Laparoscopic repair of incisional hernia.


COD: 2821_28_04_2018_AOP Categorie: ,

Antonio Zanghì, Maria Di Vita, Antonio Borzì, Andrea Cavallaro, Francesco Cardì,
Alessia Giaquinta, Emanuele Lo Menzo, Alessandro Cappellani

Ann Ital Chir, Digital Edition 2018; 7
Epub Ahead of Print – April 28

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INTRODUCTION: Some factors may affect the conversion to open of the laparoscopic treatment of incisional hernia. Their
presence can help to choose the most appropriate technique identifying patients at high risk conversion.
METHODS: A retrospective study has been performed on a cohort of 306 patients, selected among those undergone to elective
laparoscopic surgery for post incisional hernia between 2005 and 2015. Only symptomatic patients with single site
wall defect, diameter between 5 and 10 cm, ASA ≤3, have been included. Patients were divided in 2 groups, Laparoscopic
(L) and Converted (C) and preoperatory data were evaluated and statistically analyzed.
RESULTS: The L group accounted for 228 patients and C group for 78 patients. The univariate analysis showed that
risk factor for conversion included BMI ≥ 30, Smoking, Diabetes mellitus, Prior emergency surgery. Age > 60 years was
associate with lower risk of conversion.
CONCLUSIONS: The result of this retrospective study allows us to say that the choice of the technique, in the presence of
multiple risk factors, should be carefully assessed and discussed with the patient. A prospective study with a larger number
of patients would allow a better definition of the risk determined by individual factors and the development of a
score that could be used in practice to simplify the risk assessment