Laparoscopic incisional and ventral hernia repair: complications-how to avoid and handle

Hernia : the Journal of Hernias and Abdominal Wall Surgery
K A LeBlanc

Abstract

Complications will occur with any operative procedure. The possibility of this must be considered for laparoscopic incisional and ventral hernia repair (LIVH) as well. The most commonly reported of these include: intraoperative intestinal injury (1-3.5%), infection involving the prosthetic biomaterial (0.7-1.4%), (2.6-100%), postoperative ileus seromas (1-8%), and persistent postoperative pain (1-2%). The incidence of enterotomy can be reduced by careful dissection and judicious use of any energy source. Infection can be minimized by the use of perioperative antibiotics, an antimicrobially impregnated biomaterial, and careful manipulation of the prosthesis during the procedure. Seromas are so common that they should be expected but can be decreased by the use of a postoperative abdominal binder. Aspiration will be necessary in a few instances. Similarly, ileus is expected when there is significant bowel dissection and bleeding. Early ambulation and standard use of postoperative bowel care will aid in the treatment of this problem. Persistent pain will generally occur at the site of a transfascial suture. It cannot be predicted or prevented with certainty. When it occurs, local injection with bupivacaine, steroids, or non-steroi...Continue Reading

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Citations

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