Minimally invasive vs open primary linea alba and midline incisional hernia treatment: early follow-up results

Abstract

Introduction The incidence of primary linea alba hernia applies up to 5-10% and midline incisional - 10-20% [1,2]. Minimally invasive primary linea alba and midline incisional hernia treatment gains more and more popularity among treatment options. Aim To compare the early results of minimally invasive and open sublay mesh repair of small and medium size primary linea alba and midline incisional ventral hernias. Methods The prospective cohort study of patients who underwent for small and medium size of primary and incisional ventral hernia repair in the Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Department of Surgery during 2019-2020 years. The patients were divided into two groups: minimally invasive (TARM, SCOLA) and open mesh repair (sublay) groups. There were documented: demographic and hernia features, operation time, postoperative pain, use of analgesics, length of hospital stay, complications. Postoperative pain was assessed by using Visual Analogue Scale. All patients were invited for follow-up in our institution after 1, 3 and 6 months. Abdominal wall ultrasound was performed to evaluate possible complications: seroma, mesh dislocation, hernia recurrence. Results Thirty four patients were included in the study: 21 patients in the minimally invasive group (TARM - 12, SCOLA - 9) and 13 patients were in the open mesh repair group. The groups were comparable in terms of patients characteristics and hernia data. Study included 14 male and 20 female with median of age 56 years. Incisional hernias were for 20 (58.8%) and primary ventral - 14 (41.2%) patients. The time of hernia occurrence was 31.33 (SD 50.1) months in minimally invasive group and 35.1 (SD 46.7) open mesh group. The hernia defect diameter was 4.4 (SD 1.6) cm in the open repair and 3.25 (SD 2.16) cm in the minimally invasive group. The operation time was longer for the minimally invasive surgery group (224.3 (SD 106.2[...].