Surgical treatment of incisional ventral hernia - with a special reference to laparoscopic techniques
Thesis event information
Date and time of the thesis defence
Place of the thesis defence
Auditorium 1 of Oulu University Hospital, Kajaanintie 50
Topic of the dissertation
Surgical treatment of incisional ventral hernia - with a special reference to laparoscopic techniques
Doctoral candidate
Licentiate of medicine Mirella Ahonen-Siirtola
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, Medical research center Oulu
Subject of study
medicine
Opponent
Docent Tom Scheinin, University of Helsinki
Custos
Professor Jyrki Mäkelä, University of Oulu
The risk for bowel injury is low and seroma formation is diminished in incisional ventral hernia operations using hybrid technique
An incisional ventral hernia repair is a common complication following abdominal surgery. Annually 1800 incisional ventral hernia operations are performed in Finland. There are several operative methods. In this dissertation we explored the results related to incisional ventral hernia operations.
According to our results, complications followed by incisional ventral hernia operations are rather uncommon and mild. Though in routine use, laparoscopic method is more often associated with a risk of a dangerous complication, bowel injury, compared to open technique. This risk is increased in operations with intense bowel adhesions. Undetected bowel injury can lead to fatal consequences such as peritonitis. More common incident following laparoscopic hernia repair is seroma formation, which can cause pain and dysfunction.
In a rather new technique, hybrid, adhesions can be lysed and the fascial defect sutured through a mini-incision prior to laparoscopic mesh augmentation. According to our multicentre study consisting data from eleven Finnish hospitals, adhesiolysis was clearly more often described complex in laparoscopic group than in hybrid group. The incidence of postoperative seroma formation was significantly diminished after hybrid repair than laparoscopic operation. The risk of bowel injury was low. In one-year follow-up we explored recurrence rate of 6%. Anatomy of the abdominal wall is restored with fascial defect closure, which seems to be diminishing chronic postoperative pain. Based on the study results patients are rather painless after hernia operations resulting as a better quality of life.
According to our results, complications followed by incisional ventral hernia operations are rather uncommon and mild. Though in routine use, laparoscopic method is more often associated with a risk of a dangerous complication, bowel injury, compared to open technique. This risk is increased in operations with intense bowel adhesions. Undetected bowel injury can lead to fatal consequences such as peritonitis. More common incident following laparoscopic hernia repair is seroma formation, which can cause pain and dysfunction.
In a rather new technique, hybrid, adhesions can be lysed and the fascial defect sutured through a mini-incision prior to laparoscopic mesh augmentation. According to our multicentre study consisting data from eleven Finnish hospitals, adhesiolysis was clearly more often described complex in laparoscopic group than in hybrid group. The incidence of postoperative seroma formation was significantly diminished after hybrid repair than laparoscopic operation. The risk of bowel injury was low. In one-year follow-up we explored recurrence rate of 6%. Anatomy of the abdominal wall is restored with fascial defect closure, which seems to be diminishing chronic postoperative pain. Based on the study results patients are rather painless after hernia operations resulting as a better quality of life.
Last updated: 1.3.2023