HYBRID TECHNIQUE VS TOTALLY LAPAROSCOPIC IPOM TECHNIQUE IN VENTRAL HERNIA- OUR EXPERIENCE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 48
Abstract
BACKGROUND Ventral hernia develops in 7 to 11% of laparotomy incisions. Recurrent hernia occurs in 3%. Laparoscopic repair was applied to all ventral and recurrent herniae, with the expectation of earlier recovery, fewer post-operative complications, and decreased recurrence rate. The prospective study was performed to compare the outcome of laparoscopic hybrid technique and total laparoscopic IPOM Technique for all ventral hernias. The aim of the study was to summarize our experience in Laparoscopic ventral hernia repair for all types of ventral hernias using both totally laparoscopic IPOM technique and hybrid technique. MATERIALS AND METHODS We conducted an observational study involving 120 patients involving both ventral and recurrent ventral hernias. We selected 60 patients who were subjected to hybrid technique and 60 patients who were subjected to totally laparoscopic repair between the periods 2012 to 2017. All patients posted for abdominal ventral hernia by laparoscopy were included in the study. Patient unfit for general anaesthesia and open repair were excluded from study. Patient demographic details were noted. Intra-operative and Postoperative data were recorded and analysed. RESULTS The mean surgery duration and post-operative analgesics used in hybrid technique were more compared to the totally laparoscopic IPOM group in small ventral hernias. Return to activity and normal daily work is delayed in hybrid surgery. The mean surgery duration was low in hybrid group in large ventral and recurrent hernias compared to totally IPOM Group. Post-operative analgesics used in hybrid technique had no significant difference compared to Totally IPOM group for large ventral and recurrent hernias. The mean post-operative hospital stay was low in total laparoscopic IPOM Group in both recurrent and ventral hernias. Return to activity had no significant difference in totally IPOM group and hybrid technique in both recurrent and large ventral hernias. There was significant increase in recurrence rate, seroma and mesh infection in totally IPOM Group compared to Hybrid Technique in large and recurrent ventral hernias. Wound infection had no difference in both the groups in all types of hernias. Cosmesis was better in Recurrent Ventral Hernia in Hybrid Technique. The requirement of Antibiotics was similar in all the groups. CONCLUSION The hybrid technique is a safe, good alternative and sure technique for better cosmesis and prevention of recurrence and postoperative complications like seroma and bulging or eventration of mesh. In large ventral hernias and recurrent hernias with less operating time and no difference in analgesics and early return to work compared to totally IPOM Technique. Totally laparoscopic repair is better alternative for hybrid technique regarding cosmesis and analgesia and operative time for small ventral hernia and hybrid can be considered as an alternative to totally IPOM Technique in large and recurrent ventral hernias. This was an experimental study which was done to observe the outcomes of surgeries done at Karpagam Medical College from 2012 to 2017.
Authors and Affiliations
Shanker M. C. R. S, Kavitha Shanker
Keywords
Related Articles
- EP ID EP548300
- DOI 10.14260/jemds/2018/1146
- Views 78
- Downloads 0
SOCIO-DEMOGRAPHIC FACTORS FOR HIGH-RISK PREGNANCY AMONG WOMEN IN RURAL AREA OF NAGPUR DISTRICT, CENTRAL INDIA
BACKGROUND All pregnant women by virtue of their pregnancy status face some level of maternal risk. Some pregnancies are complicated by problems associated with mother’s health. Most maternal morbidities could be prevent...
STUDY ON THE CONVERSION OF LAPAROSCOPIC CHOLECYSTECTOMY OWING TO PER OPERATIVE COMPLICATIONS
BACKGROUND In the modern medical era, laparoscopic approach to surgical conditions has reached to a height that it is performed even for malignant conditions. The minimal access surgery which has grown up from minimally...
CONSERVATIVE VS. OPERATIVE MANAGEMENT OF LONG BONE FRACTURES IN OSTEOPETROSIS: LONG-TERM STUDY IN 12 YRS. PERIOD
BACKGROUND Albers-Schonberg in 1907 described a rare developmental disease. [1] In 1926, Karshner introduced the term osteopetrosis. [2] Because of diminished bone resorption due to osteoclastic abnormality, b...
CLINICO– EPIDEMIOLOGICAL PROFILE OF ROAD TRAFFIC INCIDENTS ADMITTED AT A TERTIARY CARE HOSPITAL IN GARHWAL- UTTARAKHAND
BACKGROUND: The magnitude of Road traffic incidents and fatalities in India is alarming. In 2009, 4.22 lakh road traffic incidents and 1.27 lakh road traffic fatalities were reported. These numbers translate in...
A STUDY OF EFFECTIVENESS OF EPIDURAL STEROID INJECTIONS FOR LOW BACKACHE AND SCIATICA
[b]BACKGROUND[/b]: Of all the causes, low back pain due to disc prolapse is one of the commonest causes. The treatment aspect can be conservative or surgical, and the question of which one is effective is alway...