Fascial Defect Closure Versus Non-Closure in Laparoscopic Ventral and Incisional Hernia Repair

Abstract

Background: Incisional hernias are common after abdominal surgery. Laparoscopic repair has advantages over open repair. Traditionally, laparoscopic ventral hernia repair has been done as a bridging repair, with the fascial defect circumferentially overlapped. Primary fascial closure to reaproximate the fascia before mesh implantation has become more popular in recent years. Aim of the work: The goal of this study is to examine our experience of repairing ventral and incisional hernia by laparoscope in order to evaluate the outcomes and differences in fascial defect closure and non-closure in our ventral and incisional hernia repair experience. Patients and methods: 60 patients with ventral and incisional hernias were treated at Al-Azhar University Hospital in New Damietta from July 2018 to July 2020. Laparoscopic repair was decided for all patients. Results: The mean operative time by hours for group A (2.1±0.2) Vs group B (1.3±0.4) with highly significant deferent between 2 group p < 0.001. As regards the acute post-operative pain: (group B) showed less degree of pain post-operative complications: Post-operative seroma were reported in 5 cases (16.6%) of the group A and 11 cases (36.7%) of the group B recurrence, During the one-year follow-up period, 1 case in group A and 4 cases in group B experienced recurrent incisional hernia. In group A, we had one patient with a serosal intestine rip and two patients in group B. Conclusion: Although there were no significant statistical differences between the fascial closure and non-closure groups, the fascial
closure group had reduced seroma and recurrence.