Laparoscopic Tension-free Hemioplasty For Abdominal Wall Incisional Hernia:a Review Of25Cases

Objective:To investigate the advantages, disadvantages and surgical technique of laparoscopic hernioplasty.Methods:We performed laparoscopic tension-free hernioplasty on25patients with abdominal incisional hernia from Jul.2011to Feb.2013, among which20cases underwent laparoscopic hernioplasty (group1), the other5applied hybrid technique (group2). The advantages and limitations of laparoscopic technique were discussed based on retrospective analysis of the clinical data, including operation methods, operation time, intraoperative blood loss, postoperative hospital stay, postoperative complications, ect.Results:All25operations were conducted successfully and patients recovered smoothly. For patients of group1, mean operation time was121.5±5.2min, mean blood loss was40±3.2ml, out-of-bed activity occurred in the second day and liquid diet was taken2to3days after operation. Average postoperative hospital stay was5.35±0.29d. For patients of group2, mean operation time was170±14.4min, mean blood loss was54±8.3ml. Patients got out-of-bed activity in the second day and had liquid diet2to5days after operation. Meanwhile the average postoperative hospital stay was10.4±1.84d.The25patients were followed up for2to21months and no recurrence occured.1case developed the symptoms of low fever and abdominal pain, which was confirmed to bepostoperative recurrence of colon carcinoma and abdominal wall metastasis during return visit. The other24cases recovered with no complications such as seroma, hematoma, infection, intestinal fistulaand chronic pain in the abdominal wall.Conclusion:Laparoscopic and laparoscopic-open hybridtension-free hernioplasty for abdominal wall incisional hernia have been proved feasible and reliable. However, specific condition of patient, experience and skill of surgeon should be taken into serious consideration when it comes to the choice of operative mode and patch fixation method.