Short-Term Outcome of Laparoscopic Intraperitoneal Hernioplasty of Incisional Hernia in Khulna Medical College Hospital

Abstract

Background: Herniorrhaphies that apply a large prosthetic mesh appear to have a lower failure rate, but extensive dissection of soft tissue contributes to an increased incidence of wound infections and wound-related complications. The method of laparoscopic incisional hernia repair was developed in the early 1990s. This technique is based on the same physical and surgical principles as the open underlay procedure. Therefore, this operation has increased in popularity promising shorter hospital stay, improved outcome and fewer complications than traditional open procedures. The aim of the study was to see the short-term outcome of laparoscopic intraperitoneal hernioplasty of incisional hernia in Khulna medical college hospital. Material & Methods: This study was prospective single-cantered observational study carried out at the department of surgery; Khulna Medical College Hospital included 30 patients of incisional hernia those who underwent laparoscopic intraperitoneal on lay mesh (IPOM) technique using polypropylene mesh and the mesh was fixed with Tacker. The duration of the period from January, 2013 to June, 2013. Data was collected by researcher himself with face-to-face interview using a prepared structured questionnaires & checklist and analyzed on SPSS 22. Results: The study was done on 30 patients among which 13 (43.3%) were male and 17 (56.6%) were female patients. Among them the maximum male and female came from 41-50 years age group. Among the 30 patients 16 belonged vertical incisional hernia, whereas 13 patients belonged transverse incisional hernia and the size of the defect of hernia in 27 were medium (defect is 5-10cm) and in 3 were small (defect is <5cm). 21 patients underwent emergency surgery, whereas 9 patients underwent elective surgery for different diseases previously. Every patient in this study group had some predisposing factors to appear incisional hernia. Of them, 16 (53.33%) patients were suffering from Diabetes mellitus, 6 (20%) patients were suffering from chronic cough 2 (6%) patients from chronic retention of urine, 4(13.33%) from chronic constipation and 8 (26.67%) patients from immunocompromised condition due to diseases or drugs taken by them. In case of preoperative complication, only 1 (3.3%) patient each experienced omental haemorrhage, visceral haemorrhage, bowel injury and open conversion whereas 2 (6.6%) patients featured port site bleeding. As postoperative complication, the study shows that 4 (13.3%) patients developed paralytic ileus in followed by port site infection in 3(10%) patients. Conclusion: Laparoscopic hernioplasty is safe and convenient repair in short-term in our clinical setup. But to reach a precise conclusion a long-term case control study with conventional mesh hernioplasty in multiple centres should be done.