David S Strosberg1, Sara E Martin del Campo1, Katherine Bingmer2, Andrei Manilchuk1. 1The Ohio State University Wexner Medical Center, 2Case Western Reserve University
Introduction: Open component separation (OCS) is a surgical technique used to repair large, complex ventral hernias, and has long been accepted as the gold standard. Laparoscopic component separation (LCS) is a newer technique, but the literature regarding its comparison to open is limited to a small number of studies with small cohorts. The primary aim of this study was to investigate the safety and efficacy of LCS with a larger cohort of patients than has been previously published. Secondary aims included a comparison of morbidity, recurrence, and operative outcomes in comparison to open component separation. We predicted that LCS is a safe and feasible technique in the repair of complex ventral and incisional hernias.
Methods and Procedures: We performed a retrospective review for all patients who underwent open and laparoscopic component separation by a single surgeon from January 2008 to February 2015 at a large academic medical center. Demographics, comorbidities, operative time, type and size of prosthetic mesh used, conversion to an open procedure, length of operative time, length of hospital stay, estimated blood loss, recurrence, complications, and 60-day readmissions were collected and analyzed. Summary and comparative statistics were performed using student’s t-test and Fischer’s exact test as appropriate.
Results: We identified 112 patients, 89 of whom had at least one LCS performed, and 23 who underwent at least one OCS. Patients in the LCS group were younger (LCS 53.16, OCS 59.43, p<0.05); otherwise, there were no statistical differences regarding demographics. There were no significant differences regarding estimated blood loss, length of surgery, and length of hospital stay. There were no significant differences regarding morbidity and mortality, including recurrence rate (LCS 11.2%, OCS 13.0%, p=0.73), infection (LCS 19.1%, OCS 34.8%, p=0.16), readmission within 60 days (LCS 15.7%, OCS 26.1%, p=0.36), and death (LCS 1.1%, OCS 4.3%, p=0.37).
Conclusion: The use of LCS results in similar patient outcomes when compared to the gold standard of OCS. In the correctly selected patient population, LCS can be as safe and effective as OCS in the repair of complex ventral hernias.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79770
Program Number: P046
Presentation Session: Poster (Non CME)
Presentation Type: Poster