Comparative study of open onlay mesh repair versus laparoscopic intraperitoneal dual mesh repair for ventral hernia

Surya Prakash, Asha Gaud, Dinesh Kumar, Junior Resident
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Abstract

Background: Ventral abdominal wall hernia surgery is a common procedure in the armamentarium of surgeons. The most common forms of these surgical procedures in adults are the repair of incisional hernias and surgery for paraumbilical hernias. Aims and Objectives: Open onlay mesh repair versus laparoscopic intraperitoneal dual mesh repair (intraperitoneal onlay mesh[IPOM]) for ventral hernia compared to the duration of surgery, post-operative pain, postoperative complications, post-operative hospital stay, return to normal activity, recurrence, and cosmesis. Materials and Methods: The prospective non-randomized study was done in the Maharani Laxmi Bai Medical College, Jhansi, between January 2021 and June 2022 including 100 patients was applied for treatment of ventral hernia repair. Fifty patients were subjected to Group A (open onlay mesh repair) and 50 patients were subjected to Group B (laparoscopic intraperitoneal dual mesh repair). Results: The mean surgery durations were significantly lower in laparoscopic repair when compared to open repair (P<0.001). Themean post-operative stay in the hospital was shorter for the laparoscopic group than for the open hernia group (10.28±2.100 vs. 8.02±1.378 days; P≤0.001). Return to activity or normal daily work is significantly lower in the laparoscopic group as compared to open repair of hernia (5.12±0.659 vs. 2.94±0.550 days; P<0.001). There were fewer post-operative complications with laparoscopy. Conclusion: Laparoscopic intraperitoneal dual mesh repair (IPOM) for ventral hernia in our experience was safe and resulted in fewer complications, shorter hospital stays, and better cosmesis results. Hence, it should be considered the better choice for ventral hernia repair.
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腹股沟疝气开腹镶嵌式网片修补术与腹腔镜腹膜内双网片修补术的比较研究
背景:腹壁疝手术是外科医生常用的手术方式。这些手术在成人中最常见的形式是切口疝修补术和脐旁疝手术:腹腔镜腹膜内双网片修补术(intraperitoneal onlay mesh[IPOM])与开放式网片修补术治疗腹股沟疝在手术时间、术后疼痛、术后并发症、术后住院时间、恢复正常活动、复发和外观方面的比较:这项前瞻性非随机研究于 2021 年 1 月至 2022 年 6 月在詹西的 Maharani Laxmi Bai 医学院进行,共有 100 名患者接受了腹股沟疝修补术治疗。结果显示,A组(开放式腹膜网片修补术)和B组(腹腔镜腹膜内双网片修补术)各有50名患者:结果:腹腔镜修复术的平均手术时间明显短于开腹修复术(P<0.001)。腹腔镜组的术后平均住院时间(10.28±2.100 天 vs. 8.02±1.378 天;P≤0.001)短于开放式疝气组。腹腔镜组恢复活动或正常日常工作的时间明显少于开放式疝修补术组(5.12±0.659 天 vs. 2.94±0.550 天;P<0.001)。腹腔镜手术的术后并发症较少:结论:根据我们的经验,腹腔镜腹膜内双网片修补术(IPOM)治疗腹股沟疝安全、并发症少、住院时间短、外观效果好。因此,腹腔镜腹股沟疝修补术应被视为更好的选择。
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