Comparison of open and laparoscopic prosthetic repair of large ventral hernias.
OBJECTIVE
Open ventral hernia repair is associated with significant morbidity and high recurrence rates. Recently, the laparoscopic approach has evolved as an attractive alternative. Our objective was to compare open with laparoscopic ventral hernia repairs.


METHODS
Fifty laparoscopic and 22 open ventral hernia repairs were included in the study. All patients underwent a tension-free repair with retromuscular placement of the prosthesis. No significant difference between the 2 groups was noted regarding patient demographics and hernia characteristics except that the population in the open group was relatively older (59.4 vs 47.82, P < 0.003).


RESULTS
We found no significant difference in the operative time between the 2 groups (laparoscopic 132.7 min vs open 152.7 min). Laparoscopic repair was associated with a significant reduction in the postoperative narcotic requirements (27 vs 58.95 mg i.v. morphine, P < 0.002) and the lengths of nothing by mouth (NPO) status (10 vs 55.3 hrs. P < 0.001), and hospital stay (1.88 vs 5.38 days, P < 0.001). The incidence of major complications (1 vs 4, P < 0.028), the hernia recurrence (1 vs 4, P < 0.028), and the time required for return to work (25.95 vs 47.8, P < 0.036) were significantly reduced in the laparoscopic group.


CONCLUSIONS
Laparoscopic ventral hernioplasty offers significant advantages and should be considered for repair of primary and incisional ventral hernias.
Raftopoulos
Ioannis
I
Metropolitan Group Hospitals, General Surgery Residency Program at Chicago, University of Illinois at Chicago, Chicago, Illinois, USA. iraftopoulos@hotmail.com
Vanuno
Daniel
D
Khorsand
Jubin
J
Kouraklis
Gregory
G
Lasky
Philip
P
D000704:Analysis of Variance; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D012008:Recurrence; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome