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

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• 作者：Katsuhito Suwa ; Tomoyoshi Okamoto ; Katsuhiko Yanaga
• 刊名：Surgery Today
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：46
• 期：7
• 页码：764-773
• 全文大小：459 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Abdominal Surgery
  Thoracic Surgery
  Vascular Surgery
  Cardiac Surgery
  Surgical Oncology
  
• 出版者：Springer Japan
• ISSN：1436-2813
• 卷排序：46

文摘

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.KeywordsVentral herniaIncisional herniaLaparoscopic repairIPOM-plusDefect closure