Laparoscopic trans-abdominal retro muscular mesh repair of ventral abdominal wall hernia

Document Type : Original Article

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General Surgery, Faculty Of Medicine, Mansoura University, Dakahlia, Egypt

Abstract

Background: Ventral hernias are defined as a defect of the fascia in the anterior abdominal wall with or without a bulge. Trans-Abdominal Retro-Muscular Mesh Repair (TARM) was introduced as a cost-effective laparoscopic approach utilizing polypropylene mesh placed in the retro-rectus space. Methods: This study included 73 ventral hernia patients undergone laparoscopic TARM repair. Postoperative data included length of hospital stay (LOS) and pain assessment by Visual Analogue Scale, postoperative complications (as abdominal wall hematoma, oedema or seroma), time to return to work, sexual practice and regular daily exercise were documented. Results: Postoperatively, seroma was the most common complication (16.4%), while recurrence occurred in 5.5% of cases. VAS score for pain was significantly higher in complicated cases. Time to return to work was significantly prolonged in complicated cases. There were statistically significant differences between recurrence and no recurrence as regards sex distribution with higher male predominance in recurrence group, as regards site of hernia as most recurred hernia were epigastric and as regards need for extra- analgesia. Length of hospital stay was significantly longer for females than males. Patients with postoperative ileus had significantly longer duration to work. Patients with postoperative seroma or infection had significantly longer duration to work. Conclusion: Laparoscopic Trans-Abdominal Retro-muscular Mesh Repair approach ‎in managing ventral hernia with high efficacy and good outcome. ‎Laparoscopic TARM was demonstrated to be efficient for repairing small ‎hernias.  

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