LAPAROSCOPIC AND OPEN MESH REPAIR OF VENTRAL HERNIAS: A RANDOMIZED CLINICAL TRIAL

Objective: To compare the operative time and post-operative pain in laparoscopicand open mesh repair of ventral hernias. Methodology: From October, 2010 to February, 2011 in surgery department,Holy Family hospital, Rawalpindi. In this Randomized Clinical Trial a total of160 patients were included after taking approval from hospital ethical committeeand informed written consent from each patient. The admitted patientsfor elective surgical repair of ventral hernia were randomly allocated to Group A (laparoscopy) and B (open repair). Information regarding operative time andpain scores after 12, 24 and 72 hours of surgery was recorded. Results: In group A, the mean age was 41.10 ± 8.98 years and in group B41.23 ± 9.18 years. There were 36 (22.25%) male patients. There were 18(11.3%) patients of Incisional, 107 (66.9%) patients of umbilical/paraumbilical and 35(21.9%) patients of Epigastric hernia in this study. In group A, the meanoperative time was significantly (p-value= 0.000) less (66.56 ± 16.14 minutesvs. 71.21 ± 12.91 minutes) as compared to group B. There was no differencein mean pain score at 12th hour (p-value= 0.797). At 24th hour and 72nd hourthe mean pain score in Laparoscopic group was significantly (p-value = 0.000)lower. Conclusion: Laparoscopic management of ventral hernia resulted in short operativetime, less pain at 24th and 72th hours. So it should be considered asthe procedure of choice for ventral hernia repair.

[1]  U. Farooq,et al.  THE COMPARISON OF OPEN AND LAPAROSCOPIC VENTRAL HERNIA REPAIRS , 2012 .

[2]  J. Daly.  Technique and Outcomes of Abdominal Incisional Hernia Repair Using a Synthetic Composite Mesh: A Report of 455 Cases , 2009 .

[3]  M. Rosen,et al.  Laparoscopic versus open ventral hernia repair. , 2008, The Surgical clinics of North America.

[4]  Javeria Iqbal,et al.  Laparoscopic repair of ventral hernia an early experience at Khyber teaching hospital Peshawar. , 2008 .

[5]  E. Misiakos,et al.  Laparoscopic Ventral Hernia Repair: Pros and Cons Compared With Open Hernia Repair , 2008, JSLS : Journal of the Society of Laparoendoscopic Surgeons.

[6]  J. Salameh.  Primary and unusual abdominal wall hernias. , 2008, The Surgical clinics of North America.

[7]  Sajjad Ahmad,et al.  Conservative management of mesh site infection in ventral hernia repair. , 2007, Journal of Ayub Medical College, Abbottabad : JAMC.

[8]  D. Birch.  Characterizing laparoscopic incisional hernia repair. , 2007, Canadian journal of surgery. Journal canadien de chirurgie.

[9]  A. Müller,et al.  Laparoscopic repair of ventral hernia , 2003, European Surgery.

[10]  Brent D. Matthews,et al.  Pooled data analysis of laparoscopic vs. open ventral hernia repair: 14 years of patient data accrual , 2007, Surgical Endoscopy.

[11]  J. Adotey.  Incisional hernia: a review. , 2006, Nigerian journal of medicine : journal of the National Association of Resident Doctors of Nigeria.

[12]  P. Chowbey,et al.  Laparoscopic repair of ventral / incisional hernias , 2006, Journal of minimal access surgery.

[13]  S. Magnone,et al.  Prospective clinical study of laparoscopic treatment of incisional and ventral hernia using a composite mesh: indications, complications and results , 2006, Hernia.

[14]  D. Lomanto,et al.  Laparoscopic versus open ventral hernia mesh repair: a prospective study , 2006, Surgical Endoscopy And Other Interventional Techniques.

[15]  D. Candinas,et al.  Laparoscopic ventral hernia repair is safe and cost effective , 2005, Surgical Endoscopy And Other Interventional Techniques.

[16]  C. Ng,et al.  Laparoscopic ventral hernia repair: local experience. , 2004, Singapore medical journal.

[17]  F. Muysoms,et al.  Laparoscopic Intraperitoneal Repair of Incisional and Ventral Hernias , 2004, Acta chirurgica Belgica.

[18]  A. Park,et al.  Laparoscopic Repair of Ventral Hernias: Nine Years’ Experience With 850 Consecutive Hernias , 2003, Annals of surgery.

[19]  Maqbool Ahmad,et al.  Polypropylene mesh repair of incisional hernia. , 2003, Journal of the College of Physicians and Surgeons--Pakistan : JCPSP.

[20]  A. Moreno-Egea,et al.  Open vs laparoscopic repair of spigelian hernia: a prospective randomized trial. , 2002, Archives of surgery.

[21]  Philip P Goodney,et al.  Short-term outcomes of laparoscopic and open ventral hernia repair: a meta-analysis. , 2002, Archives of surgery.

[22]  K. Cassar,et al.  Surgical treatment of incisional hernia , 2002, The British journal of surgery.

[23]  O. Zmora,et al.  Pitfalls and complications with laparoscopic intraperitoneal expanded polytetrafluoroethylene patch repair of postoperative ventral hernia , 2002, Surgical Endoscopy and Other Interventional Techniques.

[24]  R. Gonzalez,et al.  Laparoscopic Ventral Hernia Repair Reduces Wound Complications , 2001, The American surgeon.

[25]  A. Park,et al.  Laparoscopic ventral and incisional hernia repair in 407 patients. , 2000, Journal of the American College of Surgeons.

[26]  C. de la Cuesta,et al.  Laparoscopic treatment vs open surgery in the solution of major incisional and abdominal wall hernias with mesh , 1999, Surgical Endoscopy.