STUDY OF LAPAROSCOPIC VENTRAL HERNIA REPAIR IN A SINGLE INSTITUTIONAL SETUP

Abstract

Objective: Incidence of Ventral hernias or anterior abdominal wall hernias is about 2-13% worldwide. Laparoscopic ventral hernia repair (LVHR) technique has proven to be effective treatment option with reduced complications. This study aims to assess the feasibility and outcome of LVHR in a government set up. A prospective observational study of patients of a single government institution was conducted. Surgical technique,Methods: Long- term outcomes such as pain, mesh infections, bowel adhesions, recurrence and feasibility were assessed. Mean age of studyResults: patients was 44.45 years, with highest incidence (33.33%) in the age group of (31-40) years. Male: Female ratio was 1: 2.529. Obesity accounted for predominant risk factor (15 %). Around (31.67 %) patients had other co morbidities like diabetes, hypertension, obesity, COPD and pulmonary tuberculosis. Incision hernia accounted for (50 %). Remaining (50 %) include the epigastria hernia, umbilical hernia, traumatic hernia and spigelian hernia. 44(73.34%) patients had defect size between (2-5) cm, 11(18.33%) patients between (5-10) cm and 5(8.33%) patients less than 2 cm. Mean defect size was 3.51 cm. 54 patients (90 %) having defect size more than 2 cm were operated by laparoscopic Intra peritoneal on lay mesh repair. 6 (10%) patients having defect size less than 2 cm operated by Laparoscopic fascial closure by intracorporeal suturing. Mean surgical time was 55.17 minutes. (Range 40 - 110 minutes). Mean postoperative hospital stay was 2.25 days. 65% of patients got discharged after 2 days. Total 8 (13.33%) patients developed complications which were managed conservatively. 1 (1.67%) patient developed recurrence. There were no mortality and minimum morbidity observed. Although we cannot conclude regarding cost factor, we can vouch that all patients with anyConclusion: primary ventral hernia should have the repair performed by the laparoscopically if technically feasible. Laparoscopic ventral hernia repair is feasible, effective and can be performed as short stay surgery even in government set up.