Abstract :
Background and Objectives: This prospective observational study conducted at Parul Sevashram Hospital, Vadodara aimed to examine the diversity in surgical techniques used for primary and incisional ventral hernia repair (VHR).
Methods: Twenty-five elective VHR patients treated from January 1, 2023, to March 31, 2023, were enrolled. Patients were monitored for 90 days post-surgery. Exclusion criteria included patients under 18 years old and those undergoing emergency surgeries. The primary objective was to compare surgical approaches between primary and incisional hernia repairs. Secondary objectives focused on intraoperative procedures such as mesh selection, fixation techniques, and drain placement, as well as evaluating postoperative outcomes at 3 months, including infection rates, surgical site issues, mortality, and readmission rates within 90 days.
Results: Data from 25 patients were analysed: 14 (58%) had primary hernias (PH) and 11 (42%) had incisional hernias (IH), including 1 (9.09%) recurrent case.
– PH Group: Procedures included 6 (42.85%) open Onlay, 4 (28.57%) open Sublay, 1 (7.14%) intraperitoneal Onlay meshplasty (IPOM), and 3 (21.42%) suture repairs. Complications: 7% seroma, 0% surgical site infection (SSI), 0% recurrence.
– IH Group: Procedures included 7 (63.63%) open Onlay, 3 (27.3%) open Sublay, and 1 (9.09%) suture repair. Complications: 9% seroma, 9% hematoma, 0% SSI, 9% wound sinus, 0% recurrence.
Conclusion: Onlay meshplasty emerged as the predominant procedure for both primary and incisional hernias. However, open Sublay repair showed promising results with fewer seroma-related complications. Standardizing guidelines could optimize outcomes in VHR.
Keywords :
Hernia outcomes, Incisional hernia, Primary ventral hernia.References :
- Köckerling, F., Hoffmann, H., Mayer, F., Zarras, K., Reinpold, W., Fortelny, R., et al. (2021). Trends in incisional hernia repairs: A decade of real-world data from the Herniamed registry. Hernia, 25, 255-265.
- Luhar, S., Timæus, I.M., Jones, R., Cunningham, S., Patel, S.A., Kinra, S., et al. (2020). Predicting the prevalence of overweight and obesity in India up to 2040. PLoS ONE.
- Priya, P., Kantharia, N., Agrawal, J.B., Agrawal, A., Agrawal, L., Afaque, M.Y., et al. (2020). Midterm outcomes after posterior component separation with transversus abdominis release in India. World Journal of Surgery.
- Helgstrand, F., Rosenberg, J., Kehlet, H., Jorgensen, L.N., & Bisgaard, T. (2013). A nationwide prospective study on the outcomes following elective incisional hernia repairs. Journal of the American College of Surgeons, 216, 217-228.
- Köckerling, F., Brunner, W., Fortelny, R., Mayer, F., Adolf, D., Niebuhr, H., et al. (2021). Treatment of small hernias. Hernia, 25, 605-617.