Case Report- Evaluation of the mesh fixation technique in laparoscopic incisional hernioplasty

The laparoscopic repair of incisional hernias still has controversial aspects, among which is the technique for mesh fixation to the posterior abdominal wall. Whereas some authors advocate single fixation with mechanical suture, others recommend a combined fixation of transmural sutures and staples.
Case history: We report the case of a recurrent incisional hernia, which was treated via the laparoscopic approach and found to be caused by a failure in mesh fixation. The re-operation was completed via laparoscopy and 12 months after surgery she remains asymptomatic with no apparent recurrence.
Conclusion: (1) ′Ideal mechanical fixation′ does not yet exist and must always be tested before the operation can be considered completed and (2) folds or creases in double-layer meshes must be avoided as they seem to favour the formation of visceral adhesions.