外科ジャーナル

Ventral Hernia Repair by Laparoscopic Approach, how to do it

Abstract

R Moldovanu*

Background: Laparoscopic approach for ventral hernias is associated with decreased hospital stay, reduced risk of infection and low recurrence rate compared with the open repair techniques. However, these good outcomes depend of several surgical techniques related key points. Aim: The aim of this paper is to present and highlight these “critical” key points. Method: The paper presents the procedure in a step-by-step manner; operative room set-up, peritoneal access and trocars placement, abdominal wall defect exploration, accurate mesh placement with a minimum 4 to 5 cm mesh overlap of the hernia defect and an adequate mesh fixation. The different key points as mesh insertion and unrolling as well as mesh placement and fixation are highlighted. Several data from literature were also discussed. Conclusion: The laparoscopic ventral hernia repair is a feasible and safe procedure. The respect of procedure’s “critical” key points allows the best outcomes in term of hospital stay, postoperative pain and morbidity