Retroprosthetic seroma after laparoscopic ventral hernia repair: incidence, risk factors and clinical significance

Hernia. 2015 Dec;19(6):943-7. doi: 10.1007/s10029-015-1352-y. Epub 2015 Feb 10.

Abstract

Background: The seroma generated between the abdominal viscera and the prosthesis (retroprosthetic seroma), after laparoscopic ventral hernia repair (LVHR) with the implant of an intraperitoneal mesh is an unknown entity with few references in the literature. Our objective is to analyze its incidence, clinical repercussions and course of retroprosthetic seroma during the first 3 months post-operation and the factors related to its appearance, such as the relationship to preprosthetic seroma, the size of the prosthesis and the patient BMI.

Materials and methods: Prospective, descriptive study in patients undergoing LVHR using the double crown technique. After surgery, the patients had follow-ups on the seventh day and the first and third months post-operation with clinical examination and abdominal CT scan. The study endpoints were: incidence and volume of retroprosthetic seroma, clinical repercussions, relationship to body mass index (BMI), prosthesis size and the existence of preprosthetic seroma.

Results: Fifty patients underwent LVHR using the double crown technique and were included in the study. The incidence of retroprosthetic seroma during the 3-month follow-up was 46%, there being a progressive process of spontaneous reabsorption. In just one patient (2%) there were clinical repercussions as a result of the seroma. No statistically significant relationship was found with BMI and preprosthetic seroma. A statistical relationship was found between the size of the prosthesis and the risk of suffering retroprosthetic seroma in the third month post-operation (p = 0.048).

Conclusions: Retroprosthetic seroma is an entity produced in 46% of patients undergoing LVHR with few clinical repercussions (2%). In most cases it develops in the first week post-operation and then undergoes a reabsorption process that is usually complete by the third month post-operation. The size of the prosthesis delays the reabsorption process.

Keywords: Laparoscopic repair; Retroprosthetic; Seroma; Ventral hernia.

MeSH terms

  • Aged
  • Female
  • Hernia, Ventral / surgery*
  • Herniorrhaphy / adverse effects*
  • Herniorrhaphy / methods
  • Humans
  • Incidence
  • Laparoscopy
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Seroma / epidemiology*
  • Seroma / etiology
  • Treatment Outcome