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To evaluate the short term recurrence, pain scores, infection rates and cost factors by using 5cm all around composite mesh reinforcement of the closed defect after endoscopic video-assisted component separation for large ventral hernia repair.


All patients who were clinically assessed to have large (≥5cm diameter of defect) midline ventral hernia underwent an abdominal CT as per protocol to calculate the Component Separation Index and were subjected to endoscopic video-assisted component separation. Next laparoscopy is done, hernial contents were reduced with adhesiolysis and midline defect is closed vertically with VLoc sutures, under physiologic tension. The closed suture line is reinforced with a mesh having a 5cm all round overlap irrespective of the original hernia defect.


A total of 30 patients were operated. Over a follow up period ranging from 3-18 months there were no recurrences, no surgical site infection, no seroma formation, no mesh infection, fewer tackers were required resulting in more favorable pain scores. Due to smaller mesh and fewer tackers there was significant cost reduction per case.


Endoscopic component separation technique is useful in tension less large midline ventral hernia repair. Only 5cm all around mesh reinforcement of midline closure is required thus significantly cutting down the cost of surgery with excellent patient outcome.


endoscopic component separation mesh repair laparoscopic repair ventral hernia

Article Details

Author Biographies

Ravi Kumar Gupta, Department of cardiothoracic surgery, GB Pant Hospital, New Delhi, India

Senior resident

Satyajit Samal, Department of cardiothoracic surgery, GB Pant Hospital, New Delhi

Senior resident

Nishit Shrivastava, Department of Surgical Oncology, Tata Memorial Centre Mumbai, India

Senior resident

Romesh Lal, Department of General Surgery Lady Hardinge Medical College, New Delhi, India.

director professor

How to Cite
Kumar Gupta, R., Samal, S., Shrivastava, N., Sharma, . D., & Lal, R. (2021). Evaluation of outcomes of 5cm all-around mesh reinforcement after endoscopic component separation and midline closure during laparoscopic ventral hernia repair. Journal of Gastric Surgery, 3(2).


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