Abstract:
Background: Para-umbilical hernia (PUH) repair has shown a progressive development over
the time. It was initially performed by the open technique. With the introduction of new mesh
types, laparoscopic para-umbilical hernia repair is gaining increasing acceptance.
Objectives: To compare the intra operative time, post-operative surgical site infection and
duration of hospital stay of Laparoscopic with open PUH repair.
Methods: A retrospective study was conducted with 302 patients between 30 to 60 years
including both males and females from National Hospital of Sri Lanka and Teaching Hospital
Karapitiya. Of the participants, 150 patients have undergone Laparoscopic PUH repair and the
rest have undergone open PUH repair. Intra operative time, post-operative surgical site infection
and duration of hospital stay of the patients were recorded. All surgeries were performed by two
experienced general surgeons and they have used both methods on similar number of patients. A
95% confidence interval was selected to compare with the mean differences of two samples.
Critical value for 95% confidence interval with 149 degrees of freedom is 1.976.
Results: The mean (SD) operative times for open PUH repair and laparoscopic PUH repair
were 46 (3.1) and 25 (2.9) minutes, respectively. Except one patient, others were discharged
on post-operative second day following laparoscopic PUH repair, resulting the mean (SD)
number of days of post-operative stay in hospital as 2.01 (0.01) days. The post-operative stay
of the open PUH repair group had a mean (SD) of 5.4 (2.12) days. In comparison to four
patients with post-operative surgical infections following open PUH repair, none of the
laparoscopic PUH repair patients developed post-operative surgical site infections. There was a
significant difference of the mean number of days of post-operative stay in hospital between
two groups (p<0.05) and the mean operative time between two groups (p<0.05).
Conclusions: Laparoscopic repair has significantly better outcomes in-terms of intra operative
time, post-operative complications and duration of hospital stay. Therefore, the laparoscopic
PUH approach should be considered as a better strategy for para umbilical hernia repair than
open PUH.
