Laparoscopic versus open incisional hernia repair: comparative non-randomized study

Mohamed, Wael Barakaat Ahmed; Abdelmgeed, Magdy Khalil

doi:10.18203/2349-2902.isj20172769

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…The open access surgical technique includes: incision at the site of the previous scar or hernia defect, adhesiolysis, measurement of the defect and plan for mesh placement, intraperitoneal placement of the mesh and fixation with transfacial sutures (on average 8 sutures) with overlap of 3-5 cm depending on the size of the defect, closing the defect (if possible), drainage in certain cases. [9,10] The surgical technique for laparoscopic approach includes: pneumoperitoneum -by open method or with a Veress needle, placing working troacar as far away from the defect as possible, adhesiolysis, measuring the defect and placing the mesh intraperitoneally and fixation of the mesh with the transfascial sutures and absorbable tackers ("Double -Crown") at a distance of about 1.5-2.5 cm. [11,12]…”

Section: Surgical Proceduresmentioning

confidence: 99%

Comparative Analysis between Laparoscopic and Open IPOM Ventral Hernioplasty

Kadri¹,

Panikj²,

Mladenovic³

et al. 2020

JHMN

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Introduction: In everyday surgical practice, ventral hernia repair is one of the most commonly performed surgeries worldwide. Ventral hernioplasty can be performed either with open or laparoscopic approach and in this study both approaches use the IPOM technique of mesh placement. From the clinical experience so far, the laparoscopic approach is characterized by a lower rate of early postoperative complications, shorter hospital stay and a period of convalescence. The aim of the study was to compare early postoperative complications, duration of surgery, hospital stay, recurrence in the first year and convalescence period between patients undergoing open and laparoscopic access with IPOM ventral hernioplasty. Material and methods: The study was designed as a randomized, prospective, comparative study of 63 patients who met the inclusion criteria, operated by IPOM technique and divided into two groups: open access to 32 patients and laparoscopic access to 31 patients. Early postoperative complications, duration of surgery, hospital stay, recurrence in the first year, and convalescence were compared in both groups. Statistical processing and data analysis was performed in the statistical programme SPSS version 23.0. Values of p <0.05 were taken as statistically significant. Results: Regarding the early postoperative complications, it was found that the occurrence of seroma is more common in the laparoscopic group (p = 0.013), while in open hernioplasty the number of surgical site infections is significantly higher (p = 0.03). The hospital stay expressed in days is longer in open hernioplasty (p = 000001). Regarding the duration of the operation (p = 0.8) and the period of convalescence (p = 0.28), there is no statistically significant difference between the two groups. Discussion: The results shown by our experience shows that laparoscopic ventral IPOM hernia repair is characterized by lower rates of SSI, a shorter hospital stay, but without statistical significant benefit in terms of a period of convalescence, duration of surgery and recidive rate in the first year. Тhe choice of treatment and access should be based according to individual patient characteristics. A laparoscopic approach, due to its minimal invasiveness, should be more common in ventral hernioplasty.

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Section: Surgical Proceduresmentioning

confidence: 99%

Comparative Analysis between Laparoscopic and Open IPOM Ventral Hernioplasty

Kadri¹,

Panikj²,

Mladenovic³

et al. 2020

JHMN

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“…9,10 The surgical technique for laparoscopic approach includes: pneumoperitoneum -by open method or with a Veress needle, placing working troacar as far away from the defect as possible, adhesiolysis, measuring the defect and placing the mesh intraperitoneally and fixation of the mesh with the transfascial sutures and absorbable tackers ("Double -Crown") at a distance of about 1.5-2.5 cm. 11,12…”

Section: Surgical Proceduresmentioning

confidence: 99%

Comparison of the Intensity of Postoperative Pain Between Open and Laparoscopic Access of Ventral Hernioplasty with IPOM (Intraperitoneal Onlay Mesh) Technique

2020

JHMN

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Introduction: Despite the numerous advantages of laparoscopic ventral hernioplasty over the open access hernioplasty, described in the literature, the general clinical experience is that patients have severe pain in the first few days, hence early postoperative pain is a challenge in this procedure.The aim of this study was to compare early postoperative pain and whether there was statistically significant difference in the intensity of postoperative pain among patients operated with open and laparoscopic approach with IPOM hernioplasty during resting and activity.Material and methods: A randomized, prospective, comparative study was performed on 63 patients who met the inclusion criteria, operated with the IPOM technique and divided into two groups: open access in 32 patients and laparoscopic approach in 31 patients. In both groups, postoperative pain was compared at eight time intervals during rest and activity, quantified using VAS. The statistical processing and analysis of the data was done in the statistical programme SPSS version 23.0.Results: The results of the study showed that at rest and activity, patients in both groups had significantly different pain intensities on the day of the intervention, the first and second day after the intervention (p<0.0001). At these time points, the intensity of pain was significantly stronger in patients undergoing laparosopic hernioplasty. On the third and seventh postoperative days, as well as one and six months after the intervention, there was no significant difference in pain intensity between the two methods during rest and activity.Discussion: The general clinical experience confirmed in our study is that patients after laparoscopic ventral hernioplasty suffer from severe pain in the early postoperative period and it is the biggest challenge and problem after these operations. The explanation is that it is the result of transfascial sutures for mesh fixation in both groups and additionally multiple lesions of the parietal peritoneum in the laparoscopic method due to the numerous fixations of the mesh with tackers. Future research should focus on developing new non-traumatic methods for mesh fixation (Fibrin Glue) and studies that will analyse in detail the impact of postoperative pain on quality of life.

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A Clinical Study of Anterior Abdominal Wall Hernias and Its Management: A Medical College Experience

Ali,

Shetty K,

Shetty

2024

Cureus

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Objective We aim to evaluate the various risk factors contributing to the occurrence of anterior abdominal wall hernias and assess the various surgical modalities. Materials and methods This prospective observational research was conducted between 2022 and 2024 at a tertiary care health center, involving 100 participants with an anterior abdominal wall hernia diagnosis aged over 14 years. The study excluded patients under 14 years with bleeding diathesis, inherited coagulopathies, inguinal or femoral hernias, or recurrent ventral hernias. Participants underwent detailed clinical examinations and biochemical evaluations and underwent a primary ultrasonography (USG)/contrast-enhanced computed tomography (CECT) to determine defect size. Risk factors were documented, including age, gender, occupation, body mass index (BMI), comorbidities, previous surgery history, multiparity, smoking, chronic straining due to constipation or benign prostatic hyperplasia (BPH), malnutrition, chronic steroid use, chronic renal failure, and chronic liver disease. The surgical procedure was determined by the same surgical team for all cases. Standard antibiotic prophylaxis and preoperative painting/draping protocols were followed in all cases. Intraoperatively, intraoperative time (in hours) was documented. Postoperative parameters included pain, hematoma formation, seroma formation, surgical site infections (SSIs), and early recurrence. These intra- and postoperative findings constituted the primary outcome parameters. Secondary outcome parameters included hospital stay duration and time taken to return to work. Data analysis was performed using Statistical Package for the Social Sciences (SPSS) version 16 (IBM SPSS Statistics, Armonk, NY) software. Results The study analyzed the occurrence of ventral hernias in 100 patients, with the fourth decade having the highest occurrence (n=42 (42%)). The majority of the participants were male (female: n=47 (47%), male: n=53 (53%)). The majority of the participants were laborers, and 24% (n=24) were office workers. The study found that hypertension, diabetes mellitus, and chronic obstructive pulmonary disease were risk factors for hernias. Other risk factors included obesity, previous history of surgery, multiparity, smoking, chronic straining, malnutrition, and chronic steroid use. The most common type of ventral hernia was umbilical hernia (n=33 (33%)), followed by paraumbilical hernias (n=30 (30%)), and incisional hernias (n=20 (20%)). Of the 100 patients, 74% underwent open hernia repair, with the mean operation time being minimal in cases managed with laparoscopic repair (2.5±0.67 hours). Postoperative pain was highest with the Rives-Stoppa (RS) repair with component separation group. The incidence of surgical site infection was the maximum among cases of open anatomical repair (41.7%), followed by RS repair (31.3%), while it was the minimum in laparoscopic repair (3.7%). Early recurrence was lower in the laparoscopic group (n=1 (...

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Laparoscopic versus open incisional hernia repair: comparative non-randomized study

Cited by 3 publications

References 14 publications

Comparative Analysis between Laparoscopic and Open IPOM Ventral Hernioplasty

Comparative Analysis between Laparoscopic and Open IPOM Ventral Hernioplasty

Comparison of the Intensity of Postoperative Pain Between Open and Laparoscopic Access of Ventral Hernioplasty with IPOM (Intraperitoneal Onlay Mesh) Technique

A Clinical Study of Anterior Abdominal Wall Hernias and Its Management: A Medical College Experience

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