title: Laparoscopic versus Hybrid Approach for Treatment of Incisional Ventral Hernia.
abstract: BACKGROUND
  The aim of this study was to compare the efficacy of a hybrid approach (HA) versus laparoscopy in reducing the risk of complications related to complex adhesiolysis in incisional ventral hernia repair (IVHR).
  
  
  METHODS
  This study included 269 adult patients who underwent laparoscopic IVHR at the Oulu University Hospital, Finland during 2006-2012. Baseline, operative and postoperative data was collected and compared between the treatment groups; that is, a comparison was made between the laparoscopic approach (LA, 38 patients) and the hybrid approach (HA, 24 patients).
  
  
  RESULTS
  In the LA group, 11 (28.9%) patients experienced postoperative complications. There were 4 undetected enterotomies that led to major complications, reoperations and one death. In the HA group, 6 (25%) patients experienced mild and moderate complications. During adhesiolysis, 4 enterotomies occurred but were immediately sutured without any complication.
  
  
  CONCLUSIONS
  Adhesiolysis through a minimally invasive open technique may be associated with a lower risk of undetected enterotomy in patients with complex adhesions. In IVHR, the hybrid should be considered the operative method of choice when adhesions are foreseeable.
authors.affiliation: Department of Surgery, Oulu University Hospital, Oulu, Finland.
authors.forename: Mirella
authors.initials: M
authors.lastname: Ahonen-Siirtola
authors.forename: Tero
authors.initials: T
authors.lastname: Rautio
authors.forename: Fausto
authors.initials: F
authors.lastname: Biancari
authors.forename: Pasi
authors.initials: P
authors.lastname: Ohtonen
authors.forename: Jyrki
authors.initials: J
authors.lastname: Mäkelä
mesh_terms: D000368:Aged; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D000069290:Incisional Hernia / Q000601:surgery*; D007416:Intestinal Perforation / Q000209:etiology*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012086:Reoperation; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000150:complications / Q000601:surgery
keywords: Adhesiolysis; Adhesions; Bowel; Complication; Hybrid approach; Iatrogenic injury; Incisional hernia; Laparoscopic approach