A comparative study of Surgical Complications in Laparoscopic versus Open ventral hernia mesh repair in a Tertiary Care Center of Nepal

Introduction: Ventral hernia repair is one of the common surgical procedure nowadays. Ventral Hernia/Incisional hernia is a protrusion occurring through the anterior abdominal wall fascia. Several methods of repair have been proposed for ventral hernias, however, mesh repair has been widely accepted. Along with other benefits of minimal invasive surgery, complications such as bleeding, bowel injury, seroma, hematoma, postoperative pain and surgical site infection (SSI) and recurrence has been shown to be relatively less common in laparoscopic methods. Methods: This is a prospective comparative observational study conducted at tertiary care center, Bir Hospital, for a period of one year. A total of 84 patients were enrolled in the study comprising of 42 in LVHR (Laparoscopic Ventral Hernia Repair) group and 42 in OVHR (Open Ventral Hernia Repair) group. Hospital ethical committee approval was taken and written. Informed consent was obtained. Data was collected on a structured proforma and analyzed with SPSS version 23 and Microsoft excel 2010. Outcomes measured were association with BMI, length of hospital stay, operative time, surgical complications within 1 year. Results: Among total 84 cases,54.8% were female. The mean age of patients for LVHR and OVHR group were 48.52±12.793 years and 43.50± 14.920 years respectively.58.61% patients had BMI >25 kg/m2. LVHR group had significantly less postoperative pain than the OVHR group at 24 ,48 hours and on 7th postoperative day (P value<0.05). The mean hospital stay after surgery was less for LVHR group (2.33±0.52vs 3.48±1.31) which was statistically significant. (p = <0.05). Conclusion: Laparoscopic ventral hernia repair has become popular method as compared to open methods and the short-term results are rewarding with less complications such as bleeding, post-operative pain, seroma, hematoma, SSI, recurrence and improved quality of life when compared to open repair.