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Peter T. Kennealey, MD; Cynthia S. Johnson, MA; A. Joseph Tector III, MD, PhD; Don J. Selzer, MD

Arch Surg. 2009;144(3):228-233.

Hypothesis  Laparoscopic incisional hernia repair (LIHR) is efficacious in transplant recipients.

Design  Retrospective review.

Setting  University hospital.

Patients  Thirty-one transplant recipients who underwent LIHR between July 9, 2004, and October 27, 2005.

Main Outcome Measures  Operative complications and incisional hernia recurrence.

Results  The mean (SD) mesh size required for LIHR was 611 (307) cm². Median (range) hospital stay was 4 (1-28) days, with follow-up of 589 (22-953) days. Eighteen patients developed a postoperative complication, most frequently seroma formation, which occurred in 13 patients (72%). The mesh size required for LIHR was significantly larger in patients with a postoperative complication (n = 18; 706 [319] cm² vs n = 13; 480 [244] cm²; P = .04). Seroma formation was not associated with previous open hernia repair, diabetes mellitus, or corticosteroid use. No statistically significant relationship was noted between the transplanted organ and seroma development. There were no post-LIHR wound infections. In 7 patients (23%), hernia recurred.

Conclusions  Laparoscopic incisional hernia repair in solid-organ transplant recipients is associated with a high rate of seroma formation but minimal long-term morbidity. The recurrence rate after LIHR is equivalent to that after open hernia repair. These results suggest that LIHR is a safe and effective alternative to open repair in this patient population.

Author Affiliations: Departments of Surgery (Drs Kennealey, Tector, and Selzer) and Medicine, and Division of Biostatistics (Ms Johnson), Indiana University School of Medicine, Indianapolis. Dr Kennealey is now with the Department of Surgery, Division of Transplantation, Massachusetts General Hospital, Harvard Medical School, Boston.

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Laparoscopic Incisional Hernia Repair After Solid-Organ Transplantation—Invited Critique
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Arch Surg. 2009;144(3):233.
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