Post-operative Pain Outcomes of Laparoscopic Ventral Hernia Repair (LVHR): An eight-year experience

Abstract

Objective:To evaluate post-operative pain, recovery time and standard of living in patients undergoing LVHR in detail. Study design and Setting: This prospective cohort study was conducted at a tertiary care hospital of Karachi, Pakistan,after getting approval from the “National Medical Centre EthicalReview Board”, from January 2011 to December 2019, Methodology: Total n= 577 patients undergoing standard LVHR procedure (defect closed with non-absorbable monofilamentsuture, reinforced with intra-abdominal dual layer mesh, anchored with non-absorbable tacks & sutures). Patient demographics,perioperative & postoperative findings and post-operative pain analysis were investigated and presented as descriptivestatistics. Follow-up was carried out at 1stweek, 2ndweek, 3rdmonthly, 6 monthly and 12 monthly post-operative appointments. Results: During the study period of nine years (January 2011 to December 2019), 577 patients (primary ventral hernia n=232, recurrent ventral hernian=188 patients, incisional hernian=157) underwent LVHR. Mean post-operative hospitalstay was 1.53 ± 1.8 days. Mean post-operative pain assessment onvisual analog scale (VAS) after surgery (0-3days) wasreported to be 38.5±29 by 65 patients out of 577 (11.26%), which significantly decreased at the end of 1st week to 27.9 ± 25.6. Only 3 patients (0.51%) reported chronic pain during the span of 3-6 months. Conclusion: LVHR was associated with considerably less post-operative pain, shorter hospital stay and reduced time of convalescence. It is demonstrated that LVHR to be a safe and superior approach for the repair ventral hernias

Evaluation of outcome of systemic tranexamic acid injection in drain output in ventral hernia repair

“…After surgery abdominal wall restores only 80% tensile strength and operating at incisional site restores around 64% of tensile strength in a healthy individual (2)(3)(4)(5). Clinically the presentation of ventral hernia varies among individuals some may remain asymptomatic for many weeks to months while some patients present with strangulation or in-carceration with the need to be operated in emergency (6,7). Elective repairs have good outcomes as compared to emergency repairs.…”

“…Elective repairs have good outcomes as compared to emergency repairs. Mortality after strangulated hernial repairs have been reported in 5% of cases (6)(7)(8). Studies have shown reduction in complications in ventral hernia with use of tranexamic acid.…”