An overview of laparoscopic versus open incisional hernia repair

Authors

  • D. Boopathy Department of Surgery, Sri Venkateshwaraa Medical College and Hospital, Redhills, Chennai, Tamil Nadu, India
  • P. K. Asokan Department of Surgery, Ponneri Government Hospital, Chennai, Tamil Nadu, India
  • T. R. Yeshwanth Department of Surgery, Sri Venkateshwaraa Medical College and Hospital, Redhills, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20233015

Keywords:

Hernia repair, Laparoscopy, Open incision

Abstract

Background: An incisional hernia is perceived as a morbidity following an abdominal wall operation. Risk factors that increase the chances of developing these hernias are wound infection, male sex, obesity, abdominal distension, underlying disease process and occasionally poor surgical closure. The aim of this study was to compare laparoscopic vs open incisional hernia repair with regard to postoperative pain and nausea, operative time, postoperative complications and length of hospital stay.

Methods: We conducted retrospective review of consecutive patients with hernia in department of surgery, Sri Venkateshwaraa Medical College and Hospital, Redhills, Chennai, Tamil Nadu between September 2022 to February 2023 (6 months). We analyzed 140 patients that met the inclusion criteria and their clinical data. The patients were divided into two groups: open incision hernia repair (OI=70) group and laparoscopic hernia repair (LR=70) group.

Results: In our study, the mean operative time of 99.64±13.1 min for the laparoscopic repair group was longer than the mean operative time of 74.64±9.14 min for open repair (p =0.264). Hospital stay was not significantly in the laparoscopic group with a mean of 2.4±0.6 days compared with 2.8±1.4 of the open repair group (p=0.0515).

Conclusions: Smaller incisional hernias with a transverse diameter <10 cm can be repaired successfully by a laparoscopic approach if a suitably skilled surgeon is available, although an ugly scar may remain on the anterior abdominal wall. Major defects >10 cm was best repaired by an open operation.

References

Henriksen NA, Jensen KK, Muysoms F. Robot-assisted abdominal wall surgery: a systematic review of the literature and meta- analysis. Hernia. 2019;23(1):17-27.

Muysoms F. IPOM: history of an acronym. Hernia. 2018;22(5):743-6.

LeBlanc KA, Booth WV. Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endosc. 1993;3(1):39-41.

Tandon A, Pathak S, Lyons NJ, Nunes QM, Daniels IR, Smart NJ. Meta-analysis of closure of the fascial defect during laparoscopic incisional and ventral hernia repair. Br J Surg. 2016;103(12):1598-607.

Patel PP, Love MW, Ewing JA, Warren JA, Cobb WS, Carbonell AM. Risks of subsequent abdominal operations after laparo- scopic ventral hernia repair. Surg Endosc. 2017;31(2):823-8.

Kokotovic D, Bisgaard T, Helgstrand F. Long-term recurrence and complications associated with elective incisional hernia re- pair. JAMA. 2016;316(15):1575-82.

Baker JJ, Oberg S, Andresen K, Klausen TW, Rosenberg J. Systematic review and network meta-analysis of methods of mesh fixation during laparoscopic ventral hernia repair. Br J Surg. 2018;105(1):37-47.

Belyansky I, Daes J, Radu VG, Balasubramanian R, Zahiri H, Weltz AS, et al. A novel approach using the enhanced-view totally extraperitoneal (eTEP) technique for laparoscopic retro- muscular hernia repair. Surg Endosc. 2018;32(3):1525-32.

Reinpold W, Schroder M, Berger C, Nehls J, Schroder A, Hukauf M, et al. Mini- or less-open sublay operation (MILOS): a new minimally invasive technique for the extraperitoneal mesh repair of incisional hernias. Ann Surg. 2019;269(4):748-55.

Helgstrand F, Jorgensen LN. The Danish Ventral Hernia Database-a valuable tool for quality assessment and research. Clin Epidemiol. 2016;8:719-23.

Kockerling F, Simon T, Hukauf M, Hellinger A, Fortelny R, Reinpold W, et al. The importance of registries in the post marketing surveillance of surgical meshes. Ann Surg. 2018;268(6):1097-104.

Helgstrand F, Thygesen LC, Bisgaard T, Jorgensen LN, Friis-Andersen H. Differential recurrence after laparoscopic incisional hernia repair: importance of a nationwide registry-based mesh surveillance. Br J Surg. 2020;107(9):1130-6.

Sundararajan V, Henderson T, Perry C, Muggivan A, Quan H, Ghali WA. New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality. J Clin Epidemiol. 2004;57(12):1288-94.

WHO. ICD-10 Online Versions. Available at: https://wwwwhoint/classifications/icd/icdonlineversions/en/. Accessed on 26 December 2019.

Sauerland S, Walgenbach M, Habermalz B, Seiler CM, Miserez M. Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst Rev. 2011;(3):007781.

Zhang Y, Zhou H, Chai Y, Cao C, Jin K, Hu Z. Laparoscopic versus open incisional and ventral hernia repair: a systematic review and meta-analysis. World J Surg. 2014;38(9):2233-40.

Awaiz A, Rahman F, Hossain MB, Yunus RM, Khan S, Memon B, et al. Meta-analysis and systematic review of laparoscopic versus open mesh repair for elective incisional hernia. Hernia. 2015;19(3):449-63.

Arita NA, Nguyen MT, Nguyen DH, Berger RL, Lew DF, Suliburk JT, et al. Laparoscopic repair reduces incidence of surgical site infections for all ventral hernias. Surg Endosc. 2015;29(7):1769-80.

Sanjay P, Reid TD, Davies EL, Arumugam PJ, Woodward A. Retrospective comparison of mesh and sutured repair for adult umbilical hernias. Hernia. 2005;9(3):248-51.

Usher FC, Ochsner J, Tuttle LL. Use of marlex mesh in the repair of incisional hernias. Am Surg. 1958, 24:969-7 Am Surg. 1958;24(12):969-74.

Olmi S, Scaini A, Cesana GC, Erba L, Croce E. Laparoscopic versus open incisional hernia repair: an open randomized controlled study. Surg Endosc. 2007;21(4):555-9.

Misra MC, Bansal VK, Kulkarni MP, Pawar DK. Comparison of laparoscopic and open repair of incisional and primary ventral hernia: results of a prospective ran- domized study. Surg Endosc. 2006;20(12):1839-45.

McGreevy JM, Goodney PP, Birkmeyer CM, Finlayson SR, Laycock WS, Birk-meyer JD. A prospective study comparing the complication rates between lapa- roscopic and open ventral hernia repairs. Surg Endosc. 2003;17(11):1778-80.

Navarra G, Musolino C, De Marco ML, Bartolotta M, Barbera A, Centorrino T. Retromuscular sutured incisional hernia repair: a randomized controlled trial to compare open and laparoscopic approach. Surg Laparosc Endosc Percutan Tech. 2007;17(2):86-90.

Moreno-Egea A, Carrasco L, Girela E, Martin JG, Aguayo JL, Canteras M. Open vs laparoscopic repair of spigelian hernia: a prospective randomised trial. Arch Surg. 2002;137:1266-8.

Carbajo MA, Mart´ın del Olmo JC, Blanco JI. Laparoscopic treatment vs open surgery in the solution of major incisional and abdominal wall hernias with mesh. Surg Endosc. 1999;13(3):250-2.

Barbaros U, Asoglu O, Seven R. The comparison of laparoscopic and open ventral hernia repairs: a prospective randomized study. Hernia. 2007;11(1):51-6.

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Published

2023-09-29

How to Cite

Boopathy, D., Asokan, P. K., & Yeshwanth, T. R. (2023). An overview of laparoscopic versus open incisional hernia repair. International Journal of Research in Medical Sciences, 11(10), 3662–3666. https://doi.org/10.18203/2320-6012.ijrms20233015

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Original Research Articles