Hybrid: Evolving techniques in laparoscopic ventral hernia mesh repair

Abstract

Introduction: Laparoscopic repair is now the treatment of choice for most cases of ventral/incisional hernia. Although the technique has undergone many refinements, there is no standard technique for difficult or complicated hernias. Aim: The aim of this study was to show the different innovative methods used to treat difficult ventral hernia through hybrid techniques. Materials and Methods: A total of 75 ( n = 75) patients underwent Laparoscopic Ventral Hernia Hybrid Mesh Repair (LVHHMR) by our surgical unit between January 2014 and December 2016. Three different techniques of repairing the defects were used. Mesh fixation time, post-operative pain score (visual analogue score) and follow-up for pain and recurrence (at 6 months, 12 months and 24 months) were recorded and analysed. Results: Out of 75 patients (20 men and 55 women), the median age was 45 years and body mass index of the patients was 25–35. Types of hernias operated were paraumbilical hernias, incisional and recurrent hernias. The techniques used were (1) laparoscopic adhesiolysis, open sac excision with closure of defect and laparoscopic mesh placement, (2) laparoscopic adhesiolysis, omphalectomy with closure of defect and laparoscopic mesh placement and (3) open adhesiolysis, sac excision with closure of defect and laparoscopic mesh placement. Five patients required analgesics for 48 h. No patients complained of pain at follow-ups (1 month, 6 months, 12 months and 24 months). Mean hospital stay postoperatively was 2–3 days. Conclusion: LVHHMR is safe and feasible approach for complicated/difficult ventral hernias. However, further larger studies are required to establish these methods as gold standard.

Hybrid: Evolving Techniques in Laparoscopic Ventral Hernia Mesh Repair

“…Our study (Hybrid: Evolving techniques in laparoscopic ventral hernia mesh repair) published in journal of minimal access surgery July 2020, has similar results as compared to that of literature [18]. We have demonstrated various hybrid techniques and their post-operative outcome.…”

Hybrid operation technique for incisional hernia repair: a systematic review and meta-analysis of intra- and postoperative complications

“…After full-text reading, 12 articles were judged eligible and included for final data analysis, representing a total of 1681 patients. Two articles were the short-and long-term outcomes of one randomized controlled trial of Ahonen-Siirtola et al [10,19], and ten were retrospective cohort studies [20][21][22][23][24][25][26][27][28][29]. An overview of study characteristics including methodological quality of each included study is shown in Table 1.…”

“…Amaral et al [21] used a HIHR technique in sixteen patients that commenced with a laparoscopic adhesiolysis part, continued with a laparotomy for mesh placement, and laparoscopic fixation of the mesh in the final part. This sequence is also used by Van den Dop et al [23] in 70 patients, Kudsi et al [28] in 20 patients, by Ji et al [22] in 42 patients and by Wasim et al [24], in 30 patients.…”