COMPLICATIONS IN LAPAROSCOPIC AND OPEN MESH REPAIR OF VENTRAL HERNIAS IN A TERTIARY CARE HOSPITAL

Introduction: Ventral hernias are defects in the abdominal wall. They are normally classified by aetiology and location. The main reason of ventral hernias can be prior surgery (incisional) or spontaneously (umbilical, epigastric, spigelian, or lumbar hernias). Ventral hernia repair is one of the most common operations performed by general surgeons. The purpose of this study was to compare the complications rate, post-operative pain, hospital stay and time to return to normal activity in laparoscopic and open mesh repair of ventral hernias. The study was conducted from October, 2010 to February, 2011 in surgery department Holy Family Hospital, Rawalpindi. Patients and Methods: In this randomised clinical trial a total of 160 patients were selected by taking approval from hospital ethical committee and informed written consent from each patient. The admitted patients for elective surgical repair of ventral hernia were randomly allocated to Group A (laparoscopy) and B (open repair) including 80 patients in each group. Information regarding study parameters was recorded on a predesigned performa. Results: The mean age in laparoscopic group was 41.20 ± 5.44 years and in open repair group it was 43.32 ± 4.31 years. In laparoscopic group there were 61 females (76.25%) and in open mesh repair group there were 63 (78.75%) females. The post-operative pain was significantly (p-value = 0.000) less in laparoscopic group (3.59 + 1.58) as compared to open repair group (5.49 ± 1.59). The mean hospital stay was also significantly greater in open mesh repair group (31± 5.8 vs. 39 ± 7.36, p-value = 0.001). The time to resume work activities for the laparoscopic group was significantly (p-value = 0.046) shorter (median, 21.0 days; inter-quartile range, 24 days) compared with that for the open repair group (32.5 days; 36 days). There was significantly greater complication rate in open mesh repair group (48.75% vs 33.4%, p-value = 0.032) as compared to laparoscopic group. Intra-operative complications were noted higher in laparoscopic group as compared to open mesh repair group. Conclusion: The laparoscopic management of ventral hernia repair has less post-operative pain, less complications, shorter hospital stay and shorter time of return to normal activity work.