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Laparoscopic ventral hernia repair during the learning curve
J R Salameh1, J F Sweeney, E A Graviss
1Michael E DeBakey Department of Surgery, Baylor College of Medicine, Smith Tower, 6550 Fannin, Suite 1661, Houston, TX 77030, USA.
Hernia : the Journal of Hernias and Abdominal Wall Surgery
|November 9, 2002
Summary
Laparoscopic ventral hernia repair offers a shorter hospital stay compared to open repair. However, this minimally invasive approach presents risks, including unrecognized enterotomy and a potentially high risk-benefit ratio during the learning curve.
Area of Science:
- Abdominal Surgery
- Minimally Invasive Procedures
- Hernia Repair
Background:
- Laparoscopic ventral hernia repair (LVHR) shows promise but comparative studies yield conflicting results.
- Evaluating LVHR outcomes against traditional open repair is crucial for surgical practice.
Purpose of the Study:
- To compare the outcomes of laparoscopic ventral hernia repair with open repair.
- To assess the safety and efficacy of LVHR during its early adoption phase.
Main Methods:
- Retrospective review of 29 LVHR cases at a VA Medical Center (2000-2001).
- Comparison of LVHR outcomes with open repairs performed concurrently.
- Analysis of outcomes including length of stay, conversion rates, complications, and recurrence.
Main Results:
- LVHR demonstrated a significantly shorter hospital stay compared to open repair.
- Conversion rate for LVHR was 13.8%, with one mortality due to unrecognized enterotomy.
- Recurrence rates were comparable (1 in LVHR vs. 3 in open repair) with a 13-month follow-up.
Conclusions:
- LVHR offers a reduced hospital stay but lacks other significant benefits over open repair.
- Unrecognized enterotomy poses a risk, suggesting a potentially high risk-benefit ratio during the learning curve for LVHR.
