Comparative study between laparoscopic and open repair of paraumbilical hernia

Abstract

This randomized prospective study compared the effectiveness of laparoscopic paraumbilical hernioplasty to the conventional open technique. Forty patients with paraumbilical hernia were randomly categorized into 2 equal groups. GL treated by laparoscopic paraumbilical hernioplasty and GO treated by conventional (open) umbilical hernioplasty. The mean length of follow up was 36 months. In GL, mean operative time was 58.1 +/- 15.5 minutes, in GO, it was 42.2 +/- 10.3 minutes (p = 0.0005). Postoperative pain score 6 hours after surgery was 2.95 +/- 1.19 in GL patients as compared to 6.10 +/- 1.74 in GO ones (p < 0.0001). Mean hospitalization time was 1.05 +/- 0.224 days in GL versus 1.25 +/- 0.550 days in G O (p = 0.14). There was one conversion (5%) to the open repair. Postoperative seroma occurred in 2 patients (10%) in GL and 3 patients (15%) in GO. Three patients (15%) in G O developed surgical site infection. Hernia recurrence was not seen in either 2 Groups. Mean patient satisfaction score for GL patients was 7.85 +/- 1.27 versus 6.00 +/- 1.69 for GO patients (p = 0.0004).

Conclusion: Compared to open repair, laparoscopic repair is technically feasible, safe and effective, with good clinical outcome. It is associated with longer time for surgery but reduced postoperative pain, analgesic requirement, complication and infection rates with earlier return to normal activities.