Endoscopic Rives-Stoppa Procedure for Incisional Ventral Hernia after Subtotal Stomach Preserving Pancreaticoduodenectomy

Abstract

Endoscopic Rives-Stoppa procedure can relieve and avoid the pain caused by fixation devices in laparoscopic intraperitoneal onlay mesh (IPOM) repair or the suturing pain in IPOM-plus repair. A 76-year-old man had undergone subtotal stomach preserving pancreaticoduodenectomy for pancreatic head cancer. He developed incisional ventral hernia, 5 cm in diameter, at midline scar. We chose endoscopic Rives-Stoppa procedure because he had suffered from postoperative severe pain after the previous operation. He took analgesic medicine only once during hospitalization and was discharged on postoperative day 3. After 2 weeks, he developed seroma, but it disappeared with conservative treatment. We believe that endoscopic Rives-Stoppa procedure is an effective method, because it can avoid adhesion, ileus, abscess formation, and mesh infection which are complications of IPOM repair.