Experience of laparoscopic incisional and ventral hernia repair (2005 – 2012) UO di Chirurgia...
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Transcript of Experience of laparoscopic incisional and ventral hernia repair (2005 – 2012) UO di Chirurgia...
Experience of laparoscopic incisional and ventral hernia repair
(2005 – 2012)
UO di Chirurgia Dott. Paolo A. Riccio
Patient Characteristics (222)Male/Female 84/138
Age (y) 61.7 (15-88)
Body mass index 28.8 (18-45)
ASA classification 2.1 (1-3)
Previous open hernia repair
24 (10.8%)
Max diameter size (cm) 8.4 (2-28)
Operating time (min) 97.5 (25-240)
Postoperative hospital stay (d)
4.8 (1-27)
Associated procedures 15 10 cholecistectomy
5 inguinal hernia
Type of defect (1)Laparoscopic Incisional Hernia Repair - LIHR (172)
Median laparotomies 145
Lateral: 24
Left side 5
Mc Burney 5
Subcostal 10
Lumbar hernia 4
Parastomal 3
Laparoscopic Ventral Hernia Repair - LVHR (50)
Umbilical hernia 29
Epigastric hernia 21
Type of defect (3)Chevrel classification
Small (<= 5 cm) 45 (20.2%)
Medium (6-9 cm) 69 (31.0%)
Large (=> 10 cm) 71 (32.1%)
Type of defect (2)ABDOMINAL BORDER (42)
Subxiphoidal 8
Suprapubic 24
Subcostal 10
Type of defect (4)Swess-Cheese 37 (16.7%)
Type of ProsthesisSEPRAMESH
VENTRALIGHT
40 (18.0%)
20 (9.0%)
DYNA-MESH 12 (5.4%)
PARIETEX 5 (2.2%)
COMPOSIX 33 (14.8%)
PROCEED 110 (49.5%)
PHISIOMESH 2 (0.9%)
Type of fixation (1)ABSORBABLE TACK 52 (23.5%)
NON ABSORBABLE TACK 170 (76.5%)
Type of fixation (2) Use of Tissucol
OUTCOMES
Complications 32 (14.4%)
Recurrence 12 (5.4%)
Conversion to open technique 8 (3.6%)
COMPLICATIONS (32)Prolonged seroma (> 8 wk) 12 (5.6%)
Prolonged ileus 10 (4.7%)
Prolonged pain (> 6 months) 5 (2.3%)
Pulmunary Embolism 1 (0.6%)
Myocardial Infarction 1 (0.6%)
Pneumonia + wound infection 1 (0.6%)
Wound infection 2 (0.9%)
RE-OPERATION (7)Intestinal injury 4 (1.8%)
Postoperative bleeding 2 (0.9%)
Trocar site erniation 1 (0.6%)
RECURRENCE 12 (5.4%)Time to recurrence (days): 537 (31-1517)
Treatment of recurrence:
Laparoscopic repair 2
Open repair 5
No repair 5
CONVERSION TO OPEN TECHNIQUE 8 (3.6%)
Severity of adhesions 5 (2.2%)
Severity of adhesions and obesity 1 (0.5%)
Complete prosthesis detachment 1 (0.5%)
Intestinal injury 1 (0.5%)