Occult ventral hernia defects: a common finding during laparoscopic ventral hernia repair

Background: In many incidences, laparoscopic exploration reveals occult ventral hernia defects that were not detected on physical examination. The objective of this study was to describe the frequency of occult ventral hernia defects detected during laparoscopy. Methods: Prospectively collected data on 146 consecutive patients who underwent laparoscopic ventral hernia repair were reviewed. The numbers of ventral defects found on preoperative physical examination were compared with those found during the laparoscopic procedure. Results: Out of 146 laparoscopic ventral hernia repair patients, 70 patients (48%) were found to have occult defects that were not detected on preoperative abdominal examination. Among all the possible variables, only the type of hernia was found to have a significant difference. Conclusion: Almost half of the patients with a ventral hernia have clinically occult hernia defects that can be recognized laparoscopically. This indicates the importance of careful inspection of the anterior abdominal wall during the surgical procedure. (c) 2008 Elsevier Inc. All rights reserved.