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Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
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Incisional hernias following gallstone surgery. A population-based study.
Andreas Howie1, Gabriel Sandblom2, Lars Enochsson3
1Department of Surgery, Mora Hospital, Mora, Sweden.
Summary
Laparoscopic cholecystectomy has a lower risk of incisional hernias (IH) than open surgery. Obesity and open surgical technique are key risk factors for developing IH after gallstone surgery.
Area of Science:
- Surgical outcomes and patient safety
- Gastroenterology and hepatology
- Public health and epidemiology
Background:
- Incisional hernia (IH) is a potential complication following abdominal surgery.
- Gallstone surgery, particularly cholecystectomy, is a common procedure with varying IH risks.
- Understanding IH incidence and risk factors is crucial for patient management.
Purpose of the Study:
- To determine the incidence of incisional hernia (IH) in a population-based cohort after gallstone surgery.
- To identify significant risk factors associated with IH development post-cholecystectomy.
Main Methods:
- Utilized data from the Swedish register for cholecystectomy and ERCP (2006-2014).
- Obtained post-procedural IH data from the National Patient Register.
- Analyzed a cohort of 81,964 cholecystectomies across different surgical techniques.
Main Results:
- The five-year cumulative IH incidence was 1.04% (laparoscopic), 3.37% (open), and 2.11% (minilaparotomy).
- Obesity (HR 4.11), open surgical technique (HR 2.97), and liver cirrhosis (HR 2.95) were major IH predictors.
- Other significant risk factors included chronic kidney disease, minilaparotomy, older age, and chronic pulmonary disease.
Conclusions:
- Laparoscopic cholecystectomy demonstrates a significantly lower risk of IH compared to open surgical approaches.
- Identifying and managing risk factors like obesity and comorbidities can potentially reduce IH incidence.
