Background: Laparoscopic repair of ventral hernia is rapidly becoming
more commonplace in the armamentarium of general surgeons. Its
utility and low recurrence rates make it a very attractive option. The technique
of the laparoscopic repair is based on the principle described by
Stoppa, however the hernial sac is not dissected and is left behind. This
minimizes difficult dissection, blood loss and Large incisions. The laparoscopic
technique also ensures that all defects are seen and repaired.
Objective: The aim of the study is to evaluate this technique in comparison
to open onlay mesh repair of ventral hernia.
Methods: From November 2004 to October 2006, 60 patients with
ventral hernias were equally randomized into two groups; in group
I, laparoscopic repair was practiced using a composite mesh (Panetext)).
fixed intraperitoneally by sutures and tackers, while in group
II, open mesh repair was employed after dissection, herniotomy and
peritoneal closure, a prolene mesh used to close the defect. fixed by continuous
prolene 0 suture. The two groups were compared in regard
to operative time, postoperative complications, hospital stay, recurrence
and the cost.
Results: The patients in the two groups were comparable at baseline
in terms of sex, age, presenting complaints, and comorbid conditions. The
mean surgery durations were 90.6 minutes for the laparoscopic repair
and 99.3 minutes for the open repair with no significant difference. The
mean postoperative stay was shorter for laparoscopic group than for open
hernia group (1.8 Vs 3.7 days with significant difference). Mere were
fewer complications (20% and no recurrences) among the patients who
underwent laparoscopic repair than among those who had open repair (40% and no recurrence). The cost of composite mesh and tacker were signficantly
higher than the cost of prolene mesh.
Conclusions: Laparoscopic ventral hernia repair is safe and resulted
In shorter hospital stays, fewer complications and so far no recurrence
during the period offollow-up. |
