Initial experience with laparoscopic repair of incisional hernia

INTRODUCTION: The development of the laparoscopic approach has changed the approach to incisional hernia, which is one of the most common surgical operations. In this study, we aimed to analyze the results of laparoscopic incisional hernia cases performed in our clinic.
METHODS: Between April 2015 and March 2019, 234 patients underwent surgery for incisional hernia (abdominal wall) in our clinic, and those who underwent laparoscopic incisional hernia repair were included in this study. All procedures were performed using the same surgical technique. Demographic data, operation history, length of hospital stay, postoperative complications and recurrence were recorded. The minimum follow-up period for recurrence was 6 months.
RESULTS: Forty-seven (20%) patients underwent laparoscopic incisional hernia repair during four-year period. Thirteen male and 34 female patients with a mean age of 53±9 years were identified. Primary operations were classified as umbilical hernia operation (n=12), gynecologic operations (n=9), colorectal surgery (n=9), port site hernia (n=6), and others (n=11). The mean defect diameter was 5.8±1.7 cm. Seven patients underwent primary repair with prolene, while a composite mesh for repair was used with or without prolene suture support in the other patients (n=40). The postoperative complication rate was 12% [seroma (3), hematoma (1), infection (1), parietal wall defect (1)]. Recurrence was detected in 4 (8.5%) patients with a mean follow-up of 31±14 months.
DISCUSSION AND CONCLUSION: In our series investigating laparoscopic incisional hernia repairs, acceptable results including short hospital stay and complication rates were achieved. On the other hand, the slightly higher recurrence rate has been expected due to the small population of patients and large group of surgeons. For this reason, better results can be achieved with the implementation of restrictions on patient selection (small defect diameter, weak patient, etc.) and increased experience.