Comparing outcomes of the endoscopic and open external oblique myofascial release

Abstract

AIMS: The external oblique release (EOR) is a well-described technique for myofascial advancement during hernia repair. One of the reported drawbacks of an open approach is the high wound morbidity associated with this procedure. One proposed technique to reduce wound morbidity is the endoscopic EOR. The purpose of this study was to compare the outcomes of the open and endoscopic EOR. METHODS: Data from the Americas Hernia Society Quality Collaborative were queried on May 10, 2017. All patients undergoing open or endoscopic incisional hernia repair with an EOR were evaluated with comparative outcomes including hernia recurrence, quality of life, and 30-day wound complications. RESULTS: Four hundred and eighty-five patients met inclusion criteria of undergoing open or endoscopic EOR. Surgical site infections (SSIs) occurred in 6% of the patients undergoing open EOR and 14% undergoing endoscopic EOR. There were no differences in outcomes comparing open and endoscopic EOR for hernia recurrence, quality of life, or 30-day SSI rate (P > 0.05). Laparoscopic EOR had a significantly higher rate of surgical site occurrences (SSOs) compared with open EOR (P 0.05). CONCLUSIONS: Equivalent outcomes were achieved using the open or endoscopic EOR technique in open repair of incisional hernia. Both techniques offer good outcomes and are important adjuncts in the repair of complex incisional hernias.