Closure Vs Non-Closure of Fascial Defect in Laparoscopic Ventral Hernia Repair: A Randomized Observational Study
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 9
Abstract
Background: surgery for ventral hernia has always been challenge for surgeons. The management approach has shifted from open to minimally invasive methods, and nowadays emphasis is not only on the improvement of symptomatology but also the cosmesis. Aim of present study was to evaluate beneficial effect of closure of fascial defect over non closure in patients with ventral hernia undergoing laparoscopic repair. Material and methods: sixty patients of ventral hernia (both primary & incisional) were randomized into two groups. Thirty patients underwent standard laparoscopic hernia repair without closure of fascial defect. In other 30 patients closure of fascial defect was also performed in addition to standard procedure. Both the patient groups were prospectively followed up. Results: Mean operative duration and need for non opioid analgesics for first 48 hours was higher in study group in whom closure of fascial defect was performed. Mesh bulging was noticed in control group but not in study group. Seroma formation, recurrence, and surgical site infections were comparable in both the groups. Conclusion: Accepting higher pain on VAS manageable by nonopioid analgesics and slight increase in operative duration on account of closure of fascial defect during laparoscopic mesh repair of primary ventral or incisional hernia is an acceptable alternative to non fascial closure with less postoperative pain, but with added risk of seroma formation, mesh bulging, recurrence and/or other wound related complications.
Authors and Affiliations
Dr. Indu Bhushan Dubey
Keywords
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