Retromuscular sutured incisional hernia repair: a randomized controlled trial to compare open and laparoscopic approach.
To compare the early and intermediate results of the open and laparoscopic tension-free repair of incisional hernia, 24 patients were randomized prospectively to undergo laparoscopic or open repair of incisional hernia with retromuscular placement of the prosthesis using transabdominal sutures for mesh fixation. All the procedures were completed as planned. The mean duration of surgery was not significantly different between the 2 groups (P=0.15). Time to oral solid food intake was longer in the open group (P=0.002). The analgesic requirement was lower in the laparoscopic group (P=0.05). One patient after open surgery and 2 in the laparoscopic group suffered postoperative complications (P=0.71). Postoperative stay was shorter in the laparoscopic group (P=0.006). No readmission or recurrence was registered within 6 months from surgery in either group. Laparoscopic incisional hernia repair, based on the Rives-Stoppa technique, is a safe, feasible alternative to open techniques. However, larger studies and long-term follow-up are required to further evaluate the true effectiveness of this operation.
Navarra
Giuseppe
G
Department of Surgical Sciences, Faculty of Medicine, University of Messina, G. Martino University Hospital, V. Cons. Valeria, Messina, Italy. gnavarra@unime.it
Musolino
Cinzia
C
De Marco
Maria Luisa
ML
Bartolotta
Marcello
M
Barbera
Alberto
A
Centorrino
Tommaso
T
D000328:Adult; D000368:Aged; D005260:Female; D046449:Hernia, Abdominal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D013537:Sutures; D013997:Time Factors; D016896:Treatment Outcome