History and Latest Trends in Laparoscopic Incisional Hernia Surgery

Abstract

A major paradigm shift has recently occurred in laparoscopic incisional hernia repair. The methodology has evolved from a tension-free repair method to the reconstruction of abdominal wall function by suture closure of the hernial orifice. This was accompanied by changes in the repair layer from the intraperitoneal to extraperitoneal route to prevent mesh-related complications and fixation to the abdominal wall. The transversus abdominis muscle release (TAR) approach reported by Novitsky et al. is an epoch-making procedure that overcomes the limitations of the Rives-Stoppa method, the gold standard open procedure, and enables abdominal wall reconstruction for giant hernias. Laparoscopic abdominal wall reconstruction and extraperitoneal mesh placement have become possible with the advent of novel surgical procedures such as eTEP and EMILOS, which have a similar approach to that of open surgery.

This paper describes the history and changes of laparoscopic incisional hernia repair procedures, which were first reported by LeBlanc in 1993, along with the latest trends.