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: The 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.
Cite this paper
A., M. Y. , Mohamed, M. A. S. , R., A. G. , Ahmed, M. S. and Husein, H. M. (2018). Laparoscopic Ventral Hernia Repair: Tow Centre Experience Prospective Comparative Study. Open Access Library Journal, 5, e4871. doi: http://dx.doi.org/10.4236/oalib.1104871.
Lomanto, D., Iyer, S.G., Shabbir, A. and Cheah, W.K. (2006) Laparoscopic versus Open Ventral Hernia Mesh Repair: A Prospective Study. Surgical Endoscopy, 20, 1030-1035. https://doi.org/10.1007/s00464-005-0554-2
Stoppa, R.E. (1989) The Treatment of Complicated Groin and Incisional Hernias. World Journal of Surgery, 13, 545-554. https://doi.org/10.1007/BF01658869
Hoer, J., Lawong, G., Klinge, U. and Schumpelick, V. (2002) Factors Influ-encing the Development of Incisional Hernia. A Retrospective Study of 2983 Laparotomy Patients over a Period of 10 Years. Chirurg, 73, 474-480.
Knuutinen, A., Kokkonen, N., Risteli, J., et al. (2002) Smoking Affects Collagen Synthesis and Extracellular Matrix Turnover in Human Skin. British Journal of Dermatology, 146, 588-594. https://doi.org/10.1046/j.1365-2133.2002.04694.x
Sorensen, LT. (2006) Effect of Life Style, Gender and Age on Collagen Formation and Degradation. Hernia, 10, 456-461. https://doi.org/10.1007/s10029-006-0143-x
Van’t Riet, M., Steyerberg, E.W., Nellensteyn, J., Boryer, H.G. and Jeekel, J. (2002) Meta-Analysis of Techniques for Closure of Midline Abdominal Incisions. British Journal of Surgery, 80, 1350-1356. https://doi.org/10.1046/j.1365-2168.2002.02258.x
Cuccurullo, D., Piccoli, M., Melotti, G., et al. (2013) Laparoscopic Ventral Incisional Hernia Repair: Evidence-Based Guidelines of the First Italian Consensus Conference. Hernia, 17, 557-566.
Raftopoulos, I. and Courcoulas, A.P. (2007) Outcome of Laparoscopic Ventral Hernia Repair in Morbidly Obese Patients with a Body Mass Indexes Exceeding 35 kg/m2. Surgical Endoscopy, 21, 2293-2297.
Zhang, Y., Zhou, H., Chai, Y., et al. (2014) Laparoscopic versus Open Incisional Andventral Hernia Repair: A Systematic Review and Meta-Analysis. World Journal of Surgery, 38, 2233-2240. http://www.appliedmedical.com/Products/GelPoint
Agarwal, B.B., Agarwal, S. and Mahajan, K.C. (2008) Laparoscopicventral Hernia Repair: Innovative Anatomical Closure, Mesh Insertion without 10 mm Transmyofascial Port, and a Traumatic Mesh Fixation: A Preliminary Experience of a New Technique. Surgical Endoscopy, 23, 900-905.
Chelala, E., Thoma, M., Tatete, B., Lemye, A.C., Dessily, M. and Alle, J.L. (2007) The Suturing Concept for Laparoscopic Mesh Fixation in Ventral and Incisional Hernia Repair: MID Term Analysis of 400 Cases. Surgical Endoscopy, 21, 391-395. https://doi.org/10.1007/s00464-006-9014-x
Melvin, W.S. and Renton, D. (2011) Laparoscopic Ventral Hernia Repair. World Journal of Surgery, 35, 1496-1499. https://doi.org/10.1007/s00268-011-1028-4
Elazary, R., Abu-Gazala, M., Schlager, A., Khalaileh, A., Shussman, N., Rivkind, A.I. and Mintz, Y. (2011) Trans-Fascial Laparoscopic Mesh Fixation: A Procedural Comparison Using the Standard Suture Passer versus Imesh Stitcher? Device. Hernia, 15, 321-324. https://doi.org/10.1007/s10029-011-0789-x
Rea, R., Falco, P., Izzo, D., Leongito, M. and Amato, B. (2012) Laparoscopic Ventral Hernia Repair with Primary Transparietal Closure of the Hernial Defect Rea et al. BMC Surgery, 12, S33. http://www.biomedcentral.com/1471-2482/12/S1/S33