Post-operative Pain Outcomes of Laparoscopic Ventral Hernia Repair (LVHR): An eight-year experience

Authors

  • Shahid Rasul
  • Hassan Ahmed
  • Sanum Ali
  • Surrendar Dawani
  • Sarah Zahid
  • Sehrish Hussain
  • Salman Jafferi
  • Mansab Ali

DOI:

https://doi.org/10.51985/JBUMDC2021048

Keywords:

Chronic pain, Laparoscopic ventral hernia repair, Post-operative pain, Ventral hernia, Visual analog scale

Abstract

Objective: To evaluate post-operative pain, recovery time and standard of living in patients undergoing LVHR in detail.
Study design and Setting: This prospective cohort study was conducted at a tertiary care hospital of Karachi, Pakistan,
after getting approval from the “National Medical Centre Ethical Review Board”, from January 2011 to December 2019,
Methodology: Total n= 577 patients undergoing standard LVHR procedure (defect closed with non-absorbable monofilament
suture, reinforced with intra-abdominal dual layer mesh, anchored with non-absorbable tacks & sutures). Patient demographics,
perioperative & postoperative findings and post-operative pain analysis were investigated and presented as descriptive
statistics. Follow-up was carried out at 1st week, 2nd week, 3rd monthly, 6 monthly and 12 monthly post-operative appointments.
Results: During the study period of nine years (January 2011 to December 2019), 577 patients (primary ventral hernia
n=232, recurrent ventral hernia n=188 patients, incisional hernia n=157) underwent LVHR. Mean post-operative hospital
stay was 1.53 ± 1.8 days. Mean post-operative pain assessment on visual analog scale (VAS) after surgery (0-3days) was
reported to be 38.5±29 by 65 patients out of 577 (11.26%), which significantly decreased at the end of 1st week to 27.9 ±
25.6. Only 3 patients (0.51%) reported chronic pain during the span of 3-6 months.
Conclusion: LVHR was associated with considerably less post-operative pain, shorter hospital stay and reduced time of
convalescence. It is demonstrated that LVHR to be a safe and superior approach for the repair ventral hernias.

References

Mohamed Yousef A, Mohamed MA, Gaber A, Ahmed MS,Husein HM. Laparoscopic Ventral Hernia Repair: Tow CentreExperience Prospective Comparative Study. OAlib 2018;5(09):1. DOI: https://doi.org/10.4236/oalib.11048712.Williams N, O’Connell PR, McCaskie AW editors. Bailey &Love's Short Practice of Surgery. 27th ed. CRC press; 2018.p.1036-10393.Colavita PD, Tsirline VB, Belyansky I, Walters AL, LincourtAE, Sing RF, et al. Prospective, long-term comparison ofquality of life in laparoscopic versus open ventral herniarepair. Ann Surg 2012; 256(5):714-23. DOI: https://doi.org/SLA.0b013e3182734130.4.Kroese LF, Gillion JF, Jeekel J, Lange JF, Kleinrensink GJ,Members HC. Identification of risk factors for 30-daypostoperative complications in patients undergoing primaryventral hernia repair: a prospective cohort study of 2,374patients. Surgery. 2018; 163(5):1160-4.5.Kumar D, Khan H, Qureshi MS. Outcome of four yearsexperience in laparoscopic ventral hernia repair. Pak J MedSci 2015; 31(4):987.6.Mercoli H, Tzedakis S, D’Urso A, Nedelcu M, Memeo R,Meyer N, et al. Postoperative complications as an independentrisk factor for recurrence after laparoscopic ventral herniarepair: a prospective study of 417 patients with long-termfollow-up. Surg Endosc. 2017; 31(3):1469-77. DOI:https://doi.org/10.1007/s00464-016-5140-27.He C, Lu J, Ong MW, Lee DJ, Tan KY, Chia CL. Seromaprevention strategies in laparoscopic ventral hernia repair: asystematic review. Hernia 2020; 24(4):717-31.8.Bernardi K, Olavarria OA, Holihan JL, Kao LS, Ko TC, RothJS, et al. Primary fascial closure during laparoscopic ventralhernia repair improves patient quality of life: a multicenter,blinded randomized controlled trial. Ann Surg 2020;271(3):434-9. DOI: https://doi.org/ 10.1097/SLA.00000000000035059. Froylich D, Segal M, Weinstein A, Hatib K, Shiloni E, HazzanD. Laparoscopic versus open ventral hernia repair in obesepatients: a long-term follow-up. Surg Endosc. 2016; 30(2):670-5.10. Awaiz A, Rahman F, Hossain MB, Yunus RM, Khan S,Memon B, Memon MA. Meta-analysis and systematic reviewof laparoscopic versus open mesh repair for elective incisionalhernia. Hernia 2015; 19(3):449-63.11. Ahmed MA, Tawfic QA, Schlachta CM, Alkhamesi NA.Pain and surgical outcomes reporting after laparoscopic ventralhernia repair in relation to mesh fixation technique: a systematicreview and meta-analysis of randomized clinical trials. JLaparoendosc Adv Surg Tech A 2018; 28(11):1298-315.12. Warren JA, McGrath SP, Hale AL, Ewing JA, Carbonell AM,Cobb IV WS. Patterns of recurrence and mechanisms offailure after open ventral hernia repair with mesh. Am Surg2017; 83(11):1275-82.13. Uranues S, Salehi B, Bergamaschi R. Adverse events, qualityof life, and recurrence rates after laparoscopic adhesiolysisand recurrent incisional hernia mesh repair in patients withprevious failed repairs. J Am Coll Surg 2008; 207(5):663-9.14. Gronnier C, Wattier JM, Favre H, Piessen G, Mariette C.Risk factors for chronic pain after open ventral hernia repairby underlay mesh placement. World J Surg 2012; 36(7):1548-54.Eker HH, Hansson BM, Buunen M, Janssen IM, Pierik RE,Hop WC, et al. Laparoscopic vs open incisional hernia repair:a randomized clinical trial. JAMA Surg 2013; 148(3):259-63. doi:10.1001/jamasurg.2013.146616.Harsløf S, Krum-Møller P, Sommer T, Zinther N, Wara P,Friis-Andersen H. Effect of fixation devices on postoperativepain after laparoscopic ventral hernia repair: a randomizedclinical trial of permanent tacks, absorbable tacks, and syntheticglue. Langenbecks Arch Surg. 2018; 403(4):529-37.17.Rogmark P, Petersson U, Bringman S, Ezra E, Österberg J,Montgomery A. Quality of life and surgical outcome 1 yearafter open and laparoscopic incisional hernia repair. Ann Surg.2016; 263(2):244-50.18.Liot E, Bréguet R, Piguet V, Ris F, Volonté F, Morel P.Evaluation of port site hernias, chronic pain and recurrencerates after laparoscopic ventral hernia repair: a monocentriclong-term study. Hernia 2017; 21(6):917-23.19.Thota A, Ravishankar KS, Rao KV, Ramesh BS, Ananda BB.Comparative study between open and laparoscopic ventralhernia repair: A prospective non-randomized single institutionalstudy. J Dr NTR Univ Health Sci 2017; 6(4):217. DOI:https://doi.org/10.4103/JDRNTRUHS.JDRNTRUHS_115_1620.Baghdady AS, Mostafa HA, Salem AE, Abdullah HA, SaadMR. Short Outcome Evaluation of Laparoscopic VentralHernia Repair Ahmed Saleh Mostafa Baghdady, Hussein AliMostafa. Egypt J Hosp Med. 2021; 83(1):1338-4.

Downloads

Published

2021-10-01

How to Cite

Rasul, S. ., Ahmed, . H. ., Ali, . S., Dawani, S. ., Zahid, S. ., Hussain, . S. ., Jafferi, S. ., & Ali, M. . (2021). Post-operative Pain Outcomes of Laparoscopic Ventral Hernia Repair (LVHR): An eight-year experience. Journal of Bahria University Medical and Dental College, 11(4), 148–152. https://doi.org/10.51985/JBUMDC2021048

Issue

Vol. 11 No. 4 (2021): Volume 11 Issue 4

Section

Original Articles

License

Copyright (c) 2021 Shahid Rasul, Hassan Ahmed, Sanum Ali, Surrendar Dawani, Sarah Zahid, Sehrish Hussain, Salman Jafferi, Mansab Ali

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0

Most read articles by the same author(s)