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Laparoscopic versus open ventral hernia mesh repair: a prospective study.
D Lomanto1, S G Iyer, A Shabbir
1Minimally Invasive Surgical Centre, Department of Surgery, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore. surdl@nus.edu.sg
Surgical Endoscopy
|May 17, 2006
Summary
Laparoscopic ventral hernia repair offers a safe alternative to open repair, showing reduced complications, shorter hospital stays, and lower recurrence rates. This minimally invasive approach is recommended for ventral hernia repair.
Area of Science:
- Abdominal surgery
- Minimally invasive surgery
- Hernia repair
Background:
- Incisional hernias occur in 3-13% of laparotomies, with open repair yielding high recurrence rates.
- Prosthetic mesh reduces recurrence but open repair involves extensive dissection and flap creation, increasing complications.
- Minimally invasive laparoscopic repair aims for faster recovery, fewer complications, and reduced recurrence.
Purpose of the Study:
- To prospectively compare outcomes of open versus laparoscopic ventral hernia repair.
- To objectively analyze complication rates, recurrence, and recovery times between the two surgical approaches.
Main Methods:
- A prospective study comparing 50 laparoscopic ventral hernia repairs (intraperitoneal onlay mesh - IPOM) with 50 open repairs (Rives and Stoppa techniques).
- Patients were unselected, and outcomes were compared based on defect size, operative time, hospital stay, pain, complications, and recurrence.
- Mean follow-up was 20.8 months.
Main Results:
- Laparoscopic group had larger defects (93.96 vs 55.88 cm2) but similar operative times (90.6 vs 93.3 min).
- Shorter postoperative stay (2.7 vs 4.7 days) and less pain at 72 hours were observed in the laparoscopic group.
- Fewer complications (24% vs 30%) and significantly lower recurrence rates (2% vs 10%) were noted with laparoscopic repair.
Conclusions:
- Laparoscopic ventral hernia repair is safe and effective, demonstrating advantages over open repair.
- The procedure offers shorter operative times, fewer complications, reduced hospital stays, and less recurrence.
- Laparoscopic repair should be considered the preferred method for ventral hernia repair.