LAPAROSCOPIC HERNIOGRAPHY OF SMALL SIZED MIDLINE VENTRAL HERNIAS IN DAY SURGERY UNIT RESULTS IN ACADEMIC TEACHING HOSPITAL
Background: Repair of ventral hernia (VH) is a commonly performed procedure. The purpose of this study is to evaluate the results of primary repair of midline VH using laparoscopic approach as a day surgery procedure in an academic teaching hospital. Material and methods: This prospective study was conducted in General Surgery department, Minia University Hospital, Egypt, for 82 patients with midline ventral hernias subjected to primary repair of the defect using laparoscopic approach in the period from February 2017 till February 2019. Patients were followed up for seroma, hematoma, wound infection, or recurrence. Results: Study included 81 patients; 30 cases (37%) were males and 51 (63%) were females. Ages ranged from 20 – 57 years. Thirty-eight (46.9%) patients presented with epigastric hernias, 34 (42%) had paraumbilical hernias, and port site hernias were found in 9 (11.1%) patients. Mean width of the defect was 15 ± 4.3 mm. Mean operative time was 52.3 min. All cases were done on a day surgery setting. No cases showed intestinal injury or paralytic ileus. Eighteen patients (22.2%) developed seroma not requiring aspiration. Hematoma was seen in three (3.7%) patients and was conservatively managed. Only two cases (2.5%) developed superficial wound infection. Rate of recurrence was 4.9%. Conclusion: Primary laparoscopic ventral hernia repair (LVHR) with defects less than 2 cm in diameter is a safe, simple, time-saving procedure associated with less complications, less risk of surgical site infection (SSI), shorter hospital stay and low cost.
Keywords:Ventral hernia, Laparoscopic Repair, Primary Repair
Ahonen-Siirtola M, Rautio T, Ward J, Kossi J, Ohtonen P, Makala J. Complications in laparoscopic versus open incisional ventral hernia repair. A retrospective comparative study. World J Surg. 2015;39(12): 2872-77.
Alhussini MA, Awad AT, Kholosy HM. Using quilting sutures in decreasing seroma formation after managing large ventral hernias: a comparative study. Hernia. 2019:23(4):717-22
Anadol AZ, Tezel E, Yilmaz U, Kurukahvecioglu O, Ersoy E. Laparoscopic primary repair of ventral hernias: early results of a new technique. Surg Today. 2010;40(1):88-91.
Bailey C, Ahuja M, Bartholomew K, et al. Guidelines for day-case surgery 2019.Anaesthesia. 2019;74(6):778–92.
Barbaros U, Asoglu O, Seven R, et al. The comparison of laparoscopic and open ventral hernia repairs: a prospective randomized study. Hernia. 2007;11(1):51–56.
Basheer M, Negm A, El-Ghadban H, Samir M, Hadidy A, Dawoud I. Laparoscopic versus open ventral hernia repair: a comparative study. Egypt J Surg. 2018;37(4):465-71.
Begum S, Khan MR. Outcome assessment of primary ventral versus incisional hernia repair by laparoscopic approach. Int J Abdom Wall Hernia Surg. 2018;1(3):94-98.
Cho JE, Helm MC, Helm JH, et al. Retro-rectus placement of bio-absorbable mesh improves patient outcomes. Surg Endosc. 2019;33(8):2629-34
Choi YB, Lee IS. Incisional and Ventral Hernia Repair. J Minim Invasive Surg. 2018;21(1):5-13.
Davis K, Mahishi V, Singal R, et al. Quality Improvement in Ambulatory Surgery Centers: A Major National Effort Aimed at Reducing Infections and Other Surgical Complications. J Clin Med Res. 2019;11(1):7–14.
Ecker BL, Kuo LE, Simmons KD, Fischer JP, Morris JB, Kelz RR. Laparoscopic versus open ventral hernia repair: longitudinal outcomes and cost analysis using statewide claims data. Surg Endosc. 2016;30(3):906–15.
Emanuelsson P, Dahlstrand U, Strömsten U, Gunnarsson U. Strigård K, Stark B. Analysis of the abdominal musculo-aponeurotic anatomy in rectus diastasis: comparison of CT scanning and preoperative clinical assessment with direct measurement intraoperatively.Hernia. 2014;18(4):465-71.
Juo YY, Skancke M, Holzmacher J, Amdur RL, Lin PP, Vaziri K. Laparoscopic versus open ventral hernia repair in patients with chronic liver disease. Surg Endosc. 2017;31(2):769–77.
Kappikeri VS, Thalasta P. Clinical study of hernia in females. Int Surg J. 2017;4(5):1632-36
Langbach O, Bukholm I, Benth JS, Rokke O. Long term recurrence, pain and patient satisfaction after ventral hernia mesh repair. World J Gastrointest Surg. 2015;7(12):384-93.
Lindmark M, Strigård K, Löwenmark T, Dahlstrand U, Gunnarsson U. Risk Factors for Surgical Complications in Ventral Hernia Repair World J Surg. 2018;42(11):3528–36.
Petro CC, Haskins IN, Perez AJ, et al. Hernia repair in patients with chronic liver disease - A 15-year single-center experience. Am J Surg. 2019;217(1):59-65.
Poulose BK, Shelton J, Phillips S, et al. Epidemiology and cost of ventral hernia repair: making the case for hernia research. Hernia. 2012;16(2):179-83
Rogmark P, Petersson U, Bringman S, et al. Short-term outcomes for open and laparoscopic midline incisional hernia repair: a randomized multicenter controlled trial: the ProLOVE (prospective randomized trial on open versus laparoscopic operation of ventral eventrations) trial. Ann Surg. 2013;258(1):37–45.
Saber AA, Rao AJ, Itawi EA, Elgamal MH, Martinez RL. Occult ventral hernia defects: A common finding during laparoscopic ventral hernia repair. Am J Surg. 2008;195(4):471-73.
Salgaonkar H, Wijerathne S, Lomanto D. Managing complications in laparoscopic ventral hernia. Ann Laparosc Endosc Surg. 2019;4:11.
Schlosser KA, Arnold MR, Otero J, et al. Deciding on Optimal Approach for Ventral Hernia Repair: Laparoscopic or Open. J Am Coll Surg. 2019;228(1):54-65.
Shah SK, Liang MK. Laparoscopic ventral hernia repair. ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com (Literature review current through: May 2019).
Sharma A, Mehrotra M, Khullar R, Soni V, Baijal M, Chowbey PK. Laparoscopic ventral/incisional hernia repair: a single centre experience of 1,242 patients over a period of 13 years. Hernia. 2011;15(2):131-39.
Stickel M, Rentsch M, Clevert DA, et al. Laparoscopic mesh repair of incisional: an alternative to the conventional open repair. Hernia. 2007;11(3):217–22.
Stoikes N, Roan E, Webb D, et al. The Problem of Seroma After Ventral Hernia Repair. Surg Technol Int. 2018;32:93-98.
Tsuruta A, Hirai T, Nakamura M. Retrospective comparison of open versus laparoscopic ventral and incisional hernia repair. Asian J Endosc Surg. 2014;7(3):246–50.
Ujiki MB, Weinberger J, Varghese TK, Murayama KM, Joehl RJ. One hundred consecutive laparoscopic ventral hernia repairs. Am J Surg. 2004;188(5):593-97.