Comparative study between fascial defects closure and non-closure in laparoscopic incisional and ventral hernia repair

Abstract

Background: Incisional hernias are common after abdominal surgery. Laparoscopic repair has advantages over open repair. Traditionally, laparoscopic ventral repair of hernia has been done as a bridged repair to accomplish circumferential overlap of the fascial defect. More recently, there has been a growing trend to do primary fascial closure to reapproximate the fascia before mesh insertion. Aim of the work: to present our experience with laparoscopic ventral and incisional repair of hernia to determine outcomes and different results of fascial defects closure and non-closure. Patient and methods: From January 2016 to April 2018, 68 patients suffering from ventral and incisional hernias were treated in New Damietta University Hospital. Laparoscopic repair was decided for all patients. Results: Operative time for group A ranged from 50-120 minutes (average 96.8 min), 30-90 minutes (average 66 min) for group B. Chronic postoperative pain reported in 12.9% in group A and 6.6% in group B. 16.1% from group A had seroma lasting 4 weeks, while it was reported in 36.7% from group B, which remain for 6 weeks. There were 7 patients from group A complaint of post-operative respiratory embarrassment which resolved conservatively except for one patient, who necessitated ICU admission for two days. No one from group B complaint of post-operative respiratory complications. Conclusion: Although there were no major statistical differences between fascial closure and non-closure groups, the seroma and recurrence were less in fascial closure group.

Keywords

• ventral hernia
• incisional hernia
• laparoscopy ventral hernia repair (lvhr)
• fascial closure