, consisted in removal of recurrent hernia and dislocated mesh when present, closure by self-locking running sutures of the hernia defect and the DR. Repair is consolidated placing an intra-peritoneal mesh” Results “In all patients, recurrence was repaired, DR reconstructed and abdominal wall anatomy and physiological functionality successfully restored. No intra operative bleeding, seroma formation, chronic pain, nor mesh infection have been recorded. 98% follow up at 12 months, 91% at 24, no recurrences observed” Conclusions “Higher incidence of recurrent umbilical/midline hernias observed in this analysis, compared to average recurrence rate reported in literature, suggest that regardless primary repair technique, the repair of the sole hernia engaged on a DR is likely to lead to a recurrent hernia, further midline hernia defects formation and worsening of the DR. A significant correlation between the recurrency after primary umbilical/midline repair when a concomitant RMD is left untreated is likely to lead to a more invasive and complicated re-intervention, higher complication rate and discomfort for the patient”