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Laparoscopic ventral hernia repair: primary versus secondary hernias
Anuradha Subramanian1, Marissa L Clapp, Stephanie C Hicks
1Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA.
The Journal of Surgical Research
|July 17, 2012
Summary
Laparoscopic ventral hernia repair (LVHR) outcomes differ between primary hernias (PHs) and secondary incisional hernias (SHs). SHs show higher recurrence, pain, and lower satisfaction, necessitating separate study groups.
Area of Science:
- General Surgery
- Minimally Invasive Surgery
Background:
- Laparoscopic ventral hernia repair (LVHR) studies often group primary hernias (PHs) and secondary incisional hernias (SHs).
- This grouping may obscure differences in LVHR outcomes between PHs and SHs.
- Distinct analysis is needed to accurately assess LVHR efficacy for different hernia types.
Purpose of the Study:
- To compare the outcomes of laparoscopic repair for primary hernias (PHs) versus secondary incisional hernias (SHs).
- To determine if combining PHs and SHs in studies leads to inaccurate conclusions about LVHR effectiveness.
Main Methods:
- Retrospective chart review of 201 LVHR cases (2000-2010) from two institutions.
- Analysis of patient demographics, comorbidities, hernia type, and complications.
- Postoperative pain, cosmetic satisfaction, and functional outcomes assessed via telephone survey.
Main Results:
- Secondary incisional hernias (SHs) were larger and associated with more comorbidities than primary hernias (PHs).
- SH repairs showed significantly higher recurrence rates (16% vs. 5%), mesh explantation (7% vs. 0%), and postoperative pain.
- Patients with SHs reported lower satisfaction scores and more chronic pain issues compared to PH patients.
Conclusions:
- Primary hernias (PHs) and secondary incisional hernias (SHs) exhibit distinct characteristics and outcomes after laparoscopic ventral hernia repair (LVHR).
- LVHR for SHs is linked to increased recurrence, pain, and diminished patient satisfaction.
- Future research should analyze LVHR for PHs and SHs separately to provide clearer insights.
