Prospective randomized comparison between laparoscopic and conventional hernioplasty in the treatment of ventral abdominal hernias

Abstract

Objectives: This randomized prospective study compares the effectiveness of laparoscopic ventral hernioplasty to the conventional open hernioplasty. Patients and methods: Forty patients with ventral hernias were randomized into 2 equal groups. Group L treated by laparoscopic hernioplasty and Group O treated by open hernioplasty. Patients were followed for 35.5 ±15.3 months in Group L patients and 32.5 ±14.5 months in Group O patients. Results: Mean greater dimension of hernia defect was 6.40 ±2.76 cm in group L and 5.25 ±2.94 cms in Group O (p: 0.21). In group L, mean operative time was 59.4 ± 16.4 minutes. In group O it was 47.2 ±13.8 minutes (p: 0.016). Postoperative pain score 6 hours after surgery was 2.95±1.19 in group L patients versus 3.75 ± 0.786 in group O patients (p: 0.017). Group L patients needed a mean of 1.20 ± 0.410 ampoules of 100 mg Pethedine for analgesia in the first postoperative day versus 2.15 ± 0.671 ampoules in group O patients (p < 0.0001). Mean hospitalization time was 1.10 ±0.308 days in group L versus 1.45 ±0.605 days in group O (p: 0.027). We had 1 conversion (2.5%) to the open repair. Postoperative seroma occurred in 2 patients (5%) in group L and 2 patients (5%) in group O. Two patients (5%) in group O developed surgical site infection. Hernia recurrence was not seen in either Group. Mean patient satisfaction score for Group L patients was 7.90 ± 1.25 versus 6.00 ± 1.72 for Group O patients (p: 0.0003). Conclusion: Compared to open repair, laparoscopic repair is technically feasible, safe and effective, with good clinical outcome. It is associated with longer time for surgery but reduced post-operative pain, analgesic requirement, complication rate and infection rate and earlier return to normal activities.