Comparative outcomes of open retrorectus versus laparoscopic intraperitoneal onlay mesh repair of ventral hernia in a tertiary care center

Authors

  • Vivek V. Mukhamale Department of General Surgery, Seth. G. S. Medical College and KEMH, Parel, Mumbai, India
  • Bhushankumar A. Thakur Department of General Surgery, Seth. G. S. Medical College and KEMH, Parel, Mumbai, India
  • Snehal Deotale Department of General Surgery, Seth. G. S. Medical College and KEMH, Parel, Mumbai, India
  • Rajas Mudgerikar Third year MBBS Student, Seth. G. S. Medical College and KEMH, Parel, Mumbai, India

DOI:

https://doi.org/10.18203/2349-2902.isj20211302

Keywords:

IPOM, Retrorectus, Ventral hernia

Abstract

Background: The combined Rives-Stoppa technique has been adopted as the gold standard for open incisional hernia repair. Laparoscopic intraperitoneal onlay mesh (IPOM) hernioplasty is a newer technique in managing ventral hernia. Based on this we have done single institution retrospective study of IPOM and open rectrorectus mesh repair for ventral hernia with size less than 5 cm.

Methods: This study was single institution retrospective study, where we have analyzed the data of 30 patients in each group of ventral hernia, with median 18 months of follow up. Their data analyzed for demographics, surgical site occurrence and short terms recurrence.

Results: Our study consists of 30 heterogenous population with similar age distribution in each group, mean time for surgery was 70.83 min for open and 66.33 minutes for IPOM. There was surgical site infection in 3 patients operated by open procedure and 2 patients in IPOM procedure. Duration of hospital stay which is more in open retrorectus repaired patients, 5.47 (mean) days and less in laparoscopic IPOM repaired patients, 5.07 (mean) days. Recurrence in both groups of patients is not seen in 6 months follow up in our study.

Conclusions: Study supports safety in terms of duration of surgery, postoperative pain, surgical site infection, duration of hospital stays and efficacy in terms of return of normal activity and recurrence, equally effective in both open retrorectus and laparoscopic IPOM repair of ventral hernia with size less than 5 cm.

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Al Chalabi H, Larkin J, Mehigan B, McCormick P. A systematic review of laparoscopic versus open abdominal incisional hernia repair, with meta-analysis of randomized controlled trials. Int J Surg. 2015;20:65-74.

Awaiz A, Rahman F, Hossain MB, Yunus RM, Khan S, Memon B, et al. Meta-analysis and systematic review of laparoscopic versus open mesh repair for elective incisional hernia. Hernia. 2015;19(3):449-63.

Jensen KK, Jorgensen LN. Comment to: meta-analysis and systematic review of laparoscopic versus open mesh repair for elective incisional hernia. Awaiz A et al. Hernia 2015;19:449-63. Hernia. 2015;19(6):1025-66.

Awaiz A, Rahman F, Hossain MB, Yunus RM, Khan S, Memon B, et al. Reply to comment to Meta-analysis and systematic review of laparoscopic versus open mesh repair for elective incisional hernia. Jensen K, Jorgensen LN. Hernia. 2015;19(6):1027-9.

Bittner R, Bingener-Casey J, Dietz U, Fabian M, Ferzli GS, Fortelny RH, et al. Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS)- Part 1. Surg Endosc. 2014;28(1):2-9.

Bittner R, Bingener-Casey J, Dietz U, Fabian M, Ferzli GS, Fortelny RH, et al. Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society [IEHS])- Part 2. Surg Endosc. 2014;28(2):353-79.

Bittner R, Bingener-Casey J, Dietz U, Fabian M, Ferzli G, Fortelny R, et al. Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society [IEHS])-Part III. Surg Endosc. 2014;28(2):380-404.

Silecchia G, Campanile FC, Sanchez L, Ceccarelli G, Antinori A, Ansaloni L, et al. Laparoscopic ventral/incisional hernia repair: updated guidelines from the EAES and EHS endorsed Consensus Development Conference. Surg Endosc. 2015;29(9):2463-84.

Earle D, Roth JS, Saber A, Haggerty S, Bradley JF, Fanelli R, et al. SAGES guidelines for laparoscopic ventral hernia repair. Surg Endosc. 2016;30(8):3163-83.

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Published

2021-03-26

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Original Research Articles