Laparoscopic transcutaneous closure of central defects in laparoscopic incisional hernia repair

Surg Laparosc Endosc Percutan Tech. 2012 Apr;22(2):e66-70. doi: 10.1097/SLE.0b013e3182471fd2.


Purpose: The aim of this technical report is to investigate the safety, efficacy, and outcome of transcutaneous closure of central defects (TCCD) for laparoscopic incisional hernia repair (LIHR).

Methods: Twenty-two patients with incisional hernias underwent a LIHR-TCCD repair. After clearance of the abdominal wall from adhesions, laparoscopic central closures were performed transcutaneously with 0-polypropelene sutures placed every 1 cm of the defect starting at the cranial-most edge of the hernia and ending at the caudal-most edge of the hernia. A standard LIHR was performed with coated polyester mesh placed with at least 6 cm of overlap with mesh on all borders. Transfascial sutures with 0-polypropelene sutures were placed every 4 cm circumferentially, and titanium tacks were used to secure the mesh to the peritoneum every 1 cm.

Results: The mean age was 52 years and the mean body mass index was 35 kg/m. The mean hernia defect was 4.7 cm×7.2 cm with a mean area of 37 cm. There were no mortalities and no major perioperative morbidities. Minor complications included 2 (9%) cases of pneumonia/pneumonitis. There were no clinically significant seromas, no radiographic or clinical eventrations, and no hernia recurrences with a mean follow-up of 21 months.

Conclusions: LIHR-TCCD is safe and technically feasible in incisional hernias of width <10 cm. By closing the central defect, seromas and eventrations can be reduced.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Feasibility Studies
  • Female
  • Hernia, Abdominal / surgery*
  • Herniorrhaphy / methods*
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Patient Safety
  • Retrospective Studies
  • Suture Techniques
  • Treatment Outcome
  • Wound Closure Techniques