LAPAROSCOPIC REPAIR OF RECURRENT VENTRAL HERNIAS

Break down after repair of recurrent ventral hernias can exceed 50 per cent. Laparoscopic techniques offer an alternative. This study evalua ted the efficacy of the laparoscopic approach for recurrent ventral he rnias. A retrospective review on all patients with a recurrent ventral hernia who underwent laparoscopic repair at our institution from Augu st 1995 to June 1997 was performed. Demographic, operative, postoperat ive, and follow-up data were collected. Thirty-one patients underwent an attempted laparoscopic ventral hernia repair. Sixteen were for recu rrent hernias; 15 were successfully repaired laparoscopically. The pat ients were typically obese (mean body mass index, 30 kg/m(2)), had an average of 2.4 previous open repairs (range, 1-7), and six patients ha d previously placed intraabdominal mesh. An average of 3.5 (range, 1-1 6) defects were found per patient with a mean total hernia size of 130 cm(2) (6-480 cm(2)). In all cases, expanded polytetrafluoroethylene m esh (average, 299 cm(2)) was secured with transabdominal sutures. Post operatively patients required an average of 19 mg of narcotics (MSO4 e quivalent). Bowel function returned in 1.7 days. Length of stay averag ed 2.0 days (1-4 days). There were two complications: cellulitis, whic h resolved with antibiotics, and skin breakdown, which required mesh r emoval. With follow-up averaging 18 months (7-29 months), there is one recurrence; the case in which the mesh was removed. Laparoscopic repa ir of recurrent ventral hernia seems promising. Decreased hospital sta ys, postoperative pain, wound complications, and a low rate of recurre nce are benefits of this technique.