Results of Laparoscopic Intraperitoneal Ventral Hernia Repair with Sutures

The short and long term results of open repair of incisional/ventral hernia have been reported extensively in the literature. Despite the use of a variety of procedures, the recurrence rate has remained significant. In a well conducted study, Hesselink et al. (4) found a 36 percent recurrence rate with a mean follow-up period of 34.9 months. Other recurrence rates reported after primary repair of ventral and incisional hernia range from 25% to 52% (4,17). In a multicenter randomized trial, Luijendijk et al. (10) compared the recurrence rate following primary suture repair with that following mesh repair; they found the latter to be superior with regard to the recurrence of hernia, regardless of the size of the hernia. In this study, the recurrence rate following mesh repair was 24 percent. It has been well documented that the Rives/Stoppa repair leads to the lowest rates of recurrence. For this reason, the American Hernia Society has declared that this open repair for large ventral/incisional hernias should be the standard of care. The use of prosthetic material in the repair of ventral and incisional hernias has reduced the rate of recurrence; however, more important wound complications were seen with this technique. The laparoscopic repair of ventral and incisional hernia achieves the same result as the Rives/Stoppa open repair. Since the wounds are smaller and the abdominal wall soft tissue is manipulated minimally, the wound complications are expected to be less. Early in our experience, the mesh was fixed to the abdominal wall by staples.