Incisional Hernia Repair: Laparoscopy versus Open Surgery - A Prospective Study

Objective: To assess the feasibility of laparoscopic incisional hernia repairs and to examine possible differences in operative time, morbidity, recurrence rates and length of hospital stay compared to repairs performed by open surgery. Patients: Between January 2016 and June 2019, sixty patients who underwent parietal repair were enrolled in this study. Patients were divided into two non-randomised groups. Data were collected prospectively and recorded in a database. The statistical analysis was performed using SPSS24 biomedical statistics software and Microsoft Excel. The statistical analysis was performed using the chi-two test, with calculation of the P value (Pearson test). Results: Thirty patients who underwent parietal repair by laparoscopic preperitoneal prosthesis placement (first group), and 30 patients who underwent open repair (2nd group). The two groups were comparable in terms of gender distribution and body mass index. No significant differences were observed in age and comorbidities between the two groups. In the first group, implantation of an intraperitoneal bifacial prosthesis was possible in 93.3% of patients. In the second group, the prosthesis was placed retromuscularly in 56.6% of patients and perifascial in 41% of patients. The conversion rate to open surgery was 6.6%. The average operating time was (81mn vs 92min). The complication rate was (26.6% vs 43.3%). The average length of hospital stay was 2 days 5.6 days. The recurrence rate at 3 years is (3.3% 6.6%; P< 0.05). Conclusion: The results of this study suggest that parietal repair by laparoscopic intraperitoneal prosthesis placement has some advantages over open surgery.