Role of Laparoscopy in the management of incisional hernia: A comparative study from medical school

Introduction: The conventional open repairof incisional hernia requires extensive dissection. The applicability and superiority of the laparoscopy have been evolving overthe last few years.The aim of our study was to compare the surgical outcomes of laparoscopic versus open mesh repair in the management of incisional hernia. Methods: This prospective comparative study was carried out in the SKIMS Medical College, Hospital, over a period of ۵ years. The total of ۶۲ subjects with non-complicated primary incisional hernias between ۱۵-۶۵ years of age were included. Polypropylene mesh in open surgery and Proceed prosthesis(ePTFE Mesh) in laparoscopy was used for repair. After hospital discharge, the patients were attached to the Out-Patient Department for follow-up. The data was collected and analyzed. Result: The maximum numbers of patients (۴۱.۹%) were in the age group of ۳۶-۴۵ years with amale to female ratio of ۰.۵۵.۳۲ patients were operated by convention open mesh repair and ۳۰ patients underwentintra-abdominal preperitoneal on-lay mesh repair.۳۰.۶% of female patients had history of a lower abdominal caesarean section followed by hysterectomy (۱۷.۷%). The majority of males had history of exploratory laparotomy secondary to trauma (۱۷.۷%) or peptic ulcer perforation (۱۲.۹%). The difference in mean operative time of laparoscopic technique (۸۷±۸.۶۲ minutes)and open repair (۹۶.۵۶±۹.۳۱minutes) was statistically significant (p-value of ۰.۰۵).The difference between the mean duration of hospitalstay in the open repair (۵.۵۸±۱.۶۹ days) and thelaparoscopy (۳.۳۶±۱.۱۷ days) was statistically significant. None of our patients expired during the study period. Conclusion: Laparoscopic management of incisional hernia is a promising alternative to conventional repair with encouraging results.In our study, it was found that laparoscopic repair is safe and resulted in lesser operative time, fewer complications, shorter hospital stay and early return to activity.