Laparoscopic ventral hernia repair with primary closure versus no primary closure of the defect: potential benefits of the robotic technology

Abstract

Background: Some authors recommend primary closure of the defect before placement of the mesh. The purpose of this study is to compare laparoscopic ventral hernia repair (LVHR) without primary closure of the defect (NPCD) versus LVHR with primary closure of the defect (PCD).

Methods: A retrospective review of 134 LVHR was performed. Each group included 67 cases. For the PCD group the robotic platform was used.

Results: Groups were similar in terms of demographics and comorbidities. For NPCD and PCD groups mean surgical time was 87.9±53.1 and 107.6±33.9 minutes (p = 0.012); conversion to open surgery was seen in 3(4.5%) and 1(1.5%) (p = 0.310); complications were 7(10.4%) and 2(3%) (p = 0.084); and finally, recurrences were seen in 5(7.5%) and 1(1.5%) (p = 0.095).

Conclusions: PCD has longer surgical time, however, a tendency in terms of complications and recurrences was found favoring the PCD group. The robotic assistance is a good alternative when primary closure of the defect is attempted.

Keywords: defect; incisional hernia; laparoscopic; robotic; surgery; ventral hernia.