Page 7 - WJOLS - Journal of Laparoscopic Surgery

Vinaya K Ambore et al
So we conducted a comparative prospective study of Patients were kept nil by mouth after 10 pm the previ-
laparoscopic intraperitoneal onlay mesh fixation using ous day of surgery. Patients were shaved and prepared,
tacker and glue. and informed, valid, written consent for surgery taken.
This study is aimed at comparing 60 patients of ventral All patients received preoperative dose of antibiotic.
hernias, selected randomly from patients admitted to the Patients were operated by experienced laparoscopic sur-
Sir Jamshedjee Jeejeebhoy Group of Hospitals, Mumbai, geons of the hospital with experience of >50 laparoscopic
India, between the period June 2015 and June 2016. ventral hernia repair (LVHR) procedures done previously.
All incisions were infiltrated with local anesthetic at the
MATERIALS AND METHODS end of the procedure.
Research Site Duration of surgery was measured from the time of
incision to the time of closure. Patients were started on
Grant Government Medical College and Sir Jamshedjee liquid diet on the evening of surgery and full diet on the
Jeejeebhoy Group of Hospitals, Byculla, Mumbai, India.
next morning of surgery. All patients were encouraged to
mobilize as early as possible. Inj. Diclofenac sodium 50 mg
Sample Size
intramuscular was given as analgesic postoperatively on
A total of 60 cases; 30 cases assigned randomly to two demand by the patient as guided by the VAS in which
groups, either tacker or glue fixation. the pain experienced by the patient was graded by the
patient on a scale of 1 to 10 and recorded every 6 hourly
Inclusion Criteria for the first 24 hours postoperatively. Analgesics were

Patients diagnosed with ventral hernias clinically, given if VAS score was >5 (Fig. 1).
patients who gave consent to undergo the procedure and Postoperative hospital stay was measured from the
be a part of the study, patients between 18 and 70 years date of surgery to the date of discharge. Patients were
of age, patients with ventral hernias and defect size <6 asked to follow-up on day 7, at 1 month, and 3 months
cm without any complications were included. postoperatively. Suture removal was on postoperative day
7 in all cases. Time to return to normal activity was noted
Exclusion Criteria in all patients. Patients were reassessed on all occasions
and wound infection, port site herniation were checked,
Patients with body mass index >35, patients with recur-
rence after previous repair, patients afflicted with chronic and all patients were followed up for minimum 6 months
obstructive pulmonary disease, lower urinary tract after surgery and were assessed for recurrence.
syndromes, prostatomegaly with complaints of nocturia,
patients unfit for general anesthesia, and patients with OBSERVATIONS AND RESULTS
acute abdominal emergency were excluded. The following facts and figures are observed from our
study.
CONDUCTION OF STUDY • In our study, 28 (46.66%) out of 60 cases were females,
Patients were selected for the study after taking careful whereas 32 (53.33%) cases were males, which shows
detailed history, clinical examination, laboratory inves- a higher incidence in males.
tigations, and ultrasound examination as described • In our study, the mean duration of surgery was
above. The patients eligible for the study were selected, 83.67 minutes in the glue fixation group, which was
informed, and explained regarding the above study and significantly more (p = 0.000) than the tacker fixation
a proper informed, valid, written consent was taken for group where mean duration of surgery was 64.50
participation in the study. minutes.

Fig. 1: Visual analog scale
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