Mesh repair of incisional hernia: comparison of laparoscopic and open repair.

Objective: To compare our results of open and laparoscopic mesh repair of incisional hernias.

Design: Retrospective cohort study.

Setting: Teaching hospitals, The Netherlands.

Subjects: All patients who had had a laparoscopic (n = 25) or an open (n = 76) mesh repair of incisional hernia between January 1996 and January 2000.

Interventions: Physical examination at the time of the study.

Main outcome measures: Morbidity and recurrence.

Results: The groups were comparable. 11 patients (14%) developed postoperative infections after open repair and 1 (4%) after laparoscopic repair (p = 0.29). Median hospital stay was 5 days (range 1-19) in the open group and 4 (range 1-11) in the laparoscopic group (p = 0.28). The 2-year cumulative incidence of recurrence was 18% after open repair (median follow-up of 17 months (range 1-46) and 15% after laparoscopic repair (median follow-up of 15 months, range 1-44). Recurrences in the laparoscopic group were all among the first 7 cases in which the mesh was fixed with staples alone.

Conclusion: There were fewer infections and hospital stay was shorter in the laparoscopic group, but not significantly so. Recurrence rates were comparable.