An Analysis of Postoperative Outcome of Ventral Hernia Repair with Laparoscopic Repair versus Conventional Hernia Repair - A Cross-Sectional Clinical Study in a Government Tertiary Hospital, Nizamabad, Telangana

Abstract

BACKGROUND Aim of the surgeon repairing the ventral hernia is to alleviate the symptoms and prevent complications with minimal recurrence rates. Recent times have seen the popularity of laparoscopic approach but there is reasonable controversy to its optimal approach when compared to conventional method. The present study analyses and correlates the postoperative outcomes of patients who underwent laparoscopic and conventional methods of ventral hernia repair during the last three years. METHODS This is a cross-sectional clinical study in which 87 patients diagnosed with ventral hernia from the Department of General Surgery of Government Medical College and Hospital, Nizamabad from September 2017 to August 2020 were included. 42 patients underwent laparoscopic repair and 45 underwent conventional hernia repair. Patients aged between 35 and 74 years belonging to American Society of Anaesthesiologist (ASA) grade I and II were included. Clinical history, surgical profile and anaesthesia fitness were obtained using standard operating procedures. All patients were followed up to 06 months. Data variables such as age, gender, BMI (Body Mass Index) size of defect, postoperative hospital stay and other complications were collected and analysed. RESULTS Out of 87 patients, laparoscopic group had 27 (59.52 %) females and 15 (35.71 %) males with a female to male ratio of 1.8:1. Whereas conventional hernia repair group had 29 (64.44 %) females and 16 (35.55 %) males with a female to male ratio of 2:1. 38 out of 87 (43.67 %) patients were in the age group of 45 to 54 years. Incisional hernia - infra umbilical type was found in 34 out of 87 (39.08 %) patients while incisional hernia - supra umbilical type was found in 23 out of 87 (26.43 %) patients. Correlating the adverse events between laparoscopic method and conventional methods of ventral hernia repair showed a statistical significance. Pearson correlation coefficient was with R factor of 0.983 and the P value was 0.00001 (P significant at < 0.05) CONCLUSIONS Laparoscopic ventral hernia repair (LVHR) using bio-material mesh for the repair resulted in low postoperative pain, wound infection, graft rejection and higher long-term recurrence free patient satisfaction when compared to conventional hernia repair. KEYWORDS Ventral Hernia, Anterior Abdominal Wall, Laparoscopy, Repair and Recurrences