Retrospective comparison of open versus laparoscopic ventral and incisional hernia repair.
BACKGROUND
We performed a retrospective study to determine the mid-term recurrence and complication rates of patients following laparoscopic ventral and incisional hernia repair (LVHR) with DualMesh, an expanded polytetrafluoroethylene (ePTFE) mesh. Additionally, a study of the mesh contraction rate was performed postoperatively.


METHODS
We compared open mesh repair of ventral and incisional hernias (OR) and LVHR. We also analyzed the shrinkage rate of ePTFE mesh. We included 45 patients (21 OR, 24 LVHR) who underwent mesh repair for primary ventral and incisional hernias between January 2008 and December 2012. Patients' characteristics did not significantly differ between the two groups.


RESULTS
Mean operating time was 152.7 min for the OR group and 143.1 min for the LVHR group (P = 0.25). Mean postoperative hospital stay was 13.4 days for the OR group and 6.8 days for the LVHR groups (P = 0.01). The postoperative complication rate was 28.6% for the OR group and 12.5% for the LVHR group (P = 0.03). Among OR patients, causes of morbidity were variable: two recurrent cases, one surgical-site infection, one re-recurrence, one case of enteritis, and one case of heart failure. Among the LVHR patients, there was one surgical-site infection and two cases of seroma. No patients in the LVHR group experienced recurrence, while 14.3% of OR patients had a recurrence. In the LVHR group, the mean ePTFE mesh contraction rate was 10.6%.


CONCLUSIONS
LVHR has advantages compared with OR, and the post-insertion contraction rate of ePTFE mesh was 10.6%.
Department of Digestive Surgery, Kawasaki Medical School, Okayama, Japan; Department of Surgery, Kurashiki Central Hospital, Okayama, Japan.
Atsushi
A
Tsuruta
Toshihiro
T
Hirai
Masafumi
M
Nakamura
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011138:Polytetrafluoroethylene / Q000009:adverse effects; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh / Q000009:adverse effects; D016896:Treatment Outcome
D011138:Polytetrafluoroethylene
DualMesh; ePTFE; laparoscopic ventral and incisional hernia repair (LVHR)