Pure transvaginal ventral hernia repair in humans.

Abstract

INTRODUCTION:

Transvaginal natural orifice transluminal endoscopic surgery procedures are at the forefront of minimally invasive innovation, remarkable for shorter recovery times and decreased postoperative pain. We aim to demonstrate a novel technique of pure transvaginal laparoscopic ventral hernia repair in a series of patients performed in our institution.

TECHNIQUE DESCRIPTION:

The patient was placed in lithotomy position and steep Trendelenburg. A 2-cm transverse colpotomy incision was made and a SILS port was introduced. One 12-mm trocar and two 5-mm trocars were placed through the SILS port and standard straight laparoscopic instruments were used. An appropriately sized round mesh was deployed within a specimen retrieval bag into the peritoneal cavity. Complete anterior circumferential fixation of the mesh was achieved using an AbsorbaTack device. The colpotomy incision was closed.

RESULTS:

There were a total of 6 pure transvaginal ventral hernia repair procedures performed in our institution between November 2010 and February 2012. The first case was converted to an open procedure after a rectal injury was recognized and repaired. Two patients had transient urinary retention that resolved after 24 hours. One patient had vaginal wound granulation noted at 2 months postoperatively. No long-term complications or recurrences were noted with a median follow-up of 9 months. The mean operative time was 107 minutes.

CONCLUSION:

Our initial experience with transvaginal ventral hernia repair in humans suggests that this procedure is feasible, safe, and associated with improved cosmetic results.

• Authors: Stephanie G Wood, Lucian Panait, Andrew J Duffy, Robert L Bell, Kurt E Roberts
• Journal: Surgical innovation (Surg Innov) Vol. 21 Issue 2 Pg. 130-6 (Apr 2014) ISSN: 1553-3514 [Electronic] United States
• PMID: 23899619 (Publication Type: Journal Article)

Topics

• Adult
• Female
• Hernia, Ventral (surgery)
• Herniorrhaphy (adverse effects, methods)
• Humans
• Laparoscopy (adverse effects, methods)
• Middle Aged
• Natural Orifice Endoscopic Surgery (adverse effects, methods)
• Pain, Postoperative
• Quality of Life
• Treatment Outcome
• Vagina (surgery)