Bulging of the Mesh After Laparoscopic Repair of Ventral and Incisional Hernias
| Autor: | Johan T. F. J. Raymakers, Srdjan Rakic, Ernst J. P. Schoenmaeckers, Eelco B. Wassenaar |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty medicine.medical_treatment Hernia Inguinal Asymptomatic Recurrence Scientific Papers medicine Humans Ventral incisional hernia Hernia Clinical significance Laparoscopy Device Removal Aged Retrospective Studies Mesh medicine.diagnostic_test business.industry Medical record Retrospective cohort study Middle Aged Surgical Mesh medicine.disease digestive system diseases Hernia Ventral Prosthesis Failure Surgery stomatognathic diseases surgical procedures operative Laparoscopic repair Treatment Outcome Surgical mesh Female medicine.symptom business Bulging Watchful waiting Follow-Up Studies |
| Zdroj: | JSLS : Journal of the Society of Laparoendoscopic Surgeons |
| ISSN: | 1938-3797 1086-8089 |
| DOI: | 10.4293/108680810x12924466008240 |
| Popis: | Although not a hernia recurrence, symptomatic bulging after laparoscopic ventral hernia repair requires a new repair. Background and Objectives: To investigate the prevalence, diagnosis, clinical significance, and treatment strategies for bulging in the area of laparoscopic repair of ventral hernia that is caused by mesh protrusion through the hernia opening, but with intact peripheral fixation of the mesh and actually a still sufficient repair. Methods: Medical records of all 765 patients who underwent laparoscopic ventral hernia repair were reviewed, and all patients with a swelling in the repaired area were identified and analyzed. Results: Twenty-nine patients were identified. They all underwent a computed tomography assessment. Seventeen patients (2.2% of the total group) had a hernia recurrence; in an additional 12 patients (1.6%), radiologic examinations indicated only bulging of the mesh but no recurrence. Bulging was associated with pain in 4 patients who underwent relaparoscopy and got a new, larger mesh tightly stretched over the entire previous repair. Eight asymptomatic patients decided on “watchful waiting.” All patients remained symptom free during a median follow-up of 22 months. Conclusion: Symptomatic bulging, though not a recurrence, requires a new repair and must be considered as an important negative outcome of laparoscopic ventral hernia repair. In asymptomatic patients, “watchful waiting” seems justified. |
| Databáze: | OpenAIRE |
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