Laparoscopic incisional hernioplasty utilising on-lay expanded polytetrafluoroethylene DualMesh: prospective study

H Lau, NG Patil, WK Yuen, F Lee
Department of Surgery, University of Hong Kong Medical Centre, Tung Wah Hospital

OBJECTIVE. To evaluate the early outcomes of laparoscopic incisional hernioplasties using on-lay GORE-TEX DualMesh.

DESIGN. Prospective study.

SETTING. Medical centre of a regional hospital, Hong Kong.

SUBJECTS AND METHODS. Between June 2000 and October 2001, 11 consecutive patients underwent attempted laparoscopic incisional hernioplasties at the University of Hong Kong Medical Centre. A prospective collection of perioperative data and assessment of postoperative outcomes was performed.

RESULTS. Laparoscopic incisional hernioplasty was successfully performed for 10 (91%) patients. One patient was converted to open repair because of extensive adhesions within the peritoneal cavity. The overall mean operative time was 107 minutes. Five (45%) patients were found to have more than one hernial defect after reduction of the hernial contents. Eight (73%) patients were discharged within 2 days after operation. Postoperative morbidities included wound bruising (n=4), seroma (n=2), and prolonged suture site pain (n=1). All postoperative morbidities resolved spontaneously without intervention. With a mean follow-up of 3 months, no early recurrence was detected.

CONCLUSION. Early outcomes of laparoscopic incisional hernioplasty utilising GORE-TEX DualMesh were promising. This technique confers the advantages of minimal access surgery and allows clear identification of multiple hernial
defects. Extensive adhesion, which does not allow the establishment of pneumoperitoneum, is a condition that precludes the safe performance of laparoscopic repair.

Hong Kong Med J 2002;8:413-7

Key words: Hernia, ventral; Laparoscopy; Polytetrafluoroethylene; Surgical mesh