Complex Laparoscopic Abdominal Wall Reconstruction for Large Recurrent Hernia

RG Hospitals Pitampura has set a new benchmark in minimally invasive surgery by successfully performing a highly complex Laparoscopic Abdominal Wall Reconstruction (AWR) on a 60-year-old woman with large, recurrent ventral hernias and significant loss of abdominal domain. This challenging procedure was expertly led by Dr Manish D. Sharma, Head of Minimal Access, General, Robotic & Bariatric Surgery, further cementing RG Hospitals’ reputation as a leader in advanced laparoscopic treatments.

The patient reported to the hospital with infraumbilical swelling, pain and abdominal discomfort that had persisted for a week. A CT scan confirmed multiple defects across the supraumbilical, periumbilical and infraumbilical regions, with the largest measuring 5.2 × 5 cm, 10 × 4 cm and 6 × 3.5 cm, respectively.

Diagnostic imaging revealed multiple large hernia defects across the abdominal wall, presenting a “Swiss Cheese” pattern and about 15% loss of the abdominal cavity’s normal volume, an extremely rare and difficult-to-treat combination.

According to Dr Manish D. Sharma, this case demanded exceptional precision and planning due to the recurrent nature of the hernias and the extensive involvement of the abdominal wall.

He stated, “Repairing multiple large ventral hernias with loss of domain requires a high level of technical skill. Laparoscopic AWR allows us to restore the abdominal wall through small incisions while achieving a tension-free, anatomically accurate reconstruction. This significantly improves patient comfort, reduces complications and enhances long-term outcomes.”

The surgical team employed a specialised technique called Extended Total Extra-Peritoneal (E-TEP) repair for this minimally invasive Laparoscopic AWR. This included meticulous removal of adhesions, primary closure of all defects, and the placement of a durable mesh in the retromuscular space to reinforce the abdominal wall, all performed through small, keyhole incisions. The operation’s success highlights RG Hospitals’ ability to perform world-class hernia repairs generally available only at top-tier specialised centres globally.

This landmark surgery showcases RG Hospitals Pitampura’s pioneering role in delivering state-of-the-art, patient-centric care in complex minimally invasive abdominal surgery, reaffirming its commitment to improving outcomes for patients with challenging surgical conditions.