ABSTRACT
With the evolution of minimally invasive surgery, it is thought that a potential is present to reduce the postoperative complications of ventral hernia repair. Theoretical advantages of laparoscopic repair include faster recovery less postoperative pain, less morbidity, and a better cosmetic result. The purpose of this study is to report the results of our initial experience with laparoscopic tensionfree repair technique using polypropylene mesh in patients with primary ventral hernia. From March 1996 to December 1998, laparoscopic ventral hernia repair was performed on 22 patients. There were 14 women and eight men. Age of patients ranged between 28 and 55 years [mean 46.4 years]. Type of hernia included ten para-umbilical and 12 incisional hernias. Body mass index of patients was ranging between 24 and 49 kg/m[2] [mean 31 +/- 9.7 Kg/m[2]] The size of the hernia defect ranged between 20 and 160 cm[2] [mean 96 cm[2]]. Polypropylene mesh was used in all cases and the mesh size was varying from 6x6 to 20x20 cm [median 12x12 cm].There were no deaths. In two patients [9%] conversion to open surgery was mandatory. Six complications [30%] were recorded among the twenty patients who completed the laparoscopic procedure. Most of them were minors and only one patient [5%] developed intraabdominal abscess and needed surgical intervention. No complications related to intestinal adhesion or fistula formation were recorded. The mean operating time was 90 minutes. It was 105 minutes in the initial 10 patients and decreased in the subsequent 10 cases to a mean of 85 minutes. The mean hospital stay was 2.5 days [range: 1-12 days]. After a mean of 15 months follow up [range 12 to 23 months], no recurrence was recorded.Laparoscopic ventral hernia repair offers advantages over the conventional open mesh repair and may decrease the hernia recurrence rate. When properly performed, the laparoscopic approach does not compromise the principles for successful mesh repair of ventral hernias.Also decreased hospital stays postoperative pain, and wound complications, are benefits of this technique.Regarding the type of mesh, good results can be obtained using polypropylene mesh