A comparative study of open versus laparoscopic incisional hernia repair

Background: Incisional hernia occurs in 5-11% of patients subjected to abdominal operations. Laparoscopic hernia repair has revolutionized the treatment of incisional hernia by reducing the morbidity and improved post-operative outcomes. The objectives of this study were to compare open incisional hernia repair with laparoscopic incisional hernia repair in our patient population with respect to Operating time, post-operative complications, post-operative recovery, duration of analgesic administration, and cosmetic results.Methods: This is a prospective study of Forty patients who were admitted at Osmania General Hospital, Hyderabad, Telangana, India with a clinical diagnosis of incisional hernia, 20 patients in each group (open and laparoscopic).Results: Both the study groups were comparable in terms of patient characteristics. The duration of laparoscopic repair was significantly more when compared to open repair (mean time 133.75 mins versus 85.8 min respectively). Analgesic requirement, wound infection rate and complication rate were higher in open group. The laparoscopic patients tolerated oral feeds earlier compared to open patients. The duration of hospital stay was significantly longer for open group than for laparoscopic group (mean 9.6 days versus 6.4 days respectively). The cosmetic end result was better in laparoscopic patients.Conclusions: Though ours is a small study, with the benefits of laparoscopy it will be prudent to recommend laparoscopic repair as the first line of management for incisional hernia where the facilities and trained expertise were available. However, there is still a role for traditional open approach in patients who have a specific contraindication to laparoscopic repair or any additional procedures that are not amenable for laparoscopy.