World Journal of Laparoscopic Surgery

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VOLUME 1 , ISSUE 2 ( May-August, 2008 ) > List of Articles

RESEARCH ARTICLE

Long-term Outcomes in Laparoscopic vs Open Ventral Hernia Repair

M Dhanesh Kumar

Citation Information : Kumar MD. Long-term Outcomes in Laparoscopic vs Open Ventral Hernia Repair. World J Lap Surg 2008; 1 (2):32-35.

DOI: 10.5005/jp-journals-10007-1057

Published Online: 01-12-2010

Copyright Statement:  Copyright © 2008; The Author(s).


Abstract

Objective

To ruleout whether there was a difference in, recurrence rate, morbidity, and duration of hospital stay between patients undergoing open or laparoscopic ventral hernia surgery.

Materials and methods

Cohort study in single-institution was compared prospectively collected from patient cohorts undergoing laparoscopic or open intraperitoneal onlay mesh repair. Literature search was performed using search engine Google and our online facility of Springer Link. The following search terms were used. Laparoscopic versus ventral hernia repair, ‘laparoscopic repair of ventral hernia, controversies in laparoscopic ventral hernia repair, comparison of laparoscopic and open (Ventral Hernia) repair, Laparoscopic Repair of Ventral Hernia during obesity. About 143 citations found in total. Data collected from 360 consecutive patients who had undergone laparoscopic or open intraperitoneal onlay mesh repair of a ventral hernia were prospectivelycollected from October 1995 and December 2005 are recorded.

Main outcome of the study

Hernia recurrence andduration of hospital stay and morbidity. Postoperative complications of Claviengrade 2 or more than grade 2 were considered as major complications.

Results

Intraperitoneal onlay mesh surgery was performed in 233 patients by open approach and in 127 patients by laparoscopic approach. Groups were similar for sex and body mass index and it is calculated by weight in kilograms divided by the height in meters squared and the mean age for the laparoscopic group was 3 years younger; and the mesh was selected larger for the laparoscopic group. Mean follow-up for both laparoscopic and open groups was 30 and 36 months; and the conversion rates are 4%. Majormorbidities were 15% in the open group and 7% in the laparoscopic group. Recurrence rates were 9% in the open group and 12% in the laparoscopic group. Postoperative inpatient admission was more frequent after the open procedure than after the laparoscopic procedure (28% and 16%, respectively).

Conclusions

Outcomes of the study shows not much difference with respect to recurrence rates after long-term follow-up; however, lower rate of major morbidity and increased outpatient-based procedure rates favor laparoscopic repair in this study.


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  1. Dr. R. K. Mishra M.MAS, MRCS (UK).
  2. Perioperative outcomes and complications of laparoscopic ventral hernia repair. Surgery. 2005;138:708-16.
  3. Comparison of laparoscopic and open ventral herniorrhaphy. Am Surg 1999;65:827-32.
  4. Laparoscopic treatment vs open surgery in the solution of major incisional and abdominal wall hernias with mesh. Surg Endosc, 1999;13:250-52.
  5. Incisional hernia repair: laparoscopic techniques. World J Surg 2005;29:1073-79.
  6. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205-13.
  7. Repair of ventral incisional hernia: the design of a randomized trial to compare open and laparoscopic surgical techniques. Am J Surg. 2004;188(suppl):22S-29S.
  8. Laparoscopic incisional and ventral herniorrhaphy in 100 patients. Am J Surg 2000;180:193-97.
  9. Laparoscopic ventral and incisional hernia repair in 407 patients. J Am Coll Surg 2000;190:645-50.
  10. Laparoscopic repair of ventral hernias: nine years’ experience with 820 consecutive hernias. Ann Surg 2003;238:391-400.
  11. A prospective study comparing the complication rates between laparoscopic and open ventral hernia repairs. Surg Endosc. 2003;17:1778-80.
  12. Laparoscopic vs open ventral hernia mesh repair: a prospective study. Surg Endosc 2006;20:1030-35.
  13. Obesity and laparoscopic repair of ventral hernias. Surg Endosc. 2001;15:1419-22.
  14. Comparison of the stress response after laparoscopic and open cholecystectomy. Surg Endosc 2000;14:1136-41.
  15. Laparoscopic Ventral Hernia Repair: An Accelerated Systematic Review. Adelaide, South Australia: Australian Safety and Efficacy Register of New Interventional Procedures–Surgical; 2004. ASERNIP-S report 41.
  16. Open Rives-Stoppa ventral hernia repair made simple successful but not for everyone. Hernia. 2005;9:162-66.
  17. G.Birgison ‘1’, A.E.Part, ‘1’ M.J.Mastrangelo ‘1’. D.B.Witzke ‘2’. U.B.Chu ‘1’. Department of surgery, university of Kentucky chandler medical center, Lexington, KY, USA. Department of pathology, university of Kentucky chandler medical center, Lexington, KY, USA.
  18. Laparoscopic vs open incisional hernia repair: a single-institution analysis of hospital resource utilization for 884 consecutive cases. Surg Endosc. 2006;20:71-75.
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