Safety of laparoscopic ventral hernia repair in older adults.

ABSTRACT

The published recurrence rate after laparoscopic ventral hernia repair is much less than the rate of recurrence via the open approach. Studies have demonstrated the safety and efficacy of this procedure but have had relatively young patient populations. We present our experience in a significantly older population. A retrospective chart review of all patients undergoing a laparoscopic ventral hernia repair at our institution from May 2000 to September 2004 was performed. Data extracted from charts included demographics, number and type of previous abdominal operations, number of previous hernia repairs, defect and mesh size, postoperative complications, and follow-up. Ninety-seven patients underwent laparoscopic ventral hernia repair (50 men and 47 women). The mean age was 68.5 years (37-85 years) with 78% of patients over the age of 60. Patients had undergone a mean of 2.1 prior abdominal operations. Thirty-five (36%) patients had undergone a mean of 1.8 previous open hernia repairs; 54% with mesh. The mean length of stay was 3.4 days (0-31 days). Thirty-three minor complications occurred in 27 patients. Six major complications occurred in five patients. Three patients required reoperation. Thirty-one percent of patients complained of pain at a transabdominal suture site 6 weeks after surgery. Nine percent of patients had seromas lasting longer than 6 weeks. Two recurrences occurred during follow-up and two patients required mesh removal. There were no deaths. Laparoscopic ventral hernia repair can be performed safely in patients regardless of age. Length of stay and overall complications are not affected by age. Long-term follow-up is necessary to evaluate the effectiveness of LVHR in this patient population.