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Concomitant laparoscopic intraperitoneal onlay mesh repair with other clean contaminated procedures-study of
Palanivelu Praveen Raj1, Meesabile K Ganesh, Palanisamy Senthilnathan
1Department of Surgical Gastroenterology, Gem Hospital & Research Centre , Coimbatore, Tamil Nadu, India .
Background:
Laparoscopic ventral hernia mesh repair has gained wide popularity with the benefits of shorter hospital stay, improved patient outcome, and fewer complications compared with traditional open procedures. It also offers the advantage of combining procedures at different quadrants of the abdomen. In this article we have retrospectively studied the safety of combining laparoscopic intraperitoneal onlay mesh (IPOM) repair with clean contaminated surgeries like cholecystectomy and hysterectomy.
Materials And Methods:
The data of all patients who received concomitant laparoscopic ventral hernia repairs along with cholecystectomy and hysterectomy were collected retrospectively. The details of these surgeries and the immediate postoperative outcome parameters were analyzed.
Results:
Between January 2006 and January 2011, 246 cases of laparoscopic IPOM in combination with clean contaminated surgeries were performed. Of these, 126 were hysterectomies, and 120 were cholecystectomies. Mean operating time for laparoscopic IPOM with cholecystectomy was 136 minutes (range, 112-172 minutes), and that for laparoscopic IPOM with hysterectomy was 224 minutes (range, 196-285 minutes). The average hospital stays were 4.3 days (range, 3-7 days) for laparoscopic IPOM with hysterectomy and 2.73 days (range, 1-5 days) for laparoscopic IPOM with cholecystectomy. Thirty-six patients (14.6%) developed seroma, for which 16 patients (6.5%) warranted aspiration. We had 0.8% mesh infection in total. The recurrence rates were 0.83% (n=1) in the cholecystectomy group and 0.8% (n=1) in the hysterectomy group.
Conclusions:
Laparoscopic IPOM can be performed simultaneously with selected clean contaminated surgeries with acceptable morbidity. Combining clean contaminated surgeries does not significantly alter the outcome of the procedure.
Insights
Laparoscopic ventral hernia repair combined with surgeries like hysterectomy or cholecystectomy is safe and effective. This approach offers acceptable morbidity and does not significantly impact patient outcomes.
Area of Science:
- Minimally Invasive Surgery
- Abdominal Surgery
- Surgical Oncology
Background:
- Laparoscopic ventral hernia mesh repair offers benefits over open procedures, including shorter hospital stays and fewer complications.
- Combining procedures in different abdominal quadrants is an advantage of laparoscopic surgery.
- This study investigates the safety of combining laparoscopic intraperitoneal onlay mesh (IPOM) repair with clean-contaminated surgeries.
Purpose of the Study:
- To evaluate the safety and outcomes of combining laparoscopic intraperitoneal onlay mesh (IPOM) repair with hysterectomy and cholecystectomy.
- To assess the morbidity associated with simultaneous laparoscopic ventral hernia repair and clean-contaminated procedures.
Main Methods:
- Retrospective analysis of patients undergoing concomitant laparoscopic IPOM repair with either hysterectomy or cholecystectomy.
- Collected data on surgical details and immediate postoperative outcomes.
- Analyzed parameters including operating time, hospital stay, seroma formation, mesh infection, and recurrence rates.
Main Results:
- 246 cases were analyzed: 126 with hysterectomy and 120 with cholecystectomy.
- Average operating times were 136 minutes (IPOM + cholecystectomy) and 224 minutes (IPOM + hysterectomy).
- Average hospital stays were 2.73 days (IPOM + cholecystectomy) and 4.3 days (IPOM + hysterectomy).
- Seroma occurred in 14.6% of patients, with 6.5% requiring aspiration.
- Mesh infection rate was 0.8%, and recurrence rates were 0.83% (cholecystectomy group) and 0.8% (hysterectomy group).
Conclusions:
- Laparoscopic IPOM repair can be safely performed simultaneously with selected clean-contaminated surgeries.
- The combination of these procedures demonstrates acceptable morbidity.
- Simultaneous clean-contaminated surgeries do not significantly alter the outcomes of laparoscopic IPOM repair.
