Abstract:
Laparoscopic incisional and ventral hernia repair (LIVHR) was frst reported by Le Blanc and Booth in 1993. Many studies are available in the literature that have shown that laparoscopic repair of incisional and ventral hernia is preferred over open repair because of lower recurrence rates (less than 10%), less wound morbidity, less pain, and early return to work. Aim: To identify the long-term outcomes between the different types of meshes and two techniques of mesh fxation, i.e., tacks (method Double crown) and transfascial polypropylene sutures. A total of 92 patients underwent LIVHR at our department between January 2009 and August 2012. The hernias were umbilical in 26 patients, paraumbilical in 15 patients and incisional in 51 patients. All patients admitted for LIVHR were randomized to either group I (tacker fxation of ePTFE meshes) or group II (suture fxation of meshes with nitinol frame) using computer-generated random numbers with block randomization and sealed envelopes for concealed allocation. The mean mesh fxation time was signifcantly higher in the tacker fxation group (117 ±15 min vs. 72 ±6 min, p < 0.01). There were no conversions in either group. The median postoperative hospital stay was 3.5 ±1.5 days. All patients were followed up at 1, 3, 6, 12 and every 6 months thereafter postoperatively. There were 5 recurrences in the study population. In group I there were 4 patients with recurrence, and only 1 patient in the group with meshes
with a nitinol frame. Meshes of the new generation with a nitinol framework can signifcantly improve laparoscopic ventral hernia repair. The fxation of these meshes is very simple using 3–4 transfascial sutures. The absence of shrinkage of these meshes makes the probability of recurrence minimal. Absence of tackers allows postoperative pain to be minimized. We consider that these new meshes can signifcantly improve laparoscopic ventral hernia repair.
