Laparoscopic intraperitoneal onlay mesh versus open hernioplasty in ventral hernia treatment: A nonrandomized controlled trial.

Background Although ventral abdominal wall hernias are a common problem, the best method for repair remains to be determined, and although laparoscopic repair has shown favorable short-term results, long-term studies are scarce. Patients and methods In this prospective nonrandomized controlled trial, a comparison between laparoscopic intraperitoneal onlay-mesh (IPOM) repair and open hernioplasty for ventral abdominal-wall hernias as regards operative time, perioperative and postoperative complications, length of hospital stay, postoperative pain, cost, and recurrence rates. This study was conducted on 80 patients with ventral abdominal-wall hernias admitted to Ain Shams University Hospitals and Dar Al-Fouad hospitals. In total, 40 (50%) patients were managed by laparoscopic IPOM repair (group A), while the other 40 (50%) patients were managed by open hernioplasty (group B). Results In our study, the mean age among patients of both groups was 41 ± 10.6, with males representing the majority of cases (70%). Average BMI was 29 kg/m2, the average defect length for both groups was 2.5 cm. We noted a statistically significant earlier return to work and daily activities among the laparoscopic IPOM-repair group and a lower postoperative pain score. We also found lower rates of complications among laparoscopic IPOM group, however, it was statistically nonsignificant. The mean operative time was 67.5 min for laparoscopic IPOM group compared with 71.62 min for open-hernioplasty group. There were no mortalities in either group. Conclusion Laparoscopic IPOM for all ventral hernias is a safe, effective, and feasible approach, with the added benefits of shorter operating time, less hospital stay, lower postoperative pain score, and overall less complication rates than open hernioplasty. [ABSTRACT FROM AUTHOR]