Laparoscopic versus open incisional hernia repair: An institutional experience

Laparotomy performed for surgical access usually heals quickly and without complications, leaving a stable scar. An exception to this is the rare (< 1%) occurrence of acute separation of the sutured abdominal walls during the postoperative phase – known as acute wound dehiscence or burst abdomen – and the more frequent (> 20%) occurrence of chronic wound dehiscence with the formation of a hernial sac and canal months to years after surgery. This is known as incisional hernia. Incisional hernia is receiving greater attention in the medical community than in previous years, due to the increasing use of ultrasonography as part of follow-up after abdominal surgery, increased long term survival even after oncological surgery, and demographic developments which permit longer follow up. Incisional hernias and ventral hernias larger than 2 cm are preferably repaired using prosthesis, because primary repair has an unacceptable high rate of recurrences. Mesh repair has become standard for treatment of hernia now. With evolution of technology and the recent advances in surgery, surgeons started doing laparoscopic repair in 1990’s. The laparoscopic technique is believed to have fewer complications and a better postoperative course, with quicker ambulation, shorter hospital stay and less postoperative pain. Low recurrence rates of 0 to 9% are reported. With the potential advantages of this minimal invasive approach, we started to perform this technique in our institute from 2008. This study was done to evaluate the results of our initial experience with laparoscopic repair and comparing with open repair of incisional hernia.