Laparoscopic management of incisional hernia: Emphasis on intraperitoneal mesh-related complications and comparative advantages over the open technique

Background: Incisional hernia is a common surgical complication with significant morbidity, traditionally managed by open mesh repair. Laparoscopic techniques have gained popularity due to potential advantages in recovery and complication profile, particularly concerning mesh-related outcomes. Aims and Objectives: The aim of the study was to evaluate and compare the clinical outcomes, safety profile, and recovery patterns of laparoscopic versus open incisional hernia repair, with special emphasis on mesh-related complications. Materials and Methods: This prospective comparative study was conducted at the Department of General Surgery, Government Medical College, Datia, from October 2024 to September 2025. A total of 90 patients diagnosed with incisional hernia were equally divided into two groups: Laparoscopic repair (n=45) and open repair (n=45). Intraoperative parameters (operative time, blood loss), post-operative outcomes (pain scores, complications, hospital stay, return to activity, recurrence), and patient satisfaction were recorded and statistically analyzed. Results: Laparoscopic repair required longer operative time (72.5±5.3 vs. 61.4±4.8 min, P=0.001) but resulted in significantly less blood loss (27.2±4.5 vs. 49.8±9.2 mL, P=0.001). Post-operative pain scores were consistently lower in the laparoscopic group at all-time points (P=0.001). Overall complication rates were markedly reduced in the laparoscopic cohort (15.6% vs. 37.8%, P=0.01). Hospital stay (2.6±0.7 vs. 6.4±0.9 days, P=0.001) and time to return to normal activity (12.1±1.8 vs. 19.8±1.5 days, P=0.001) were also significantly shorter. Recurrence was observed only in the open group (4.4%). Patient satisfaction scores were higher with laparoscopy (8.6±1.2 vs. 6.9±1.4, P=0.001). Conclusion: Laparoscopic incisional hernia repair is a safe, effective, and patient-friendly alternative to open repair, offering superior short-term outcomes and fewer complications despite a slightly longer operative duration.