Study of 50 Cases: Open VS Laparoscopic Ventral Hernia Repair

Abstract

Introduction: The estimated incidence of ventral hernia is 15-20%. Although open repair, preferably with mesh, has been the standard approach, Laparoscopic repair is becoming increasingly popular among the surgeons and patients following the development of minimally invasive techniques. This study is done to study the risk factors for development of ventral hernia and to make comparison between open and laparoscopic methods of ventral hernia repair in view of:-Post-operative pain, Operative time, Patient morbidity and mortality, Complication, Recurrence rate, Patient compliance, Hospital stay, Return to routine work. Method: This was prospective study of comparison of open vs laparoscopic ventral hernia repair conducted during the period from December 2013 to May 2015 total 50 cases were taken for study. Results: In this study out of 50 cases, in 30 cases open ventral hernia repair and in 20 cases Laparoscopic ventral hernia repair done. It is more common in females (60%) and maximum patient (32%) belongs to age group 41-50 years. In this study, patients with chronic cough - 6(12%) ,constipation - 9(18%) and prostatism or dysuria - 4(8%). Mean duration for open ventral hernia surgery is 107 min and Laparoscopic ventral hernia repair is 126 min. Out of 50 patients, 25 patients had history of previous surgery. In laparoscopy surgery, 18(90%) patient mobilized from 1st post operative day, 17 (85%) patient returned to work within 11th to 15thpost operative day , 3(15%) patients returned to work on 16th to 20thpost operative days and in open surgery, 24(80%) patient mobilized on 2nd post operative day, 9 patient return to work on 11th -15thpost operative day while, 16 patients on 16th to 20thpost operative day and 5 patient on 21th to 25thpost operative day. Post operative pain (>2 days) was seen in 12(24%) patients among them 3(15%) in laparoscopic repair and 9(30%) in open ventral hernia repair. Conclusion: In our prospective study, comparing 50 cases of different types of ventral hernia repair open mesh repair and laparoscopic repair we concluded that there is definite difference in outcome between laparoscopic and open ventral hernia repair in selected patients. Laparoscopic approach has shown promising results and is being widely accepted. Majority of patients of ventral hernia are female (60%). Chronic cough, constipation, prostatism or dysuria is predisposing causes. Advantages of laparoscopic repair are less post-operative pain, less surgical site infection, less ambulatory period, less hospital stay, early return to work and allows to treat multiple defect through same incision.