Laparoscopic incisional hernia repair as first therapeutic choice

Aim. Incisional hernias are one of the most frequent complications of open abdominal surgery. Historically, the best results have been obtained with the open rives-stoppa approach. This is done by fixing a large piece of prosthetic mesh behind the rectus muscle. Laparoscopic approach allows similar mesh placement with minimal dissection and lower recurrence rate compared to the open mesh repair. Methods. Between October 2001 to September 2003, 75 consecutive'patients were scheduled to undergo laparoscopic incisional hernia repair with ePTFE mesh (Gore-Tex® Dualmesh® Plus). Postoperative complications were recorded and analysed. Results. Most were obese affected by multiple wall defects Conversion to open surgery was required in 1 case Postoperative complications occurred 13.3 %. Recurrence occurred in one only case. Conclusion. The key to the success of this procedure is avoidance of complications. The laparoscopic approach is safe, effective and relatively complication-free option in the management of patients presenting with a first time or recurrent incisional hernia and recommended as the treatment of choice.