LAPAROSCOPIC VENTRAL AND INCISIONAL HERNIA REPAIR

Incisional hernia repair poses a difficult problem for the general sur geon because of the high incidence of recurrence (50%) and a reported 10% infection rate. Use of a mesh by the anterior approach to replace or reinforce the defect has marginally reduced the recurrence rate, bu t not the infection rate, especially in obese patients. With the evolu tion of minimally invasive surgery, we thought that a potential was pr esent to reduce the postoperative stay, lessen pain, and decrease the incidence of both recurrence and infection. From February 1991 through February 1998, a total of 176 patients with complicated umbilical and incisional hernias have been repaired; the follow-up has been from 1 to 84 months. The complication rate was 5.1%, with an infection rate o f 1.7% and a 1.1% incidence of recurrence. Seventeen patients had comb ined procedures, including cholecystectomy, inguinal hernia repair, an d antireflux procedures.