Our Summary

This research paper aims to compare two surgical methods of fixing recurrent incisional hernias: laparoscopic intra-peritoneal onlay mesh repair (lap. IPOM) and open sublay repair. These are hernias that occur in the same spot where a previous surgery was performed. The study looked at patients who had undergone either of these surgeries between 2015 and 2021.

Before matching the patients up based on certain criteria, the study found that the open sublay repair group had larger hernias and other differences like body mass index, obesity, and European Hernia Society width classification. The results showed that the lap. IPOM group had a shorter surgery time and shorter hospital stay after surgery. Complications like wound infection and hematoma also occurred more frequently after the open sublay repair.

After matching the patients up, the characteristics were well balanced. The recurrence rate and occurrence of complications were similar between the two groups. However, the lap. IPOM group still had a shorter hospital stay after surgery.

The study concluded that the outcomes of the two surgeries were similar, except that lap. IPOM had a shorter hospital stay. However, poor outcomes were more likely due to risk factors like larger hernia size, rather than the surgical technique itself.

FAQs

  1. What are the two surgical methods compared in this study for fixing recurrent incisional hernias?
  2. What were the main differences found between the laparoscopic intra-peritoneal onlay mesh repair (lap. IPOM) and open sublay repair groups before matching the patients?
  3. According to the study, what were the main outcomes and differences between the two surgical techniques after matching the patients?

Doctor’s Tip

A helpful tip a doctor might give a patient about laparoscopic hernia repair is to follow post-operative care instructions closely, including avoiding heavy lifting and strenuous activities for a certain period of time as recommended by the surgeon. Additionally, maintaining a healthy lifestyle by eating well, staying active, and not smoking can help promote proper healing and reduce the risk of complications. It’s important to attend follow-up appointments to ensure proper healing and address any concerns promptly.

Suitable For

Overall, patients who are recommended for laparoscopic hernia repair are those with recurrent incisional hernias, particularly those with smaller hernias and without significant risk factors for poor outcomes. The laparoscopic approach may offer advantages such as shorter surgery time, shorter hospital stay, and potentially lower rates of complications like wound infection and hematoma. However, the choice of surgical technique should be individualized based on the patient’s specific characteristics and risk factors.

Timeline

In summary, before laparoscopic hernia repair, patients may experience symptoms such as pain, discomfort, and a visible bulge at the site of the hernia. They may also undergo diagnostic tests such as physical examination, ultrasound, or CT scan to confirm the hernia.

After laparoscopic hernia repair, patients typically experience a shorter surgery time, shorter hospital stay, and lower rates of complications such as wound infection and hematoma compared to open sublay repair. However, the overall outcomes and recurrence rates are similar between the two surgical methods. Patients may still experience some discomfort and limited activity during the recovery period, but most are able to resume normal activities within a few weeks after surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic hernia repair include:

  1. What are the benefits of laparoscopic hernia repair compared to open surgery?
  2. What is the success rate of laparoscopic hernia repair for my specific type of hernia?
  3. What are the potential risks and complications associated with laparoscopic hernia repair?
  4. How long is the recovery time after laparoscopic hernia repair?
  5. Will I need to follow any specific post-operative care instructions?
  6. How experienced are you in performing laparoscopic hernia repair procedures?
  7. Are there any factors that may make me a better candidate for open hernia repair instead of laparoscopic repair?
  8. What can I expect in terms of pain management after the surgery?
  9. How soon can I return to normal activities after laparoscopic hernia repair?
  10. Are there any lifestyle changes I should make to reduce the risk of hernia recurrence after surgery?

Reference

Authors: Chen F, Yang H, Wang F, Zhu Y, Chen J. Journal: Hernia. 2023 Oct;27(5):1289-1298. doi: 10.1007/s10029-023-02833-9. Epub 2023 Aug 1. PMID: 37526771