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Laparoscopic Repair of Ventral Hernia an Early Experience at Khyber Teaching Hospital
World Journal of Laparoscopic Surgery, September-December 2008;1(3):35-38
Laparoscopic Repair of Ventral Hernia an Early

Experience at Khyber Teaching Hospital, Peshawar

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1 Rooh-ul-Muqim, Qutb-E-Alam Jan, Mohammad Zarin, Muhammad Taimoor Khan, Javeria Iqbal
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6 Iftikhar Mohammad Khan, Mehmud Aurangzeb, Aziz Wazir
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1 Associate Professor, Surgical-D Unit, KTH, Peshawar, Pakistan
2 Assistant Professor, Surgical-A Unit, KTH, Peshawar, Pakistan
3 Assistant Professor, Surgical-D Unit, KTH, Peshawar, Pakistan
4 House Surgeon, Surgical-D Unit, KTH, Peshawar, Pakistan
5 Trainee Medical Officer, Surgical-D Unit, KTH, Peshawar, Pakistan
6 Trainee Medical Officer, Surgical-E Unit, KTH, Peshawar, Pakistan
7 Surgical-E Unit, KTH, Peshawar, Pakistan
8 Surgical-D Unit, KTH, Peshawar, Pakistan
Correspondence: Rooh-ul-Muqim, H. No.185, St. No. 5, Sector J-2, Phase II, Hayatabad, Peshawar, Pakistan

Abstract due to primary fascial pathology, and include umbilical,
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Objective: To analyze the results and outcome of laparoscopic ventral epigastric, spigelian, lumbar and other hernias. Postoperative
hernia repair as a relatively new technique in our setup. ventral hernia or incisional hernia is a common complication
following abdominal surgery and is a significant cause of
Design and duration: Prospective study from June 2007 to June 2
2008. morbidity. An incisional hernia develops in 3-13% of
laparotomy incisions. 3
Setting: Surgical-D Unit, Khyber Teaching Hospital, Peshawar.
Repair of ventral hernia may be difficult, and a wide range of
Patients: All the patients undergoing laparoscopic ventral hernia repair. surgical procedure have been developed for it. Tension-free
Methodology: The patients were evaluated clinically and by repair is one of the key concepts in hernia surgery. The repair
investigations. After appropriate preparation, laparoscopic mesh repair may be direct suturing or use of prosthetic mesh using the
was performed. Intra- and postoperative complications, and the open or laparoscopic technique. Prosthetic mesh and tension
outcomes were noted and the whole data analyzed. free repair has revolutionized the repair of ventral hernias
Results: Out of the total 54 cases, 7 (12.96%) were umbilical hernia, resulting in decrease in recurrence rates. 4
13 (24.07%) paraumbilical, 9 (16.66%) epigastric and 25 (46.29%) Laparoscopic repair of ventral hernias is rapidly becoming
were incisional hernia. All patients had mesh repaired, the operating more common, its utility, cost-effectiveness, lower infection
time ranged from 35 minutes to 2 hours in difficult cases with adhesions. and recurrence rates make it a very attractive option. 5,6
All cases were successfully carried out laparoscopically. The We receive a number of patients with primary and incisional
complication rate was low with only 3 patients having port-site bleeding,
9 (16.66%) omental bleeding, 2 (3.7%) seroma, 3 (5.55%) had superficial ventral hernias, sometimes recurrent hernias, from different parts
infection. Severe pain in 11 (20.37%) requiring injectable analgesics of the province. Laparoscopic repair of ventral hernias has been
and only 1 (1.85%) patient had recurrence at 4 months. No mortality recently started in our setup. This study was aimed to analyze
and major complication were reported with excellent patient and the outcome of laparoscopic repair of ventral hernias using a
surgeon satisfaction. prosthetic mesh as a relatively new technique in our setup.
Conclusion: LVHR is a safe procedure with shorter operating time,
few complications, short hospital stay, less recurrence and better MATERIALS AND METHODS
patient satisfaction.
This study was conducted in the surgical-D unit of Khyber
Keywords: Ventral hernia; laparoscopic repair; outcome; compli- Teaching Hospital, Peshawar from June 2007 to June 2008. All
cations.
patients presenting with ventral hernia were included in the
study. Patients with respiratory and cardiac compromise unfit
INTRODUCTION
for laparoscopy and anesthesia were excluded.
Ventral hernias result from a weakness or loss of structural Patients were evaluated by a detailed history including
integrity, of the musculoaponeurotic layer of the anterior history of previous surgery, medical disease. Detailed physical
abdominal wall. Primary ventral hernias occurs spontaneously examination was done to demarcate the extent and location of

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