Pre-operative Considerations of Laparoscopic Ventral Hernia Repair

Abstract

Ventral abdominal hernias constitute a challenging problem for the practicing surgeon. Nearly 80% of ventral hernias in adults are incisional; other less common hernias include: umbilical, Spegalian and epigastric hernias (1, 5, 6). Controversy has existed regarding the best repair technique since long before the advent of the laparoscopic approach. Reports in the surgical literature estimate the recurrence rate of open primary ventral hernia repair to range from 25–52% (1–3). Performing open ventral hernia repair with mesh has reduced the recurrence rate to between 11–21% (1, 2, 4), but requires more extensive dissection and the raising of flaps. This more extensive dissection leads to increased wound infections and hematomas in open repair patients despite the routine use of drains with this approach.