title: Laparoscopic versus open repair of para-umbilical hernia. Is it a good alternative?
abstract: OBJECTIVE
  To compare the experience of laparoscopic repair of para-umbilical hernia with conventional open repair in terms of operative time, pre- and post-operative complications, total hospital stay, post-operative pain, morbidity, mortality and cosmesis.
  
  
  METHODS
  The prospective, randomized study was conducted at Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan, and two private hospitals from June 2011 to June 2013, and comprised patients who were admitted with para-umbilical hernias of different sizes during the study period. The patients were divided into two groups. Group A underwent laparoscopic surgery, while Group B had conventional mesh repair. Variables studied included duration of surgery, operative and post-operative complications, morbidity and mortality. SPSS 20 was used for statistical analysis.
  
  
  RESULTS
  Of the 337 patients in the study, 200(59.34%) were at the Liaquat University Hospital, while remaining 137(40.65%) patients were operated in two private hospitals. The overall mean age of the study sample was 42.18±9.789 years (range: 23-73). There were 68(20.18%) males and 269(79.82%) females. There were 166(49.26%) patients in Group A and 171(50.74%) Group B. The operative time was comparatively longer in Group A (p<0.001) especially in the first 30 operations. The laparoscopic approach was associated with a comparatively low incidence of operative and post-operative complications, reduced duration of hospital stay and cosmetically better results (p<0.05). There was no mortality in this series.
  
  
  CONCLUSIONS
  Laparoscopic para-umbilical hernia repair, though a new technique, gave promising results compared to open conventional technique. However, there is a long way to go before coming to a consensus.
authors.affiliation: Department of Surgery, College of Medicine, Qassim University, KSA.
authors.forename: Arshad Mehmood
authors.initials: AM
authors.lastname: Malik
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006406:Hematoma / Q000453:epidemiology; D006554:Hernia, Umbilical / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D045823:Ileus / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain; D011183:Postoperative Complications / Q000453:epidemiology*; D049291:Seroma / Q000453:epidemiology; D013529:Surgical Wound Dehiscence / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology; D055815:Young Adult
keywords: Para-umbilical hernias, Laparoscopic ventral hernia repair, Open mesh repair, Morbidity, Mortality.