Comparison of laparoscopic and open ventral herniorrhaphy

The repair of large and/or recurrent ventral hernias is associated with sig nificant complications and a recurrence rate that can be more than 50 per c ent. Laparoscopic ventral herniorrhaphy, a recent development, has been sho wn to be safe and effective in the repair of ventral hernias. This study re trospectively reviews all ventral hernia repairs over a 3-year period, Nove mber 1995 through December 1998, at a community-based teaching hospital. Th e purpose of the study was to compare open and laparoscopic repairs. A tota l of 253 ventral hernia repairs were performed during this time, 174 open a nd 79 laparoscopic. The age, weight, and sex distribution was similar for e ach group. The hernias in the open group averaged 34.1 cm(2) in size, and m esh used averaged 47.3 cm(2). In the laparoscopic group, the hernia defect averaged 73.0 cm(2), and the mesh size averaged 287.4 cm(2). Operative time was longer in the open group, 82.0 versus 58.0 minutes. In the open group, there were 38 (21.8%) minor and 8 (4.6%) major complications, compared wit h 13 (16.5%) minor and 2 (2.5%) major complications in the laparoscopic gro up. Hospital stay was shorter for the laparoscopic group, 1.7 versus 2.8 da ys. At an average follow-up of 21 months (range, 2-40 months), there have b een 36 recurrences in the open group (20.7%) compared with 2 recurrences in the laparoscopic group (2.5%). In this series, laparoscopic ventral hernio rrhaphy compares favorably to open ventral herniorrhaphy with respect to wo und complications, hospital stay, operative time, and recurrence rate.