Laparoscopic Ventral Hernia Repair

In recent years, there has been an explosion of information regarding the surgical management of abdominal wall hernias. Advances in minimally invasive techniques have led to improved success and reduced complications. Regardless of the approach or specific techniques, the overall goals of any hernia repair should remain the same, which are to provide relief of symptoms and minimize recurrence. Minimally invasive approaches for ventral hernia repair offer several advantages over an open approach, which include decreased wound complications and faster recovery. Currently, there is no superior minimally invasive procedure for ventral hernia repair. Patient characteristics, type of hernia, defect size, and surgeon experience should play into decision-making regarding optimal approach, along with mesh position, and the various technical aspects for repair. Beyond the surgical approach, optimization of abdominal wall surgery is contingent on many other factors, including socioeconomics, perioperative nutrition and conditioning, specific anatomic characteristics, closure techniques, and the implications for surrounding organ systems. Alignment of patient and surgeon goals and expectations (elimination of symptoms, bulge, pain, excision of excessive skin, and so forth) before surgery will lead to improved patient satisfaction. Attention to these details will help improve patient outcomes, and further advances and research into these areas will continue to optimize treatment strategies and ultimately outcomes for all.