VENTRAL INCISIONAL HERNIAS

Ventral Incisional Hernias are a well known complication after abdominal surgery with a reported incidence of 10% - 20% and arecurrence rate of 30% - 50% after open suture repair and less than 10% after open mesh repair. Objectives: To compare the outcome of twodifferent methods of open repair of VIH (i.e. Mesh versus Non-mesh or Suture Repair in terms of morbidity, complications and recurrence.Period: 11 years period (January 2000 – December 2010). Setting: Shaikh Zayed Hospital, Lahore. Patients & Methods: The total number ofpatients who underwent surgery for repair of VIH during the study period was 321.There were only 33 patients in Group A (simple suture/Keelrepair) while Group B had 288 patients. The most common early postoperative complications seen in both the groups were wound seroma andinfection. Post-operative respiratory insufficiency was more common in the obese. Chronic pain and feeling of foreign body was more frequentlyseen in the mesh group. On the other hand, recurrence rates were far greater in the suture repair group. The overall mortality in the whole serieswas 3 patients (0.93%). Conclusions: The rates of ventral incisional hernia recurrence and complications are significantly lower after openonlay mesh repair as compared to the open suture repair. However, these results require confirmation by prospective randomized clinical trialswhich should also include the results of laparoscopic ventral incisional hernia repair which is a new and emerging technique in Pakistan.