A COMPARATIVE STUDY OF LAPAROSCOPIC VENTRAL HERNIA REPAIR WITH AND WITHOUT CLOSURE OF HERNIAL DEFECT
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 12
Abstract
BACKGROUND Despite the developments in laparoscopic repair of ventral hernia, some problems in this repair still persist. In addition to recurrence and postoperative pain, the problem of seroma with persistent postoperative bulge and loss of body image render the procedure unacceptable to patients. This was the basis on which our study was conducted. We studied and compared the safety, efficacy and postoperative morbidity of laparoscopic ventral hernia repair with and without closure of hernial defect. MATERIALS AND METHODS We compared 30 patients in Group A (where the defect was closed before mesh was placed) and 30 patients in Group B (where the defect was not closed and mesh was placed directly over the defect). RESULTS In this study, the average defect size was 43.66 cm2 in Group A and 44.53 cm² in Group B. In our study the incidence of postoperative seroma in the closure group was 6.6%, whereas it was 53% in the non-closure group. There was one recurrence in our mean follow-up of 10 months, in closure group and 3 in non-closure. 80% of patients in the closure group were very satisfied with their body image, whereas only 20% of patients in the non-closure group were very satisfied with their body image. CONCLUSION The advantage of closure of the hernial defect before mesh reinforcement in laparoscopic ventral hernia repair has been established. A drastic decrease in the incidence of seroma has occurred. Quality of life in the postoperative period is better, because there is no bulge and patients are satisfied. The correlation with reduction in the incidence of recurrence needs further follow-up.
Authors and Affiliations
Bhupinder Singh Pathania, Devika Rakesh
Keywords
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- EP ID EP412077
- DOI 10.14260/jemds/2018/339
- Views 95
- Downloads 0
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