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Hernia (2013) 17:557566DOI 10.1007/s10029-013-1055-1
REVIEW
Laparoscopic ventral incisional hernia repair: evidence-based guidelines of the rst Italian Consensus Conference
D. Cuccurullo M. Piccoli F. Agresta
S. Magnone F. Corcione V. Stancanelli
G. Melotti
Received: 21 September 2011 / Accepted: 1 February 2013 / Published online: 12 February 2013 Springer-Verlag France 2013
AbstractPurpose The laparoscopic treatment of ventral incisional hernias is the object of constant attention and is becoming increasingly widespread in the international scientic-surgical community; however, there is ample debate on its technical details and indications. In order to establish a common approach on laparoscopic ventral incisional hernia repair, the rst Italian Consensus Conference was organized in Naples (Italy) on 1415 January 2010. Methods The format of the Consensus Conference was freely adapted from the standards of the National Institute of Health and the Italian Health Institute. The parties involved included the followings: a Promotional Committee, a Scientic Committee, a group of Experts, the Jury Panel and a Scientic Secretariat.
Results Eleven statements, regarding three large chapters on the indications, the technical details and the management of complications were drafted on the basis of
literature references collected by the Scientic Committee, documents developed by the Experts, reports presented and discussed during the Consensus Conference, and discussion among the members of the Jury.
Conclusions The laparoscopic approach is safe and effective for defects larger than 3 cm in diameter; old age, obesity, previous abdominal operations, recurrence and strangulation are not absolute contraindications. Ensuring an adequate overlap, careful adhesiolysis and correct xing of the prosthesis are among the technical details recommended. Complications and recurrences are comparable to, and in some cases, less numerous than with the open approach.
Keywords Laparoscopic approach
Laparoscopic incisional hernia repair
Consensus Conference Guidelines
Introduction
The laparoscopic treatment of ventral incisional hernia is the subject of constant discussion and is becoming increasingly widespread in use by international scientic-surgical community, as it makes it possible to extend the already established well-known advantages of minimally invasive surgery to abdominal wall surgery. To date, there are no standardized approaches in the surgical technique. There is no shared consensus on technical details, such as the means and methods to achieve mesh xation and suspension, the defect overlap, and even no denite indications in both elective and emergency surgery.