Evidence map›Paper›PMID 34297250›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2022

Comparison of two fascial defect closure methods for laparoscopic incisional hernia repair.

M Melland-Smith, U Khan, L Smith, J Tan

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Article in Hernia : the journal of hernias and abdominal wall surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

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2citing papers in PubMed, 1 pooled it
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1 · What the graph read from it

What it found

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

M Melland-SmithDepartment of Surgery, Division of General Surgery, University of Toronto, Toronto, ON, Canada.
U KhanDepartment of Surgery, Division of General Surgery, University of Toronto, Toronto, ON, Canada.
L SmithDepartment of Surgery, Division of General Surgery, University of Toronto, Toronto, ON, Canada.
J TanDepartment of Surgery, Division of General Surgery, University of Toronto, Toronto, ON, Canada. jtan@hrh.ca.ORCID http://orcid.org/0000-0003-1856-5694

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCurrently there is no consensus regarding the optimal surgical approach to an incisional hernia measuring less than 10 cm. Certain hernia features including defect size, intra-abdominal adhesions, and overlying scar/skin properties contribute to choosing an open versus a laparoscopic approach. This retrospective cohort study was designed to compare incisional hernia defects repaired with laparoscopic suture closure to a hybrid approach with open defect closure, both with laparoscopic intraperitoneal onlay mesh (IPOM) reinforcement.

methodsWe identified 164 consecutive patients who underwent incisional hernia repair from two centers, North York General Hospital (NYGH) and Humber River Hospital (HRH) between 2015 and 2020. Patients were grouped by totally laparoscopic or hybrid fascial closure. Both techniques included laparoscopically placed intra-peritoneal mesh with 5 cm of overlap in all directions. Patients were analyzed by age, sex, body mass index (BMI), ASA class and hernia size. Primary outcomes included surgical site infection (SSI), other wound complications including seroma/hematoma, length of hospital stay, pain reported at follow-up appointment, and hernia recurrence.

resultsPost-operative pain, surgical site infections and seromas did not differ between the totally laparoscopic and hybrid approach. The recurrence rates were 5.8% and 6.8% for the laparoscopic and hybrid group, respectively, which were not significantly different. The time to recurrence was 15 months (range 8-12) in the laparoscopic group and 7 months (range 6-36) in the hybrid group, also not significantly different. The hernia defect size and BMI were significantly higher in the hybrid group, without increased wound complications.

conclusionThese results suggest that a hybrid approach to incisional ventral hernia repair with open defect closure is comparable to a totally laparoscopic closure. The hybrid technique can help facilitate fascial closure and resection of the hernia sac in patients with higher BMI and hernia defects up to 6 cm.

Indexed as

Hernia, VentralIncisional HerniaLaparoscopyHerniorrhaphyHumansRecurrenceRetrospective StudiesSeromaSurgical MeshSurgical Wound InfectionHerniaHybridIncisionalIPOMLaparoscopyMesh

Identifiers

PMID34297250

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.