Laparoscopic Incisional Hernia Mesh Repair With And Without Defect Closure

Original Article

Abstract

Objectives: to compare laparoscopic incisional hernia mesh repair with or without mesh defect after evaluating the rates of recurrence, complications, and postoperative recovery.

Study Design: A prospective study.

Place and duration of study: Department of  General Surgery 2024  Jinnah Post Graduate Medical Centre Karachi From May 2024 to October .

Methodology: 100 patients drawn through random sampling. Two groups of fifty patients each were operated, the first having Laparoscopic hernia repair with defect closure, the second having it without defect closure. Mesh positioning and location were aligned; follow-up extended to 12 months majoring on recurrence, bulge, and pain after surgery. Quantitative data analysis as well as qualitative data analysis included use of p-values and standard deviations for comparison between the groups.

Results: Table 3 demonstrated the mean times to first recurrent event; the recurrence rate in defect closure group was 6% and in non-closure group it was 10% with p value 0.04; statistically significant. New wall formation was symmetrical in 18% of patients with defect closure and 34% without (p=0.03). The mean postoperative pain scores were also comparable (3.2± 0.6 vs 3.4 ± 0.7; p=.35; not significant). There were no postsurgical complications of the noted surgery as a whole.

Conclusions: Closure of the defect in laparoscopic incisional hernia repair is associated with a lower recurrence rate and minimal bulging in comparison to non-closure laparoscopic incisional hernia repair with similar pain scores. Defect closure should be entertained for patients who desire better esthetic and clinical appearance, and the study demonstrated feasibility in patients with moderate size of hernias.