The Result of Conservative Management for Postoperative Seroma Following Laparoscopic Ventral Hernia Repair [LVHR]

Suppa-ut Pungpapong MD1, Fon Pakul MD1

Affiliation : 1 Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Background : Laparoscopic ventral hernia repair [LVHR] with mesh showed lower recurrent rate than suture repair, especially in defect size larger than 2 cm. Postoperative seroma formation was variable.
Materials and Methods : A retrospective descriptive review of 110 patients that received LVHR with mesh in King Chulalongkorn Memorial Hospital between January 2007 and December 2013 from collected database and medical records was done.
Results : The mean size of ventral hernia defect was 55 cm2 (range 4 to 300 cm2). Seven to fourteen days after LVHR, the seroma had been detected by clinical diagnosis in 19 patients (17.2%). Conservative management was success in 16 patients (84.2%). The mean size of seroma was 4.5 cm in diameter (range 2 to 10 cm), and the mean conservative time was two months. However, the conservative management failed in three patients (15.8%). Two patients (10.5%) received aspirated seroma at two and six months after conservative. Only one patient (5.3%) had infected seroma, managed by surgical drainage and mesh removal.
Conclusion : Almost all patients with postoperative seroma following LVRH were asymptomatic, could be observed safely, and succeeded conservative treatment within two months after operation. However, it might be necessary to perform interventional or surgical treatment if seroma was symptomatic, persisted more than two months, or became infected.

Keywords : Laparoscopic ventral hernia repair, Laparoscopic IPOM, Postoperative seroma

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