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7032488 
Journal Article 
Laparoscopic repair of suprapubic incisional hernias: suturing and intraperitoneal composite mesh onlay. A retrospective study 
Palanivelu, C; Rangarajan, M; Parthasarathi, R; Madankumar, MV; Senthilkumar, K; , 
2008 
Yes 
Hernia
ISSN: 1265-4906
EISSN: 1248-9204 
SPRINGER 
NEW YORK 
251-256 
18253807 
WOS:000260826900007 
Background Suprapubic hernias are those defects located 4 cm from the pubic symphysis. Our aim is to highlight the laparoscopic repair of suprapubic incisional hernias.Patients and methods We retrospectively reviewed 17 patients with suprapubic incisional hernias from 1999 to 2007. A modified technique of laparoscopic intraperitoneal composite mesh onlay was performed for these patients.Results There were 12 females and 5 males with a mean age of 55.9 years and a mean BMI of 30 kg/ m(2). The mean hernia size was 87.5 cm(2), with an average mesh size of 234 cm(2). Mean follow-up was 9 months. Complications were seen in five patients, with an overall recurrence rate of 5.8%. Discussion Suprapubic hernias are difficult to manage because of the complexity of dissection and their anatomic proximity to bony, vascular and nerve structures. The lower end of the mesh should be fixed to the Cooper's ligament and the pubic bone. Laparoscopic repair of these uncommon hernias is safe, effective and provides all the benefits of minimally invasive surgery.