Long-term Outcomes in Laparoscopic vs Open Ventral Hernia Repair

Objective: To ruleout whether there was a difference in, recurrence rate, morbidity, and duration of hospital stay between patients undergoing open or laparoscopic ventral hernia surgery. Materials and methods: Cohort study in single-institution was compared prospectively collected from patient cohorts undergoing laparoscopic or open intraperitoneal onlay mesh repair. Literature search was performed using search engine Google and our online facility of Springer Link. The following search terms were used. Laparoscopic versus ventral hernia repair, ‘laparoscopic repair of ventral hernia, controversies in laparoscopic ventral hernia repair, comparison of laparoscopic and open (Ventral Hernia) repair, Laparoscopic Repair of Ventral Hernia during obesity. About 143 citations found in total. Data collected from 360 consecutive patients who had undergone laparoscopic or open intraperitoneal onlay mesh repair of a ventral hernia were prospectively collected from October 1995 and December 2005 are recorded . Main outcome of the study: Hernia recurrence and duration of hospital stay and morbidity. Postoperative complications of Clavien grade 2 or more than grade 2 were considered as major complications. Results: Intraperitoneal onlay mesh surgery was performed in 233 patients by open approach and in 127 patients by laparoscopic approach. Groups were similar for sex and body mass index and it is calculated by weight in kilograms divided by the height in meters squared and the mean age for the laparoscopic group was 3 years younger; and the mesh was selected larger for the laparoscopic group. Mean follow-up for both laparoscopic and open groups was 30 and 36 months; and the conversion rates are 4%. Major morbidities were 15% in the open group and 7% in the laparoscopic group. Recurrence rates were 9% in the open group and 12% in the laparoscopic group. Postoperative inpatient admission was more frequent after the open procedure than after the laparoscopic procedure (28% and 16%, respectively). Conclusions: Outcomes of the study shows not much difference with respect to recurrence rates after long-term follow-up; however, lower rate of major morbidity and increased outpatient-based procedure rates favor laparoscopic repair in this study.