[Laparoscopic reconstruction of abdominal wall hernias]. 2007
The widespread use of tension free surgical techniques and the modern, tissue-friendly surgical meshes have led to the development of new surgical techniques. The increasing importance of minimal invasive surgery became apparent in abdominal wall reconstructions, too, and their use has been justified by literature data. This procedure combines the advantages of minimal invasive surgery with tension free technique. The authors discuss 102 patients operated with abdominal wall hernias using a laparoscopic technique. There were 978 abdominal wall hernia operations in our department between 1 January 1999 and 31 December 2006, of which 102 cases were done laparoscopically. The average size of the abdominal wall defects was 62 square cm (minimum size: 12, maximum size: 160). The average size of the implanted surgical mesh was 300 square cm (min size: 150, max size: 750). Operating time was between 30 and 180 minutes. (The average time was exactly 70 minutes.) The hospital stay was between 1 to 7 days (4 days on average). Two recurrences were observed during the follow-up so far. The follow-up was from 2 to 96 months, with an average of 18 months. The laparoscopic technique significantly decreased the complication and recurrence rate, and shortened hospital stay compared to open surgery. Furthermore, laparoscopic technique improves aesthetic outcome, too. In addition, the authors found that small, hidden incisional hernia orifices could be explored and closed more easily with laparoscopic hernia repair.