Laparoscopic ventral hernia repair with the Goretex Dualmesh: long-term results and review of the literature |
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Authors: | Ph Topart L Ferrand F Vandenbroucke P Lozac’h |
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Institution: | (1) Chirurgie Generale, Centre Hospitalier Universitaire, Brest, cedex, 29609, France |
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Abstract: | Since 1993 laparoscopy has become a popular technique of repair of ventral hernias. The authors review the long-term results
of a systematic laparoscopic repair of ventral hernias and discuss the current problems compared to open repair. Between 1997
and 2003, 146 patients had a laparoscopic ventral hernia repair using an intraperitoneal Goretex Dualmesh with a 3–5-cm mesh
overlap secured with a combination of nonabsorbable sutures and staples. A total of 155 attempts of laparoscopic repair was
performed with four conversions. The 151 laparoscopic operations were completed in 105.8 min with a mesh implant being of
341 cm2. There were two postoperative deaths and two patients had to be reoperated on. Mesh infection was diagnosed in two cases.
Mean length of stay was 4.9 days. During a follow- up of 26.6 months eight patients (5.8%) developed a recurrence. Laparoscopic
ventral hernia repair is a reproducible technique. Most of the comparative studies have shown an overall lower rate of complications
after laparoscopic repair compared to open but with a 2–4% risk of bowel injury. The two other benefits of the laparoscopy
are reduced postoperative pain and shorter hospital stay. The recurrence rate is usually between 2 and 7% but no difference
has been found compared to open repair. Laparoscopic ventral hernia repair using the Goretex Dualmesh is a reliable operation
with a low rate of conversion to open. Despite the risk of serious bowel injury, laparoscopy achieves as good results as the
mesh open repair on the long term with the benefit of a decreased complication rate and a shorter hospital stay. |
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Keywords: | Laparoscopy Ventral hernia Goretex mesh |
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