Subcutaneous switching suture technique for hernia defect closure during laparoscopic ventral and incisional hernia repair.

Morioka, Daisuke; Izumisawa, Yusuke; Ohyama, Norio; Yamaguchi, Kazuya; Horii, Nobutoshi; Asano, Fumio; Miura, Masaru; Sato, Yoshiki

INTRODUCTION A vertical penetration of the thread through the abdominal wall for the hernia defect closure in laparoscopic ventral/incisional hernia repair (LVIHR) is difficult especially in the large defect cases when applying the existing techniques. MATERIALS Sixteen LVIHRs were performed using the suture technique for defect closure we newly developed. SURGICAL TECHNIQUE With the subcutaneous switching, our technique only requires the suture-passer and easily enables the vertical penetration of the thread through the abdominal muscular wall even in the large defect cases. DISCUSSION The defect closure in LVIHR tends to be complicated in the large defect cases. Thus, we devised this technique for the easy, reliable, and firm closure even in the large defect cases. Although the sample size was currently very small, we consider that the favorable outcomes have been obtained through our technique because any noticeable complications, such as mesh bulging or recurrence, have not been observed currently.