RECURRENCES AFTER LAPAROSCOPIC VENTRAL HERNIA REPAIR AS A RESULT OF METHODOLOGICAL ERRORS

Introduction. At the moment there is a lot of debate regarding the underlying causes of recurrence after laparoscopic ventral hernia repair.

The purpose of this study was to determine the major errors in the laparoscopic treatment of ventral hernias, which are major causes of recurrences.

Materials and methods. In the period from 2008 to 2014 at theOdessaRegionalHospital conducted a comparative study involving 172 patients with postoperative ventral hernias. Initially, all patients underwent laparoscopic hernia repair using PTFE meshes.

Results. When observing patients in the period from1 to 49 months ((31.3±18.4) months), recurrent hernia was diagnosed in 14 patients after primary repair (8.1%). Causes of recurrence was the use of meshes of insufficient size (8 (4.65%) patients). 6 (3.5%) patients developed a recurrence of the hernia as a result of the use insufficient number of fixation points of the mesh.

Discussion. Using insufficient size of meshes, margin from the edge of the mesh hernia, displacement of mesh in the first days after surgery when the patient has cough, mesh shrinkage in the postoperative period and a decrease in its initial size by 20–30% depending on the mesh material, the development of invagination of the mesh hernial defect due to insufficient points of fixation, all these factors directly affect the results of laparoscopic treatment of ventral hernias.

Conclusions. The analysis of the causes of recurrence after laparoscopic hernia repair ventral hernias shows that the most common cause of recurrence of hernias after laparoscopic repair is to ignore the principles of positioning and fixing of meshes.