Laparoscopic Ventral Hernia Repair: Tow Centre Experience Prospective Comparative Study

摘要

Background: Ventral hernia is one of the most common abdominal wall hernias. Several procedures have been used for hernia repair. During the last few decades, the open surgical approach has been the standard technique for hernia repair. During the past 10 years, laparoscopic repair of ventral hernia has become increasingly established in clinical practice and aimed to be an acceptable and successful technique. There are many techniques used in laparoscopic ventral hernia repair and the most commonly used is fixation of mesh without closing the defect or closing the defect before fixation of mesh. Aim of the Study: T he aim of this study is to compare outcomes and results of closure versus non-closure of ventral hernia defect during laparoscopic ventral hernia repair in tow center and report our experience in laparoscopic ventral hernia repair. Patients and Methods: This is comparative prospective study between laparoscopic ventral hernia repair without closure of the defect and with closure of the defect before fixation of the mesh. 60 patients were divided into 2 groups: Group 1 treated with laparoscopic ventral hernia repair without defect closure and group 2 treated with laparoscopic ventral hernia repair with hernia defect closure, and we followed up the patients in both groups for operative outcomes and post-operative complications, hospital stay, recurrences, patients’ satisfactions. Results: Operative time was longer in group 2—closure group than in group 1—non-closure group. Post operative seroma is 65% in group 1 and 16% in group 2. Recurrence occurs in one patient [3.33%] in group 2 versus 4 patients [13.33%] in group 1. Conclusion: Laparoscopic ventral hernia repair is safe and feasible, although laparoscopic ventral hernia repair without closure of the defect is easy with less operative time and does not need extra-experience in intra-corporeal suturing but its benefit was in smaller defect [3 cm] and larger defect needs a laparoscopic ventral hernia repair with defect closure.