Laparoscopic Incisional Hernia Repair

Alan Saber, MD, FACS; Tara Mancl, MD

Product Details
Product ID: ACS-2504
Year Produced: 2006
Length: 8 min.


During laparoscopic ventral hernia repair, mesh placement and orientation to overlap the hernia defect is a crucial step. A simple technique for mesh deployment during laparoscopic ventral hernia repair is presented in this video. After abdominal exploration, lysis of adhesions, the hernia defect is measured. An appropriate size of dual mesh PTFE is chosen. Four corner Gortex sutures are placed. The mesh is rolled from both sides and stay sutures are placed. The rolled mesh is placed through the visiport. Once the mesh is inside the peritoneal cavity, the Gore-Tex sutures are pulled through the abdominal wall. This will bring the rolled mesh adherent to the abdominal wall to bisect the fascial defect. The transfacial sutures are tied, the vicryl stay suture is cut, and half of the mesh is unfolded. Half of the mesh is fixed circumferentially with tacks. Additional transfacial sutures are placed at 5 cm intervals. The same procedure is repeated for the other half of the mesh. This alternative technique of mesh placement minimizes the intra-corporeal mesh manipulation, maintains a precise orientation in relation to the hernia.