TY - JOUR
T1 - Laparoscopic correction of umbilical hernias using a transabdominal preperitoneal approach: results of a pilot study
AU - Hilling, D.E.
AU - Koppert, L.B.
AU - Keijzer, R.
AU - Stassen, L.P.
AU - Oei, I.H.
PY - 2009/1/1
Y1 - 2009/1/1
N2 - BACKGROUND: Laparoscopic repair of umbilical hernias is usually based on the open underlay procedure in which the mesh is placed intra-abdominally. To prevent complications such as adhesions, bowel obstruction and fistula formation we developed a new laparoscopic approach, placing the mesh in the preperitoneal space. METHODS: Our laparoscopic approach concerns a standardised procedure with introduction of three intra-abdominally placed trocars. The ventral abdominal wall is incised in a lengthwise manner approximately 5 cm from the umbilical defect, followed by development of the preperitoneal space, reposition of the umbilical peritoneal sac and placement and fixation of a Prolene mesh. The mesh is secured using transfascial Prolene sutures; the peritoneal defect is closed with a running Vicryl suture. Data on 17 patients with primary umbilical hernias laparoscopically operated on between April 2002 and March 2006 are presented. RESULTS: The 11 men and 6 women had a mean age of 57.8 years (range 37-91 years) and a mean body mass index (BMI) of 30.6 kg/m(2) (range 23.7-37.9 kg/m(2)). Mean hernia size was 1.95 cm (range 1-3 cm), average mesh size was 110 cm(2) (range 100-150 cm(2)). Mean operating time was 85.6 min (range 60-120 min). Mean hospital stay was 2.2 days (range 1-3 days). No major complications were seen. No recurrences were observed during a mean follow-up of 36.2 months (range 13-62 months). CONCLUSIONS: The preperitoneal laparoscopic technique for umbilical hernia repair combines the advantages of a laparoscopic, minimally invasive, approach, avoiding the potential complications related to intra-abdominal mesh position.
AB - BACKGROUND: Laparoscopic repair of umbilical hernias is usually based on the open underlay procedure in which the mesh is placed intra-abdominally. To prevent complications such as adhesions, bowel obstruction and fistula formation we developed a new laparoscopic approach, placing the mesh in the preperitoneal space. METHODS: Our laparoscopic approach concerns a standardised procedure with introduction of three intra-abdominally placed trocars. The ventral abdominal wall is incised in a lengthwise manner approximately 5 cm from the umbilical defect, followed by development of the preperitoneal space, reposition of the umbilical peritoneal sac and placement and fixation of a Prolene mesh. The mesh is secured using transfascial Prolene sutures; the peritoneal defect is closed with a running Vicryl suture. Data on 17 patients with primary umbilical hernias laparoscopically operated on between April 2002 and March 2006 are presented. RESULTS: The 11 men and 6 women had a mean age of 57.8 years (range 37-91 years) and a mean body mass index (BMI) of 30.6 kg/m(2) (range 23.7-37.9 kg/m(2)). Mean hernia size was 1.95 cm (range 1-3 cm), average mesh size was 110 cm(2) (range 100-150 cm(2)). Mean operating time was 85.6 min (range 60-120 min). Mean hospital stay was 2.2 days (range 1-3 days). No major complications were seen. No recurrences were observed during a mean follow-up of 36.2 months (range 13-62 months). CONCLUSIONS: The preperitoneal laparoscopic technique for umbilical hernia repair combines the advantages of a laparoscopic, minimally invasive, approach, avoiding the potential complications related to intra-abdominal mesh position.
U2 - 10.1007/s00464-008-0177-5
DO - 10.1007/s00464-008-0177-5
M3 - Article
C2 - 19015918
SN - 0930-2794
VL - 23
SP - 1740
EP - 1744
JO - Surgical endoscopy and other interventional techniques
JF - Surgical endoscopy and other interventional techniques
IS - 8
ER -