Two port Laparoscopic Trans-Fascial Cutaneo-apponeurotic repair of Ventral hernia with Diastasis of recti in overweight and obese patients. a randomized controlled study.
EAES Academy. Sieda B. 07/05/22; 366537; P280
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Abstract
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Aim
Background
Obese Patients with ventral hernia and/or diastasis can be offered a laparoscopic repair even with large defect with better outcome when compared with conventional repair.
Objective
Validating the short and long-term outcomes of laparoscopic trans-fascial repair for ventral hernia with and without diastasis of recti in overweight and obese patients.
Patients and methods
A randomized controlled multi centers study involved a total of 181 overweight and obese patients. BMI ranged from 28kg/m to 39 kg/m2. Patients were divided into two groups. Group I is the controlled group included patients underwent conventional surgery using onlay PROLENE® Polypropylene Mesh.
Group II underwent Laparoscopic Trans-fascial repair using PDS Loop sutures in midline sequential parity manner with intraperitoneal onlay dual composite mesh. Univariate and multivariate analysis was performed to compare the two groups for early and late postoperative morbidity, Patients were followed for 12 months.
Results:
Using visual analogue scale, Group I had more pain than group II from first till 6th postoperative day with significant statistical difference. Patients underwent conventional method manifested more wound complications (seroma and hematoma). Surgical site infection encountered more in group I.
Early recurrence was recorded with very low incidence in group II but no significant statistical difference between the two groups in Late recurrence.
We enrolled high Incidence of ileus and longer hospital stay in group I with peculiar statistical difference.
Conclusion
Laparoscopic sequential cutaneo-apponeurotic Trans-fascial closure repair of Diastasis with ventral hernia is a discriminatory and simple technique no matter what defect size is. The technique averts the formidable wound complication in open surgery.
Background
Obese Patients with ventral hernia and/or diastasis can be offered a laparoscopic repair even with large defect with better outcome when compared with conventional repair.
Objective
Validating the short and long-term outcomes of laparoscopic trans-fascial repair for ventral hernia with and without diastasis of recti in overweight and obese patients.
Patients and methods
A randomized controlled multi centers study involved a total of 181 overweight and obese patients. BMI ranged from 28kg/m to 39 kg/m2. Patients were divided into two groups. Group I is the controlled group included patients underwent conventional surgery using onlay PROLENE® Polypropylene Mesh.
Group II underwent Laparoscopic Trans-fascial repair using PDS Loop sutures in midline sequential parity manner with intraperitoneal onlay dual composite mesh. Univariate and multivariate analysis was performed to compare the two groups for early and late postoperative morbidity, Patients were followed for 12 months.
Results:
Using visual analogue scale, Group I had more pain than group II from first till 6th postoperative day with significant statistical difference. Patients underwent conventional method manifested more wound complications (seroma and hematoma). Surgical site infection encountered more in group I.
Early recurrence was recorded with very low incidence in group II but no significant statistical difference between the two groups in Late recurrence.
We enrolled high Incidence of ileus and longer hospital stay in group I with peculiar statistical difference.
Conclusion
Laparoscopic sequential cutaneo-apponeurotic Trans-fascial closure repair of Diastasis with ventral hernia is a discriminatory and simple technique no matter what defect size is. The technique averts the formidable wound complication in open surgery.
Aim
Background
Obese Patients with ventral hernia and/or diastasis can be offered a laparoscopic repair even with large defect with better outcome when compared with conventional repair.
Objective
Validating the short and long-term outcomes of laparoscopic trans-fascial repair for ventral hernia with and without diastasis of recti in overweight and obese patients.
Patients and methods
A randomized controlled multi centers study involved a total of 181 overweight and obese patients. BMI ranged from 28kg/m to 39 kg/m2. Patients were divided into two groups. Group I is the controlled group included patients underwent conventional surgery using onlay PROLENE® Polypropylene Mesh.
Group II underwent Laparoscopic Trans-fascial repair using PDS Loop sutures in midline sequential parity manner with intraperitoneal onlay dual composite mesh. Univariate and multivariate analysis was performed to compare the two groups for early and late postoperative morbidity, Patients were followed for 12 months.
Results:
Using visual analogue scale, Group I had more pain than group II from first till 6th postoperative day with significant statistical difference. Patients underwent conventional method manifested more wound complications (seroma and hematoma). Surgical site infection encountered more in group I.
Early recurrence was recorded with very low incidence in group II but no significant statistical difference between the two groups in Late recurrence.
We enrolled high Incidence of ileus and longer hospital stay in group I with peculiar statistical difference.
Conclusion
Laparoscopic sequential cutaneo-apponeurotic Trans-fascial closure repair of Diastasis with ventral hernia is a discriminatory and simple technique no matter what defect size is. The technique averts the formidable wound complication in open surgery.
Background
Obese Patients with ventral hernia and/or diastasis can be offered a laparoscopic repair even with large defect with better outcome when compared with conventional repair.
Objective
Validating the short and long-term outcomes of laparoscopic trans-fascial repair for ventral hernia with and without diastasis of recti in overweight and obese patients.
Patients and methods
A randomized controlled multi centers study involved a total of 181 overweight and obese patients. BMI ranged from 28kg/m to 39 kg/m2. Patients were divided into two groups. Group I is the controlled group included patients underwent conventional surgery using onlay PROLENE® Polypropylene Mesh.
Group II underwent Laparoscopic Trans-fascial repair using PDS Loop sutures in midline sequential parity manner with intraperitoneal onlay dual composite mesh. Univariate and multivariate analysis was performed to compare the two groups for early and late postoperative morbidity, Patients were followed for 12 months.
Results:
Using visual analogue scale, Group I had more pain than group II from first till 6th postoperative day with significant statistical difference. Patients underwent conventional method manifested more wound complications (seroma and hematoma). Surgical site infection encountered more in group I.
Early recurrence was recorded with very low incidence in group II but no significant statistical difference between the two groups in Late recurrence.
We enrolled high Incidence of ileus and longer hospital stay in group I with peculiar statistical difference.
Conclusion
Laparoscopic sequential cutaneo-apponeurotic Trans-fascial closure repair of Diastasis with ventral hernia is a discriminatory and simple technique no matter what defect size is. The technique averts the formidable wound complication in open surgery.
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