Laparoscopic management of non-midline incisional hernia: A multicentric study

Int J Surg. 2016 Sep:33 Suppl 1:S108-13. doi: 10.1016/j.ijsu.2016.06.023. Epub 2016 Jun 21.

Abstract

Background: The laparoscopic repair of non-midline ventral hernia (LNM) has been debated. The aim of this study is to analyze our experience performing the laparoscopic approach to non-midline ventral hernias (NMVHs) in Northwest Italy for 6 years.

Methods: A total of 78 patients who underwent LNM between March 2008 and March 2014 in the selected institutions were analyzed. We retrospectively analyzed the peri- and postoperative data and the recurrence rate of four subgroups of NMVHs: subcostal, suprapubic, lumbar, and epigastric. We also conducted a literature review.

Results: No difference was found between the four subgroups in terms of demographic data, defect characteristics, admission data, and complications. Subcostal defects required a shorter operating time. Obesity was found to be a risk factor for recurrence.

Conclusions: In our experience, subcostal defects were easier to perform, with a lower recurrence rate, lesser chronic pain, and faster surgical performance. A more specific prospective randomized trial with a larger sample is awaited. Based on our experience, however, the laparoscopic approach is a safe treatment for NMVHs in specialized centers.

Keywords: Laparoscopic repair; Non-midline ventral hernia; Ventral hernia.

Publication types

  • Multicenter Study

MeSH terms

  • Female
  • Hernia, Ventral / surgery*
  • Humans
  • Incisional Hernia / surgery*
  • Italy / epidemiology
  • Laparoscopy / statistics & numerical data
  • Male
  • Middle Aged
  • Obesity / complications
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Prospective Studies
  • Recurrence
  • Retrospective Studies
  • Risk Factors