Laparoscopic Ventral Hernia Repair: Comparative Study between Closure of Hernia Defect and Non-Closure (Tension Free Repair)

Abstract

Background: Any protrusion through the anterior abdominal wall with the exception of hernia through the inguinofemoral region is defined as ventral hernia. Incisional hernia and primary defects in the abdominal fascia, which can cause umbilical hernia, epigastric hernia, para-umbilical hernia and spigelian hernia are grouped under the definition of ventral hernia.
Objective: To evaluate the recurrence rate of laparoscopic ventral hernia repair with closure and non-closure of the hernia defect in non-complicated ventral hernia cases.
Patients and Methods: This prospective randomized study was conducted from March, 2015 till December, 2019 in General Surgery Department, Mansoura University Hospital. It involved 50 patients with ventral hernia, who were classified randomly into 2 groups by computer generated sampling technique after retrieval of the calculated sample size according to inclusion and exclusion criteria.
Results: The mean age of the non-closure group and of the closure group was 39.96 ± 6.52 and 39.84 ± 7.48 years respectively. The males were 36.0% and females were 64.0% in non-closure group, while in the closure group males were 24.0%, and the females were 76.0%. The mean BMI in the non-closure group was 31.44 ± 3.76 kg/m², while in the closure group was 30.88 ± 3.70 kg/m² . In the non-closure group, the most common  hernia sites were epigastric  (60.0%), followed by umbilical (40.0%) while in the closure group, the most common hernia sites were umbilical (96.0%).
Conclusion: Laparoscopic ventral hernia repair is a safe and feasible technique. The great advance in abdominal  laparoscopic surgery and advance  in the equipments and instruments as well as individual skills make closure of the  hernia defect represents a good alternative to conventional  laparoscopic ventral hernia repair (LVHR) with mesh only.