Comparative study between laparoscopic and open repair of umbilical and para umbilical hernia

Abstract

Background: Laparoscopic repair of umbilical and para umbilical hernia has largely replaced conventional (Open) repair. The purpose of the study is to compare the effectiveness of laparoscopic vs. open repair of umbilical & para umbilical hernia in a tertiary care government hospital. Methods: Place of study: Minimal access surgery unit, MMC/GH Chennai, between April 2013 - March 2014. Selection criteria: Patients above 18 years of age were included and those with complicated Umbilical / Para umbilical hernia, coagulopathy, severe cardiopulmonary disease, ascites and renal failure were excluded. 42 patients with Umbilical and para umbilical hernias were randomly categorized into two equal groups. Group L treated with laparoscopic mesh repair and Group O treated by conventional mesh repair and patient, surgeon and hospital related parameters were assessed. Results: The operative time, post-operative pain, mean hospitalisation, time to return to routine activity and work, complications and recurrence rates were assessed and P values derived and compared between the two types of repair and found better in patients undergoing laparoscopic repair. Conclusions: Though the cost of bilayered mesh and fixation device are high in laparoscopic repair, the patient benefits in terms of less hospital stay, less pain and early return to routine activity and work make it superior to open repair. Laparoscopic umbilical/para-umbilical hernia repair is technically safe, effective and feasible, with a better clinical outcome in patients seeking treatment in a Government Hospital set-up.