Page 33 - Journal of Laparoscopic Surgery

WJOL S
WJOLS

10.5005/jp-journals-10033-1341
Laparoscopic Repair of Non-midline Abdominal Wall Hernia
RESEARCH ARTICLE

Laparoscopic Repair of Non-midline Abdominal Wall

Hernia: Retrospective Analysis of Cases done by
a Single Surgeon in the Past Four Years

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1 Jitendra Kumar, Rajni Raina

ABSTRACT Analysis of Cases done by a Single Surgeon in the Past Four
Years. World J Lap Surg 2018;11(2):85-89.
Aim: Abdominal wall ventral hernias are either midline or non-
midline. Non-midline abdominal wall hernias are not a common Source of support: Nil
entity and even rarer is a lateral ventral hernia. Laparoscopic
management of these hernias are surgically challenging, and Conflict of interest: None
outcomes are unpredictable. This study aims to evaluate and
analyze the results of laparoscopic repair of comparatively rare INTRODUCTION
non-midline hernias done at the tertiary teaching hospital in the
span of last four years. Abdominal wall hernia represents the hernias coming
Material and methods: For this retrospective descriptive study, out through defects in the abdominal wall fascia and
from record file, all cases of laparoscopic ventral hernia repair muscle through which intra-abdominal or pre-peritoneal
done in the last four years (from 01/01/2012 to 01/01/2016) by contents protrudes out. It can be either spontaneous or as
the main author at Lady Hardinge Medical College screened a consequence of past surgery involving incision of the
and out of these, total of thirteen cases (n-13) of non-midline
ventral hernia selected for their data analysis. abdominal wall. Most of the time abdominal wall hernia
tends to originate out of the midline probably through
Results: Out of total thirteen cases (n = 13), a large percentage linea alba or weak midline vertical scar. Although
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was of female gender (76.92%), their mean age of the patients were
43 +/- 9.30 years. (SD = 11.41). Range 24–64 years. Most of abdominal wall hernias in its mid-line anatomical loca-
the patients were overweight with mean weight was 72.846 kg. tion whether spontaneous or incisional are very common,
(SD = 13.369). Mean operating time were 78.84 minutes (SD = 22.62) non-midline abdominal wall hernias are comparatively
(range 60-120 minutes). One patient (7.69%) had developed chronic rare entity and even rarer is spontaneous lateral abdomi-
infected discharging sinus which ultimately required removal of 2
mesh. Same and only patient in our series reported recurrence nal wall ventral hernia.
which makes an overall percentage of recurrence 07.69%. Even though non-midline or lateral abdominal wall
hernias are rare occurrences and its management and
Conclusion: Even though non-midline abdominal wall hernias
are comparatively atypical in its presentation and challenging outcome is not as simple as other ventral abdominal
for the laparoscopic surgeon, overall patient’s epidemiology, wall hernias, available data’s or literature in respect of
the surgical outcome in term of recurrence and complications this is very limited. Even textbooks have not dedicated
are not much different. any separate chapter in respect of non-midline or lateral

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Clinical significance: Presentation of a non-midline hernia is abdominal wall hernias.
atypical and surgically complex which require an experience In 1992, Leblanc first reported the repair of abdominal
to handle it.
wall ventral hernia by laparoscopic route. He performed
Keywords: Complex hernia, Non-midline ventral hernia, the surgery using four to five port and all repairs were
Lateral abdominal wall hernia, Non-midline incisional hernia, made using 1-mm-thick expanded polytetrafluoroeth-
Laparoscopic ventral hernia repair.
ylene patches inserted intraperitoneally and stapled to
How to cite this article: Kumar J, Raina R. Laparoscopic the anterior abdominal wall over the defects, making
Repair of Non-midline Abdominal Wall Hernia: Retrospective
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use of intra-abdominal pressure to secure the repair.
Since then laparoscopic repair of ventral abdominal wall
hernia has evolved rapidly and now been considered as
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1 Assistant Professor, Specialist
well accepted and preferred approach for management
1 Department of Surgery, Lady Hardinge Medical College and of abdominal wall ventral hernia.
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Smt. S. K. Hospital, New Delhi, India
2 Department of Anaesthesia. Dr Baba Saheb Ambedkar Medical
College and Hospital, New Delhi, India MATERIALS AND METHODS
Corresponding Author: Jitendra Kumar, Assistant Professor, For this retrospective descriptive study, the record of all
Department of Surgery, Lady Hardinge Medical College and Smt. cases of non-midline ventral hernia repaired laparoscopi-
S. K. Hospital, New Delhi, India, email: jkumar33@ymail.com
cally by the main author himself during the period from
World Journal of Laparoscopic Surgery, May-August 2018;11(2):85-89 85