Laparoscopic versus open ventral hernia repairs: 5 year recurrence rates

BACKGROUND:The purpose of this study is to compare the difference of incidence of post-operative complications, operative time, length of stay and recurrence of patients undergoing laparoscopic or open repair of their ventral/incisional hernia a meta-analytic technique for observational studies.MATERIALS AND METHODS:A literature search was performed using Medline, PubMed, Embase and Cochrane databases for studies reported between 1998 and 2009 comparing laparoscopic and open surgery for the treatment of ventral (incisional) hernia. This meta-analysis of all the observational studies compared the post-operative complications recurrence rate and length of stay. The random effects model was used. Sensitivity and heterogeneity were analysed.RESULTS:Analysis of 15 observational studies comprising 2452 patients qualified for meta-analysis according to the study's inclusion criteria. Laparoscopic surgery was attempted in 1067 out of 2452. The results showed that the length of stay (odds ratio [OR], – 1.00; 95% confidence interval [CI], – 1.09 to – 0.91; P < 0.00001) and operative time (OR, 59.33; 95% CI, 58.55 to 60.11; P < 0.00001) was significantly lower in the laparoscopic group. The results also showed that there was a significant reduction in the formation of abscesses (OR, 0.38; 95% CI, 0.16 to 0.92; P = 0.03) and wound infections (OR, 0.49; 95% CI, 0.29 to 0.82; P = 0.007) post-operatively. There is a trend which indicates that the recurrence of the hernia using laparoscopic repair versus open repair was overall lower with the laparoscopic repair (OR, 0.48; 95% CI, 0.22 to 1.04; P = 0.06), however, this was not significant.CONCLUSION:Laparoscopic incisional hernia repair was associated with a reduced length of stay, operative time and lower incidence of abscess and wound infection post-operatively. This study also highlights the benefit of using observational studies as a form of research and its value as a tool in answering questions where large sample sizes of patient groups would be impossible to accumulate in a reasonable length of time.

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“…Therefore, 15 observational trials with 2452 patients qualified for meta-analysis according to the study's inclusion criteria. [13–27]…”

Section: Resultsmentioning

confidence: 99%

Analysing the benefits of laparoscopic hernia repair compared to open repair: A meta-analysis of observational studies

2012

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“…Since Leblanc et al [8] reported the first LVHR in 1992, this technique has generated significant interest with its reduced LOS, and lower rate of wound complications and recurrence rates [9][10][11][12]. These benefits, however, are offset by higher risk of procedure-related complications, especially unrecognized hollow viscous injury, which can lead to sepsis and death [13].…”

Section: Discussionmentioning

confidence: 99%

Predictors of in-hospital length of stay after laparoscopic ventral hernia repair: results of multivariate logistic regression analysis

Kurian¹,

Gallagher²,

Cheeyandira³

et al. 2010

Surg Endosc

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“…The recurrence rate (4.4-29 %) mentioned in the recent reports on sIPOM [12][13][14][43][44][45] has been quite variable, which is attributable to the differences in the size of the hernial orifice and body mass index (BMI) of the patients and the differences in the follow-up periods. A simple comparison of the surgical outcomes of IPOM-Plus with sIPOM is meaningless because of the absence of large prospective randomized studies on the recurrence or complication rates of IPOM-Plus and sIPOM.…”

Section: Recurrencementioning

confidence: 96%

Closure versus non-closure of fascial defects in laparoscopic ventral and incisional hernia repairs: a review of the literature

2015

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The laparoscopic technique for repairing ventral and incisional hernias (VIH) is now well established. However, several issues related to laparoscopic VIH repair, such as the high recurrence rate for hernias with large fascial defects and in extremely obese patients, are yet to be resolved. Additional problems include seroma formation, mesh bulging/eventration, and non-restoration of the abdominal wall rigidity/function with only bridging of the hernial orifice using standard laparoscopic intraperitoneal onlay mesh repair (sIPOM). To solve these problems, laparoscopic fascial defect closure with IPOM reinforcement (IPOM-Plus) has been introduced in the past decade, and a few studies have reported satisfactory outcomes. Although detailed techniques for fascial defect closure and handling of the mesh have been published, standardized techniques are yet to be established. We reviewed the literature on IPOM-Plus in the PubMed database and identified 16 reports in which the recurrence rate, incidence of seroma formation, and incidence of mesh bulging were 0-7.7, 0-11.4, and 0 %, respectively. Several comparison studies between sIPOM and IPOM-Plus seem to suggest that IPOM-Plus is associated with more favorable surgical outcomes; however, larger-scale studies are essential.

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Laparoscopic versus open ventral hernia repairs: 5 year recurrence rates

Cited by 66 publications

References 18 publications

Analysing the benefits of laparoscopic hernia repair compared to open repair: A meta-analysis of observational studies

Analysing the benefits of laparoscopic hernia repair compared to open repair: A meta-analysis of observational studies

Predictors of in-hospital length of stay after laparoscopic ventral hernia repair: results of multivariate logistic regression analysis

Closure versus non-closure of fascial defects in laparoscopic ventral and incisional hernia repairs: a review of the literature

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