A comparative study of closure versus non-closure of hernial defect in laparoscopic ventral hernia mesh repair


  • Nandeesh M. Department of General surgery, Kanachur Institute of Medical sciences, Mangalore, Karnataka, India
  • Akash M. V. Department of General surgery, Kanachur Institute of Medical sciences, Mangalore, Karnataka, India




Intraperitoneal onlay mesh plus, Intraperitoneal onlay mesh, Laparoscopic hernia defect closure versus non-closure, Laparoscopic ventral hernia repair


Background: Laparoscopic ventral hernia repair has better out comes when compared to open mesh repair. But closure of the hernial defect is still a contentious issue. This study is designed to compare the outcome of closure versus non-closure of hernia defect in laparoscopic ventral hernia repair.

Methods: A 2 years prospective randomized controlled study was conducted on 60 patients undergoing elective laparoscopic ventral hernia repair in the Department of General Surgery (November 2016 to October 2018).

Results: The patients in the two groups were analyzed using Chi-square, ANOVA, Fisher exact test, and results were formulated. The mean age of ventral hernia was 41 years and overall incidence more in females. Paraumbilical hernia is the commonest variety of ventral hernia and 63.3% hernias were reducible. Average post-operative length of hospital stay was 2 days with no difference in both the groups. Post-operative pain was more in intraperitoneal onlay mesh (IPOM) plus group. Seroma formation and Incidence of mesh bulge was found be more in IPOM group, but there was no difference in the incidence of chronic pain or recurrence rate between the two groups. All the above proved statistical significance.

Conclusions: Primary defect closure in ventral hernia along with mesh placement in laparoscopy seems to have better outcome, with respect to less chance of seroma formation and mesh bulge.


Clapp ML, Hicks SC, Awad SS, Liang MK. Trans-cutaneous closure of central defects (TCCD) in laparoscopic ventral hernia repairs (LVHR). World J surg. 2013;37(1):42-51.

Rea R, Falco P, Izzo D, Leongito M, Amato B. Laparocopic ventral hernia repair with primary transparietal closure of the hernial defect. BMC surg. 2012;12(1):S33.

Bittner R, Montgomery MA, Arregui E, Bansal V, Bingener J, Bisgaard T, et al. Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society). Surg endoscopy. 2015;29(2):289-321.

Zeichen MS, Lujan HJ, Mata WN, Maciel VH, Lee D, Jorge I, et al. Closure versus non-closure of hernia defect during laparoscopic ventral hernia repair with mesh. Hernia. 2013;17(5):589-96.

Suwa K, Okamoto T, Yanaga K. Closure versus non-closure of fascial defects in laparoscopic ventral and incisional hernia repairs: a review of the literature. Surg today. 2016;46(7):764-73.

Franklin ME, Dorman JP, Glass JL, Balli JE, Gonzalez JJ. Laparoscopic ventral and incisional hernia repair. Surg laparoscopy endoscopy. 1998;8(4):294-9.

Sharma A, Mehrotra M, Khullar R, Soni V, Baijal M, Chowbey PK. Laparoscopic ventral/incisional hernia repair: a single centre experience of 1,242 patients over a period of 13 years. Hernia. 2011;15(2):131-9.

Strey CW. Triple-step laparoscopic incisional hernia repair: midline suture closure supported by dorsal component separation and intraperitoneal onlay mesh reinforcement. World journal of surgery. 2014;38(12):3276-9.

Gonzalez AM, Romero RJ, Seetharamaiah R, Gallas M, Lamoureux J, Rabaza JR. Laparoscopic ventral hernia repair with primary closure versus no primary closure of the defect: potential benefits of the robotic technology. The Intern J Med Robotics and Computer Assisted Surg. 2015;11(2):120-5.






Original Research Articles