Pseudo-recurrence following laparoscopic ventral and incisional hernia repair

Tse, George; Stutchfield, Ben M.; Duckworth, Andrew D.; Beaux, A. C. de; Tulloh, Bruce

doi:10.1007/s10029-010-0709-5

Cited by 55 publications

(50 citation statements)

References 13 publications

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“…Mesh bulging or mesh eventration is a recently reported complication of VIHR [16,17,45]. With regard to the mechanism underlying mesh bulging, the central nonfunctioning portion of the abdominal wall will protrude into the hernia sac due to the intraabdominal pressure by Laplace's law, and the patient feels this "bulging."…”

Section: Mesh Bulgingmentioning

confidence: 98%

Closure versus non-closure of fascial defects in laparoscopic ventral and incisional hernia repairs: a review of the literature

2015

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The laparoscopic technique for repairing ventral and incisional hernias (VIH) is now well established. However, several issues related to laparoscopic VIH repair, such as the high recurrence rate for hernias with large fascial defects and in extremely obese patients, are yet to be resolved. Additional problems include seroma formation, mesh bulging/eventration, and non-restoration of the abdominal wall rigidity/function with only bridging of the hernial orifice using standard laparoscopic intraperitoneal onlay mesh repair (sIPOM). To solve these problems, laparoscopic fascial defect closure with IPOM reinforcement (IPOM-Plus) has been introduced in the past decade, and a few studies have reported satisfactory outcomes. Although detailed techniques for fascial defect closure and handling of the mesh have been published, standardized techniques are yet to be established. We reviewed the literature on IPOM-Plus in the PubMed database and identified 16 reports in which the recurrence rate, incidence of seroma formation, and incidence of mesh bulging were 0-7.7, 0-11.4, and 0 %, respectively. Several comparison studies between sIPOM and IPOM-Plus seem to suggest that IPOM-Plus is associated with more favorable surgical outcomes; however, larger-scale studies are essential.

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Section: Mesh Bulgingmentioning

confidence: 98%

Closure versus non-closure of fascial defects in laparoscopic ventral and incisional hernia repairs: a review of the literature

2015

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“…Symptomatic mesh bulge, though strictly not a recurrence [203], should be considered an adverse outcome of laparoscopic incisional or ventral hernia repair. A loosely stretched mesh can protrude into the hernia defect when the pneumoperitoneum is released [204].…”

Section: Recurrent Ventral/incisional Herniamentioning

confidence: 99%

Laparoscopic ventral/incisional hernia repair: updated guidelines from the EAES and EHS endorsed Consensus Development Conference

et al. 2015

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The availability of recent level 1 evidence (a meta-analysis of 10 RCTs) allowed to recommend that not only laparoscopic repair is an acceptable alternative to the open repair, but also it is advantageous in terms of shorter hospital stay and wound infection rate. This conclusion appears to be extremely relevant in a clinical setting. Indications about specific conditions could also be issued: laparoscopy is recommended for the treatment of recurrent ventral hernias and obese patients, while it is a potential option for compensated cirrhotic and childbearing-age female patients. Many relevant and controversial topics were thoroughly examined by this consensus conference for the first time. Among them are the issue of safety of the intraperitoneal mesh placement, traditionally considered a major drawback of the laparoscopic technique, the role for the biologic meshes, and various aspects of the laparoscopic approach for particular locations of the defect such as the abdominal border or parastomal hernias.

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“…Patients with wide defects may have noticeable bulges postoperatively and may not be satisfied with the cosmetic results, despite a successful hernia repair. 13 Based on the available literature, the laparoscopic repair remains an excellent choice, and in appropriately selected patients may be a less costly repair than open ventral hernia.…”

Section: Economic Impact Of Laparoscopic Hernia Repairmentioning

confidence: 99%

Economics of Abdominal Wall Reconstruction

Bower

Roth

2013

Surgical Clinics of North America

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Pseudo-recurrence following laparoscopic ventral and incisional hernia repair

Abstract: True recurrences after LVIHR do occur but should be preventable with good surgical technique. Pseudo-recurrences are more common and may mimic true recurrence. We recommend computed tomography (CT) to clarify the diagnosis and determine the indication for revisional surgery.

Cited by 55 publications

References 13 publications

Closure versus non-closure of fascial defects in laparoscopic ventral and incisional hernia repairs: a review of the literature

Closure versus non-closure of fascial defects in laparoscopic ventral and incisional hernia repairs: a review of the literature

Laparoscopic ventral/incisional hernia repair: updated guidelines from the EAES and EHS endorsed Consensus Development Conference

Economics of Abdominal Wall Reconstruction

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