Postoperative Comparison In Open Vs. Laparoscopic Ventral Hernia Repair In Obese Patients

Abstract Introduction: Obesity is an important problem in our society. Recent studies shows that laparoscopic ventral hernia repair has advantages in obese patients comparing with the standard open approach. This study wants to compare length of stay (LOS), hospitalization costs (HC) and operative time (OT) in laparoscopic and open ventral hernia repair. Methods: A retrospective study of obese patients (BMI>30kg/m2) that underwent ventral hernia repair between 2014 and 2015 were included. We compared demographics, hernia size, OT, LOS, HC between the two approaches. Results: 100 patients with ventral hernia repair were included, 11 had laparoscopic approach (11%). Laparoscopy was performed only in elective surgery and for small defects. The operation time was almost the same (119.09 vs.118.87 min). The length of stay was significantly longer in open approach (8.53 vs. 2.9 days) and hospitalization costs were higher for laparoscopic repair. Conclusions: Laparoscopy offers a better length of stay, but the costs remains higher for this approach.

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Sutureless Laparoscopic Ventral Hernia Repair in Obese Patients

JSLS Journal of the Society of Laparoendoscopic Surgeons ◽

10.4293/108680811x13022985131859 ◽

2011 ◽

Vol 15 (2) ◽

pp. 154-159 ◽

Cited By ~ 1

Author(s):

Ehab Akkary ◽

Lucian Panait ◽

Kurt Roberts ◽

Andrew Duffy ◽

Robert Bell

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Laparoscopic Ventral Hernia Repair ◽

Obese Patients

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Laparoscopic Ventral Hernia Repair Combined with Sleeve Gastrectomy in Morbidly Obese Patients: Early Outcomes

The Surgery Journal ◽

10.1055/s-0039-1694979 ◽

2019 ◽

Vol 05 (03) ◽

pp. e87-e91 ◽

Cited By ~ 2

Author(s):

Ahmed M.S.M. Marzouk ◽

Heba O.E. Ali

Keyword(s):

Sleeve Gastrectomy ◽

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Mesh Size ◽

Laparoscopic Ventral Hernia Repair ◽

Abdominal Pressure ◽

Morbidly Obese ◽

Obese Patients ◽

The Mean

Background Morbid obesity is a serious chronic condition with, among other symptoms, increased intra-abdominal pressure and subsequent abdominal wall hernias. The optimal management of these manifestations is still controversial. The objective of this study was to assess the early postoperative outcomes of a surgical approach combining laparoscopic ventral hernia repair (LVHR) with sleeve gastrectomy in morbidly obese patients. Methods In this retrospective study, we reviewed the files of patients who are obese with a primary ventral hernia of less than 10 cm in diameter who received simultaneous laparoscopic sleeve gastrectomy and LVHR at our institution between February 2016 and July 2018. LVHR was performed using an intraperitoneal only mesh. The individual mesh size was chosen based on the number and size of the defects. Clinical and radiological follow-ups were performed between 9 and 15 months. Results A total of 15 patients were included. Five of them were males. The mean body mass index was 45.2 kg/m2 (range: 38.7–56.2 kg/m2). The mean hernia defect size was 2.6 cm (range: 1.3–4.2 cm). Mesh size was 10 × 15 cm in five, 20 × 15 cm in seven, and 25 cm× 20 cm in three patients. All patients were discharged without complications on the second postoperative day. Mean follow-up was at 12 months. One patient presented with hernia recurrence 14 months after surgery and four patients presented with self-limited seroma. Conclusion Despite ambiguous guidelines and ongoing debate regarding simultaneous bariatric surgery and ventral hernia repair, the short-term outcomes of this approach appeared promising, provided that patients are carefully selected and receive an individually tailored approach.

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Laparoscopic Ventral Hernia Repair in Obese Patients

Archives of Surgery ◽

10.1001/archsurg.141.1.57 ◽

2006 ◽

Vol 141 (1) ◽

pp. 57 ◽

Cited By ~ 91

Author(s):

Yuri W. Novitsky

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Laparoscopic Ventral Hernia Repair ◽

Obese Patients

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Laparoscopic hernioplasty of large ventral hernia with transfascial sutures: short term utility and outcome

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v18i3.15314 ◽

2016 ◽

Vol 18 (3) ◽

pp. 52

Author(s):

A Kumar ◽

CS Agrawal ◽

S Sah ◽

RK Gupta

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Laparoscopic Repair ◽

Ventral Hernia Repair ◽

Open Repair ◽

Mesh Fixation ◽

Laparoscopic Approach ◽

Laparoscopic Ventral Hernia Repair ◽

University Hospital ◽

Large Ventral Hernia

Introduction: The laparoscopic approach to repairing ventral and incisional hernias has gained increasing popularity worldwide. The approximation of the hernia defect during laparoscopic ventral hernia repair, prior to mesh fixation, provides a more physiologic and anatomic repair. Defect closure also provides more defect overlap with mesh placement and, possibly decreases recurrence rates. We reviewed the experience of laparoscopic repair of large ventral hernia (diameter ≥5cm) at a university hospital in the Nepal with particular reference to patients with massive defects (diameter ≥15cm) and transfascial closure.Methods: A total of 32 patients underwent laparoscopic ventral (incisional or umbilical/paraumbilical) hernia repair between July 2014 and September 2015.Results: The prevalence of conversion to open surgery was 3.1%. The prevalence of postoperative complications was 15.6%. Median postoperative follow-up was 8.2 months. A total of 9.4% cases suffered late complications and 3.1% developed recurrence. Twelve patients underwent repair of defects ≥10cm in diameter with no recurrence. Three patients underwent repair of ‘massive’ incisional hernia (diameter ≥15cm) with a prevalence of recurrence of 3.1%. Ten patients with a body mass index (BMI) ≥30kg/m2 (range, 32–35kg/m2) underwent laparoscopic repair without any recurrence.Conclusions: Laparoscopic ventral hernia repair with transfascial suturing can be carried out safely with a low prevalence of recurrence. It may have advantages in obese patients in whom open repair would represent a significant undertaking. Laparoscopic ventral hernia repair may be used in cases of large and massive hernias, in which the risk of recurrence increases but is comparable with open repair and associated with low morbidity.

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Laparoscopic incisional and ventral hernia repair in a district general hospital

Annals of The Royal College of Surgeons of England ◽

10.1308/003588414x14055925058913 ◽

2015 ◽

Vol 97 (1) ◽

pp. 22-26 ◽

Cited By ~ 2

Author(s):

CD Mann ◽

A Luther ◽

C Hart ◽

JG Finch

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

General Hospital ◽

Ventral Hernia Repair ◽

Open Repair ◽

Laparoscopic Approach ◽

District General Hospital ◽

Laparoscopic Ventral Hernia Repair ◽

Morbidly Obese ◽

Conversion To Open Surgery

IntroductionThe laparoscopic approach to repairing ventral and incisional hernias has gained increasing popularity worldwide. We reviewed the experience of laparoscopic ventral hernia repair at a district general hospital in the UK with particular reference to patients with massive defects (diameter ≥15cm) and the morbidly obese.MethodsA total of 144 patients underwent laparoscopic ventral (incisional or umbilical/paraumbilical) hernia repair between April 2007 and September 2012.ResultsThe prevalence of conversion to open surgery was 2.8%. The prevalence of postoperative complications was 3.5%. Median postoperative follow-up was 30.2 months. A total of 5.6% cases suffered late complications and 2.8% developed recurrence. Thirty-four patients underwent repair of defects ≥10cm in diameter with a prevalence of recurrence of 5.6%. Sixteen patients underwent repair of ‘massive’ incisional hernia (diameter ≥15cm) with a prevalence of recurrence of 12.5%. Sixteen patients with a body mass index (BMI) ≥40kg/m2(range, 40–61kg/m2) underwent laparoscopic repair with a prevalence of recurrence of 6.3% (p>0.05 vs BMI <40kg/m2).ConclusionsLaparoscopic ventral hernia repair can be carried out safely with a low prevalence of recurrence. It may have advantages in morbidly obese patients in whom open repair would represent a significant undertaking. Laparoscopic ventral hernia repair may be used in cases of large and massive hernias, in which the risk of recurrence increases but is comparable with open repair and associated with low morbidity.

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