Skip to main content
SpringerLink
Log in

Incisional hernia repair

Retrospective comparison of laparoscopic and open techniques

  • Original article
  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

Abstract

Purpose: A retrospective clinical trial was conducted to compare laparoscopic incisional hernia repair (LIHR) and open traditional repair (OR). Demographics, perioperative data, results, and follow-up data were examined to determine whether there was any difference in outcome, recurrences, and costs. Methods: From January 2000 to June 2002, 42 consecutive, unselected patients who successfully underwent LIHR were matched with 49 consecutive, unselected patients who received OR during the same period. The operating room database, clinical files, and outpatient sheets were examined. Patient demographics, results, follow-up data, and costs were compared between the two groups. Results: Demographic characteristics, obesity, ASA status, type of hernia, concomitant surgery, urgencies, and incidences of previous repair were well matched between the two groups. Hernia defect was significantly larger in the OR group (122 cm2) than in the LIHR group (83 cm2; p = 0.0006). The operative times and the overall complications rates were similar, but wound infections were more common in the OR group (12% vs 0%; p = 0.04). The analgesic requirement was smaller (mean ketorolac injections, 2 vs 5; p < 0.0001; additional opiates, 0% vs 24%; p = 0.0006) and the hospital stay was shorter (5 vs 8 days; p < 0.0001) in the LIHR group. No recurrences were noted in the LIHR group, but there were three recurrences (6%) in the OR group (p = 0.30, not statistically significant). The cost of the prosthesis was higher for laparoscopic procedure, although the reduction in the hospital stay largely balanced the overall cost (p = 0.017). Conclusions: In this study, LIHR appeared to be as safe as OR. Despite the fact that LIHR raised the prosthesis-related costs, the findings showed that LIHR has clinical (less wound complications, shorter hospital stay, reduced pain) and financial advantages over OR.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. S Bageacu P Blanc C Breton M Gonzales J Porcheron J Chabert G Balique (2002) ArticleTitleLaparoscopic repair of incisional hernia: a retrospective study of 159 patients. Surg Endosc 16 345–348 Occurrence Handle1:STN:280:DC%2BD383jtVajtQ%3D%3D

    CAS  Google Scholar 

  2. M Ben-Haim J Kuriansky R Tal O Zmora Y Mintz D Rosin A Ayalon M Shabtai (2002) ArticleTitlePitfalls and complications with laparoscopic intraperitoneal expanded polytetrafluoroethylene patch repair of postoperative ventral hernia: lessons from the first 100 consecutive cases. Surg Endosc 16 785–788 Occurrence Handle1:STN:280:DC%2BD383lvVaitQ%3D%3D Occurrence Handle11997822

    CAS  PubMed  Google Scholar 

  3. MA Carbajo JC Martin del Olmo JI Bianco C de la Cuesta M Toledano F Martin C Vaquero L Inglada (1999) ArticleTitleLaparoscopic treatment vs open surgery in the solution of major incisional and abdominal wall hernias with mesh. Surg Endosc 13 250–252 Occurrence Handle1:STN:280:DyaK1M7msF2jtg%3D%3D Occurrence Handle10064757

    CAS  PubMed  Google Scholar 

  4. MA Carbajo JC Del Olmo JI Bianco et al. (2000) ArticleTitleLaparoscopic treatment of ventral abdominal wall hernias: preliminary results in 100 patients. J Soc Laparoendosc Surg 4 141–145 Occurrence Handle1:STN:280:DC%2BD3M%2FivVygug%3D%3D

    CAS  Google Scholar 

  5. K Cassar A Munro (2002) ArticleTitleSurgical treatment of incisional hernia. Br J Surg 89 534–545 Occurrence Handle10.1046/j.1365-2168.2002.02083.x Occurrence Handle1:STN:280:DC%2BD383jsFeiug%3D%3D Occurrence Handle11972542

    Article  CAS  PubMed  Google Scholar 

  6. R Chari V Chari M Eisenstat R Chung (2000) ArticleTitleA case controlled study of laparoscopic incisional hernia repair. Surg Endosc 14 117–119 Occurrence Handle1:STN:280:DC%2BD3c7isVSrtw%3D%3D

    CAS  Google Scholar 

  7. EJ De Maria JM Moss HJ Sugerman (2000) ArticleTitleLaparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prosthetic patch repair of ventral hernia. Surg Endosc 14 326–329 Occurrence Handle1:STN:280:DC%2BD3c3ltlynsQ%3D%3D Occurrence Handle10790548

    CAS  PubMed  Google Scholar 

  8. CD George H Ellis (1986) ArticleTitleThe results of incisional hernia repair: a twelve-year review. Ann R Coll Surg Engl 68 185–187 Occurrence Handle1:STN:280:BiiD2svlslU%3D Occurrence Handle3789602

    CAS  PubMed  Google Scholar 

  9. PP Goodney CM Birkmeyer JD Birkmeyer (2002) ArticleTitleShort-term outcomes of laparoscopic and open ventral hernia repair: a meta-analysis. Arch Surg 137 1161–1165 Occurrence Handle10.1001/archsurg.137.10.1161 Occurrence Handle12361426

    Article  PubMed  Google Scholar 

  10. BT Heniford A Park BJ Ramshaw G Voeller (2000) ArticleTitleLaparoscopic ventral and incisional hernia repair in 407 patients. J Am Coll Surg 190 645–650 Occurrence Handle1:STN:280:DC%2BD3czivFequw%3D%3D Occurrence Handle10872998

    CAS  PubMed  Google Scholar 

  11. BT Heniford BJ Ramshaw (2000) ArticleTitleLaparoscopic ventral hernia repair. Surg Endosc 14 419–423 Occurrence Handle1:STN:280:DC%2BD3cvitlWiug%3D%3D Occurrence Handle10858463

    CAS  PubMed  Google Scholar 

  12. VJ Hesselink RW Luijendijk JHW de Wilt et al. (1993) ArticleTitleAn evaluation of risk factors in incisional hernia recurrence. Surg Gynecol Obstet 176 228–234 Occurrence Handle8438193

    PubMed  Google Scholar 

  13. MD Holzman CM Purut K Reintgen S Eubanks TN Pappas (1997) ArticleTitleLaparoscopic ventral and incisional hernioplasty. Surg Endosc 11 32–35 Occurrence Handle1:STN:280:ByiC2cfjsFc%3D Occurrence Handle8994985

    CAS  PubMed  Google Scholar 

  14. LA Israelsson T Jonsson (1996) ArticleTitleIncisional hernia after midline laparotomy: a prospective study. Eur J Surg 162 125–129 Occurrence Handle8639725

    PubMed  Google Scholar 

  15. M Korenkov S Sauerland M Arndt L Bograd EAM Neugebauer H Troidl (2002) ArticleTitleRandomized clinical trial of suture repair, polypropylene mesh, or autodermal hernioplasty for incisional hernia. Br J Surg 89 50–56 Occurrence Handle1:STN:280:DC%2BD387hvVCnug%3D%3D

    CAS  Google Scholar 

  16. GM Larson (2000) ArticleTitleVentral hernia repair by the laparoscopic approach. Surg Clin North Am 80 1329–1340 Occurrence Handle1:STN:280:DC%2BD3cvmtVOiuw%3D%3D Occurrence Handle10987039

    CAS  PubMed  Google Scholar 

  17. KA Le Blanc (2001) ArticleTitleThe critical technical aspects of laparoscopic repair of ventral and incisional hernia. Am Surg 67 809–812 Occurrence Handle1:STN:280:DC%2BD3Mvms1alsw%3D%3D

    CAS  Google Scholar 

  18. RW Luijendijk WC Hop MP van den Tol et al. (2000) ArticleTitleA comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343 392–398 Occurrence Handle1:STN:280:DC%2BD3czovVKhsQ%3D%3D Occurrence Handle10933738

    CAS  PubMed  Google Scholar 

  19. M Mudge LE Hughes (1985) ArticleTitleIncisional hernia: a 10-year prospective study of incidence and attitudes. Br J Surg 72 70–71 Occurrence Handle3155634

    PubMed  Google Scholar 

  20. A Park DW Birch P Lovrics KY Lexington . Hamilton (1998) ArticleTitleLaparoscopic and open incisional hernia repair: a comparison study. Surgery 124 816–822 Occurrence Handle9781006

    PubMed  Google Scholar 

  21. BJ Ramshaw P Esartia J Schwab et al. (1999) ArticleTitleComparison of laparoscopic and open ventral herniorrhaphy. Am Surg 65 827–831 Occurrence Handle1:STN:280:DyaK1MvhtFyrtw%3D%3D Occurrence Handle10484084

    CAS  PubMed  Google Scholar 

  22. SB Robbins WE Pofahl RP Gonzalez (2001) ArticleTitleLaparoscopic ventral hernia repair reduces wound complications. Am Surg 67 896–900 Occurrence Handle1:STN:280:DC%2BD3MrhvFWjtg%3D%3D Occurrence Handle11565772

    CAS  PubMed  Google Scholar 

  23. TA Santora JJ Roslyn (1993) ArticleTitleIncisional hernia. Surg Clin North Am 73 557–570 Occurrence Handle8497803

    PubMed  Google Scholar 

  24. S Susmallian G Gewurtz T Ezri I Charuzi (2001) ArticleTitleSeroma after laparoscopic repair of hernia with PTFE patch: is it really a complication? Hernia 5 139–141 Occurrence Handle1:STN:280:DC%2BD38%2Fjt1egsw%3D%3D Occurrence Handle11759799

    CAS  PubMed  Google Scholar 

  25. DS Thoman EH Phillips (2002) ArticleTitleCurrent status of laparoscopic ventral hernia repair. Surg Endosc 16 939–942 Occurrence Handle1:STN:280:DC%2BD38vgvFGmsw%3D%3D

    CAS  Google Scholar 

  26. FK Toy RW Bailey S Carey et al. (1998) ArticleTitleProspective, multicenter study of laparoscopic ventral hernioplasty. Surg Endosc 12 955–995 Occurrence Handle1:STN:280:DyaK1c3pvVeiug%3D%3D Occurrence Handle9632869

    CAS  PubMed  Google Scholar 

  27. EC Tsimoyiannis P Siakas G Glantzounis S Koulas P Mavridou KI Gossios (2001) ArticleTitleSeroma in laparoscopic ventral hernioplasty. Surg Laparosc Endosc Percutan Tech 11 317–321 Occurrence Handle1:STN:280:DC%2BD3MrmsFChsg%3D%3D Occurrence Handle11668229

    CAS  PubMed  Google Scholar 

  28. GE Wantz JP Chevrel JB Flament A Kingsnorth V Schumpelick P Verhaeghe (1999) ArticleTitleIncisional hernia: the problem and the cure. J Am Coll Surg 188 429–447 Occurrence Handle10195729

    PubMed  Google Scholar 

  29. BE Wright BD Niskanen DJ Peterson AL Ney MD Odland J VanCamp RT Zera JL Rodriguez (2002) ArticleTitleLaparoscopic ventral hernia repair: are there comparative advantages over traditional methods of repair? Am Surg 68 291–296 Occurrence Handle11893110

    PubMed  Google Scholar 

  30. A Zanghi M Di Vita E Lomenzo A De Luca A Cappellani (2000) ArticleTitleLaparoscopic repair vs open surgery for incisional hernias: a comparison study. Ann Ital Chir 71 663–667 Occurrence Handle1:STN:280:DC%2BD3MvhtVeruw%3D%3D Occurrence Handle11347318

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

Authors thank Antonella Buccianti, PhD, for statistical support in this work and Mr. Thomas Buckingham for his reading of the manuscript.

Author information

Authors and Affiliations

  1. 1st Division of General Surgery and Transplantation, Careggi, Florence Main Academic and Teaching Hospital, Viale Morgagni 85, 50134 Florence, Italy

    L. Bencini, L. J. Sanchez, B. Boffi, M. Farsi, M. Scatizzi & R. Moretti

Authors
  1. L. Bencini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. J. Sanchez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Boffi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Farsi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Scatizzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. R. Moretti
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

No financial support was provided by manufacturers or private institutions for completion of this study.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bencini, L., Sanchez, L., Boffi, B. et al. Incisional hernia repair . Surg Endosc 17, 1546–1551 (2003). https://doi.org/10.1007/s00464-002-9234-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-002-9234-7

Keywords

Search

Navigation