Evaluation of Perioperative and Quality of Life Outcomes Along with Cost Effectiveness in Laparoscopic Transabdominal Retrorectus Mesh Repair for Ventral Hernia: A Prospective Observational Study

Abstract

Introduction: Laparoscopic ventral hernia repair has its advantages of reduced postoperative complication and early return to work. Owing to the need of a cost-effective technique with similar perioperative outcomes, transabdominal retro-rectus mesh repair (TARM) is a suitable and less expensive alternative compared with other methods of laparoscopic ventral hernia repair. Methods: Patients with primary (n = 7) or incisional (n = 17) hernia were selected to be operated on using TARM procedure. Quality of life was evaluated in terms of time to return to usual routine work, the sensation of mesh (using Carolinas Comfort Scale, CCS), tolerance to early oral feed, formation of seroma, suture site infection and hernia recurrence. Results: The average defect size was 2.8 cm with a mean BMI was 28.17 kg/m2. The average duration of surgery was 165 mins. Mean postoperative pain score after 1 day, 1 week, 1 month, 3 months and 6 months were 3.5, 2, 0.58, 0.5 and 0 respectively. Seroma formation occurred in 6 (25%) and hematoma in 1 (4%) patient. The mean time to resumption of daily activities was 6.25 days. Mean CCS after 1 month and 3 months are 30 and 16.2 respectively. No cases of recurrence or chronic pain were observed during 6 months follow-up. Conclusion: Laparoscopic TARM appears to be a feasible, safe and cost-effective method of ventral hernia repair due to standard laparoscopic instruments used, no contact with bowel and use of plain polypropylene mesh respectively.