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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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Open versus laparoscopic incisional hernia repair: nationwide database study.
N A Henriksen1, H Friis-Andersen2, L N Jorgensen3
1Department of Surgery, Zealand University Hospital, Koege, Denmark.
BJS Open
|February 20, 2021
Summary
Laparoscopic incisional hernia repair shows lower complication and recurrence rates than open repair, especially for defects 2-6 cm. Despite concerns, it remains a viable option for these cases.
Area of Science:
- Abdominal surgery
- Surgical oncology
- Hernia repair
Background:
- Laparoscopic incisional hernia repair offers fewer wound complications than open repair.
- Concerns exist regarding intraperitoneal mesh placement in laparoscopic procedures.
Purpose of the Study:
- To compare outcomes of open versus laparoscopic elective incisional hernia mesh repair nationwide.
- To evaluate readmission, reoperation for complication, and long-term recurrence rates.
Main Methods:
- Analysis of merged data from the Danish Hernia Database and National Patient Registry (2007-2018).
- Inclusion of patients undergoing primary incisional hernia repair.
- Assessment of perioperative information, 90-day readmission/reoperation, and long-term recurrence.
Main Results:
- Laparoscopic repair (57.5%) had significantly lower readmission (16.2% vs 19.3%) and reoperation for complication rates (7.0% vs 12.5%) than open repair (42.5%).
- Reoperation for bowel obstruction/resection was higher after laparoscopic repair (0.6% vs 0.3%).
- Laparoscopic repair was associated with significantly lower rates of recurrence repair for defects 2-6 cm.
Conclusions:
- Laparoscopic intraperitoneal mesh repair is suitable for incisional hernias with fascial defects of 2-6 cm.
- It demonstrates reduced early complications and hernia recurrence rates compared to open repair.
- This approach should be considered despite concerns about mesh placement.
