Jason J. Lamb. M.D., Nilesh A. Patel, M.D., Tananchai A Lucktong, M.D., Daniel J. Gagne, M.D., Nancy J. Hogle, B.S.N., Dennis L. Fowler, M.D., Department of Surgery, West Penn Allegheny Health System, Allegheny General Hospital, Pittsburgh, PA.

Laparoscopic ventral hernia repair has been described as an alternative to open ventral hernia repair. Studies have shown laparoscopic repair to have some advantages, though few comparison studies are reported. We compared results for laparoscopic and open ventral hernia repairs completed at a single institution during a 15-month period.

All isolated ventral hernia repairs, excluding umbilical hernia repairs, performed between January 1998 and March 1999 were retrospectively reviewed. Demographic, operative, and postoperative data on 44 laparoscopic ventral hernia repairs were then compared to 63 open ventral hernia repairs. Differences between the groups were then assessed for significance using Student's t-test analysis.

Laparoscopic and open repair groups were similar with relation to age, body mass index, size of defect, number of defects, previous repairs, length to follow-up, and postoperative seroma. There was a conversion to open repair in 12.8% of attempted laparoscopic repairs. Laparoscopic repair had a longer mean operative time (157 vs. 98 mm; p<O.QOO1), but shorter postoperative hospitalization (2.2 vs. 3.1 days; p<O.O5), earlier return of bowel function (2.9 vs. 3.9 days; p<O.02), lower recurrence rate (8.8% vs. 34.2%; p<O.0O4), and lower infection rate (0% vs. 10.5%; p<0.03). A subgroup of open hernias repaired with prosthetics also maintained statistical significance in all these areas except infection rate.

Laparoscopic ventral hernia repair results in a significantly shorter recovery and length of stay than open repair. Short-term follow-up reveals significantly fewer recurrences and suggests that laparoscopic repair may become the procedure of choice for ventral hernia repair.



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