Page 73 - World Journal of Laparoscopic Surgery

Laparoscopic Ventral Hernia Repair: Our Experience and Review of Literature
• Operative time: The average operative time in our study was
71–90 minutes (Table 5).
• Size of mesh used: Dual mesh was used in all patients. A
15 × 15 cm mesh was used in 39 patients and in one patient the
size of the mesh used was 20 × 15 cm.
• Hospital stay and follow-up: The hospital stay was 2–4 days
with an average stay of 2.5 days and the average follow-up
period was 12 months.
Complications
Intraoperative Complications
Minor complications like bleeding and difficult dissections were
encountered which were taken care of without any long-term
consequences. Serosal bowel injury without any spillage occurred
in one patient which was managed intraoperatively. There was
no major intraoperative complication like major bleeding, bowel
injury, or conversion to open.
Fig. 4: Umbilical hernia
Early Postoperative Complications
Table 1: Sex distribution
• Early postoperative pain: A total of 10 patients complained
Sl. No. Sex No. of patients Percentage (%) of moderate to severe pain (analyzed on VAS and need for
1 Male 16 40 intravenous analgesia round the clock) on postoperative day 1.
2 Female 24 60 This number decreased to 3 by day 3. At the time of discharge,
Total 40 100 all the patients were pain free. A course of oral analgesics was
advised to patients who had mild pain at the time of discharge
for 3 days.
Table 2: Age distribution • Postoperative ileus: Early (6–8 hours postoperatively) oral
feeding was encouraged in all patients; however, three patients
Sl. No. Age-group No. of patients Percentage (%) had postoperative ileus which resolved on conservative
1 30–39 08 20 management.
2 40–49 22 55 • Port site infection: One patient developed superficial
3 50–59 05 12.5 surgical site infection at 12 mm port site, which was managed
4 60–69 04 10 conservatively with regular dressings and oral antibiotics as per
5 70–79 01 2.5 culture and sensitivity.
Total 40 100 Late Postoperative Complications (Table 6)
• Seroma: Two patients developed seroma at 1 month of
Table 3: Types of hernia follow-up. Both of these patients were managed conservatively
with assurance and regular follow-up examinations. No seroma
Total number
Sl. No. Types of hernia of patients Percentage (%) formation was reported at 12 months of follow-up.
1 Incisional hernia 32 80
2 Umbilical hernia 05 12.5 Table 5: Operative time
3 Infraumbilical hernia 03 7.5 Operative time Number
Total 40 100 Sl. No. (minutes) of patients Percentage (%)
1 <50 01 2.5
2 51–70 08 20
Table 4: Size of defect 3 71–90 29 72.5
Sl. No. Size of defect (cm) No. of patients Percentage (%) 4 >90 02 05
1 <4 07 17.5 Total 40 100
2 ≥4–10 24 60.0
3 ≥10 09 22.5
Table 6: Complications
Total 40
Sl. No. Complication 1 month 6 months 12 months
1 Seroma 02 (5%) 0 0
• Type of hernia: Thirty-two were incisional hernias, five umbilical 2 Chronic pain 03 (7.5%) 02 (5%) 0
hernias, and three infraumbilical umbilical hernias (Table 3).
• Size of the defect: The majority of our patients had the defect 4 Port site herniation 0 0 0
size ranging from <4 cm EHS Classification (Table 4). 5 Recurrence 0 0 01 (2.5%)

World Journal of Laparoscopic Surgery, Volume 15 Issue 1 (January–April 2022) 71