Laparoscopic Versus Open Repair of Ventral Hernia By A Prosthetic Mesh A Comparative Study
Saleem Jahangir, Salameh Al Dajah, sivanandan ramar, Altaf Ahmad Bhat, Seema Khan, I.K.Dhawan, V.Hangloo.
Abstract
Background: Ventral hernias, represent defects in the parietal abdominal wall fascia and muscle through which intra-abdominal or preperitoneal contents can protrude, such hernia may be asymptomatic or cause a considerable degree of discomfort, and generally enlarge over time. A hernia that cannot be reduced is described as incarcerated and will require emergent surgical correction.
Objectives: The present study is aimed to compare the effectiveness of laparoscopic repair over open mesh repair in the management of ventral hernias.
Materials and methods: it is a non-randomized observational study conducted in the department of General Surgery, Batra Hospital and Medical Research Center from February 2010 to December 2012. Forty four cases over the age of 18 years were studied prospectively, 22 cases with Laparoscopic Ventral hernia repair and 22 cases in Open Ventral hernia repair. Patients with uncomplicated umbilical, epigastria, and incisional hernia were selected.
Results: There was no statistically significant difference in the post-operative pain scores and analgesia requirements but on an average in laparoscopic ventral hernia repair post-operative pain was less severe and required less analgesia. Laparoscopic repair group recovered faster, were ambulant early, and started oral intake early with shorter hospital stay. Overall post-operative complications were higher in open group 5(25%) as compared to laparoscopic repair group 2(10%). Importantly there was no major post-operative complication in laparoscopic group while in case of open group there were 2 major post-operative complications. There was 1(5%) recurrence in open repair group and no recurrence in laparoscopic repair group.
Conclusion: Laparoscopic repair of ventral hernias is superior to open mesh repair in terms of significantly reduced blood loss, postoperative wound complications, hospital stay, decreased recurrence and excellent cosmetic outcome.
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