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

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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.
Last updated: 5.3.2020