Initial Experience Of Laparoscopic Incisional Hernia Repair

The laparoscopic incisional hernia repair is a safe alternative to open mesh repair. The procedure has the advantages of minimal access surgery and lower recurrence rate. A prospective study of laparoscopic incisional hernia repair of our first 11 patients was performed from July 2008 to December 2009. No serious intraoperative or postoperative morbidity was encountered, only two patients developed seroma. The mean operating time was 90 minutes (60 to 180 minutes). The mean day of discharge after surgery was 3 days (2-7 days). No patient developed a recurrence during mean follow up period of 10 months. Laparoscopic repair of incisional hernia has been shown to be feasible, safe and effective. However, careful patient selection and acquiring the necessary advanced laparoscopic surgical skills coupled with the proper use of equipment are mandatory before embarking on this procedure.Key Words: Incisional hernia; Laparoscopic repair; Mesh; Polypropylene DOI: 10.3329/fmcj.v5i2.6819Faridpur Med. Coll. J. 2010;5(2):41-45

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A comparative study of open versus laparoscopic incisional hernia repair

International Surgery Journal ◽

10.18203/2349-2902.isj20170428 ◽

2017 ◽

Vol 4 (3) ◽

pp. 916

Author(s):

Jagan Mohan Reddy Bathalapalli ◽

Surya Ramachandra Varma Gunturi ◽

Ram Mohan Rao V. ◽

Mythili P.

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Laparoscopic Repair ◽

Laparoscopic Hernia Repair ◽

Operating Time ◽

Incisional Hernia Repair ◽

Open Group ◽

Open Approach ◽

Laparoscopic Incisional Hernia Repair ◽

Operative Recovery

Background: Incisional hernia occurs in 5-11% of patients subjected to abdominal operations. Laparoscopic hernia repair has revolutionized the treatment of incisional hernia by reducing the morbidity and improved post-operative outcomes. The objectives of this study were to compare open incisional hernia repair with laparoscopic incisional hernia repair in our patient population with respect to Operating time, post-operative complications, post-operative recovery, duration of analgesic administration, and cosmetic results.Methods: This is a prospective study of Forty patients who were admitted at Osmania General Hospital, Hyderabad, Telangana, India with a clinical diagnosis of incisional hernia, 20 patients in each group (open and laparoscopic).Results: Both the study groups were comparable in terms of patient characteristics. The duration of laparoscopic repair was significantly more when compared to open repair (mean time 133.75 mins versus 85.8 min respectively). Analgesic requirement, wound infection rate and complication rate were higher in open group. The laparoscopic patients tolerated oral feeds earlier compared to open patients. The duration of hospital stay was significantly longer for open group than for laparoscopic group (mean 9.6 days versus 6.4 days respectively). The cosmetic end result was better in laparoscopic patients.Conclusions: Though ours is a small study, with the benefits of laparoscopy it will be prudent to recommend laparoscopic repair as the first line of management for incisional hernia where the facilities and trained expertise were available. However, there is still a role for traditional open approach in patients who have a specific contraindication to laparoscopic repair or any additional procedures that are not amenable for laparoscopy.

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Role of laparoscopy in incisional hernia and relative benefit of the laparoscopic incisional hernia repair to the open incisional hernia repair

International Surgery Journal ◽

10.18203/2349-2902.isj20202814 ◽

2020 ◽

Vol 7 (7) ◽

pp. 2165

Author(s):

Sudhir Singh Pal ◽

Azad Kumar Mourya

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Mesh Repair ◽

Laparoscopic Group ◽

Incisional Hernia Repair ◽

Visual Analogue Score ◽

Laparoscopic Incisional Hernia Repair ◽

Post Operative Pain ◽

Open Mesh Repair

Background: Incisional hernia is a common complication of abdominal surgery. Historically the open repair with or without mesh was the mainstay of treatment. However, many recently published laparoscopic repair studies have challenged surgeons to re-evaluate which technique provides the best short and long term outcomes.Methods: The study was conducted on 50 patients admitted at GMC Bhopal with approval from college ethical committee.Results: In 50 cases 21 were male and 29 were female. 7 male (14%) and 15 female (30%) patients had undergone laproscopic mesh repair (LMR) and 14 male (28%) and 14 female (28%) patients had undergone open mesh repair (OMR). Total complication in OMR group is 10 (35%) and in LMR group is 2 (9.09%). Mean duration of hospital stay in LMR group was 6.6 days and in OMR group was 15.57 days. Post-operative patients of LMR group returned back to the work early (mean 12 days) compared to OMR group (mean 20.7 days). Mean post-operative day of movement in LMR group was 1 day and in OMR group was 2.03 days. Pain measured using visual analogue score on 3rd post-operative day showed decreased pain score in laparoscopic group (mean 2) compared to open group (mean 5.35).Conclusions: Laparoscopic incisional hernia repair provides lesser post-operative pain, lesser complications, shorter hospital stay and lesser economic impact as they returned to work early. Thus patients have less morbidity and improved quality of life.

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P149 THE IMPACT OF COVID-19 ON TACKOMESH RANDOMISED CONTROLLED TRIAL COMPARING SPIRAL-TACK MESH-FIXATION DEVICES IN LAPAROSCOPIC INCISIONAL HERNIA REPAIR USING THE MANCHESTER TECHNIQUE

British Journal of Surgery ◽

10.1093/bjs/znab395.141 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

James Pilkington ◽

Catherine Fullwood ◽

Aali Sheen

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Controlled Trial ◽

Mesh Fixation ◽

Operating Time ◽

Incisional Hernia Repair ◽

Fascial Closure ◽

Fixation Time ◽

Laparoscopic Incisional Hernia Repair ◽

The Impact

Abstract Aim Provide a report on all patients who underwent laparoscopic incisional hernia repair as part of the TACKoMesh RCT prior to unblinding of treatment arms. Material and Methods Trial recruitment was for primary incisional hernia with a defect diameter of 3–10cm. 63 patients (target 74-136) were operated on prior to the outbreak of COVID-19. Post-operative pain is the primary trial outcome. Surgery was performed with either spiral-tack mesh-fixation device (Protack (permanent) or Reliatack (absorbable)), Symbotex IPOM mesh, and fascial closure with no 1 Maxon suture(s) using extracorporeal knot ties – the Manchester Technique. Data was collected on trial forms and lifestyle questionnaires (SF-36 and CCS). All data were explored and described in RStudio v1.4.1106. Results Patients were aged 36-80 and 36(57.1%) patients were male. Mean preoperative BMI was 30.91(sd5.11,range21.15–43.93). Mean operating time was 80.81(37.34,20-240)minutes. In 13(20.6%) patients multiple hernia defects were identified. A good degree of fascial closure was achieved in all patients using a median of 3(IQR 2.0-3.5)knots. Median mesh-fixation time was 286(159.5-428.0)seconds and a mean 25.24(5.49,14-41)tacks/patient were used. Median length of hospital stay was 3.5(2.0–6.0)days. Patients were asked “Please indicate on this scale [VAS 0–10] the pain that you currently experience from your incisional hernia during activity?”. Median responses for Day0/pre-op, Day1, Day6, Day30 and Day365 were 4.5, 8.0, 6.0, 3.0 and 1.5 respectively. At one year, 7(11%) patients had experienced hernia recurrence and 33(52%) post-operative seroma. Conclusions Target recruitment was not possible owing to COVID-19. The Manchester Technique has comparable recurrence rates. Reported pain increases post-operatively but is reduced at post-operative day30 and day365.

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Laparoscopic versus open incisional hernia repair: comparative non-randomized study

International Surgery Journal ◽

10.18203/2349-2902.isj20172769 ◽

2017 ◽

Vol 4 (7) ◽

pp. 2216

Author(s):

Wael Barakaat Ahmed Mohamed ◽

Magdy Khalil Abdelmgeed

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Operative Time ◽

Laparoscopic Group ◽

Incisional Hernia Repair ◽

P Value ◽

Inclusion Criteria ◽

Laparoscopic Incisional Hernia Repair ◽

The Mean ◽

Repair Group

Background: One of the most common complications of laparotomy is Incisional hernia, with an estimated incidence of 3-20%. The objective of this study was to compare the outcome of patients after laparoscopic and open incisional hernia repair.Methods: This was a prospective observational comparative study, in Sohag University Hospital, Sohag, Egypt. All adult patients who fulfilled our inclusion criteria underwent laparoscopic or open incisional hernia repair from September 2013 to September 2016 were included in the study. Primary outcome measure of this study was recurrence rate, wound infection. And secondary outcome measure of this study was operative time, postoperative complications and hospital stay.Results: Between September 2013 and September 2016, 60 patients with incisional hernia had fulfilled our inclusion criteria were operated at the general surgery department at Sohag university hospitals, Sohag, Egypt. 31 patients had open incisional hernia repair and 29 had laparoscopic incisional hernia repair. The mean age for laparoscopic repair group was 45.69±7.66 years and for open repair group was46.94±8.08 years p value 0.543. In laparoscopic group male to female ratio 20/9 was while in open group it was16/15 p value 0.197.the mean body mass index for laparoscopic group was29.83±3.56kg/m2 and for open group30.00±3.32kg/m2 p value= 0.873. the most significant finding was hospital stay which was significantly shorter in laparoscopic incisional hernia repair group p value was 0.000 as well as wound infections were significantly lower in laparoscopic incisional hernia repair group p value was 0.05. there was no significant difference between both groups as regard operative time, bowel injury intraoperative complication postoperative complications as well as recurrence rate. The mean follows uptime was 27.24±3.04 months for laparoscopic incisional hernia group and 27.12±3.06 months for open group.Conclusions: Laparoscopic incisional hernia repair is a safe alternative to laparoscopic incisional hernia repair with a shorter hospital stay and a lower wound complication.

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