Laparoscopic Ventral Hernia Repair in Patients with Child C Cirrhosis: Our Experience

Cirrhosis with refractory ascites was considered a contraindication to laparoscopic surgery,1 until recently. However, current literature has shown the efficacy and safety of various laparoscopic procedures in the diagnosis and management of surgical conditions in cirrhotic patients. The incidence of ventral hernias in cirrhotic patients with tense ascites is high. It is well known that open hernia repair in patients with ascites is associated with high morbidity and mortality due to ascitic leak from wound site, wound infection and high recurrence rate.2,3 In view of high complication rate for surgical repair in these patients most surgeons defer elective repair of hernias in these patients. But, left alone ventral hernias in such patients may undergo complications, such as rupture, obstruction, strangulation, which are life-threatening. Hence, elective surgical repair of ventral hernias in these patients should be considered. Laparoscopic ventral hernia repair in these patients helps to overcome the complications and allows earlier recovery. There have been very few studies to evaluate the efficacy of laparoscopic ventral hernia repair in patients with child A cirrhosis. However, there is no literature on efficacy of this procedure in child C cirrhotic patients. This is a retrospective study to evaluate the efficacy of laparoscopic repair using a dual mesh in child C cirrhotic patients with tense ascites and complicated ventral hernias.