Mesh repair of incisional hernia: Comparison of laparoscopic and open repair

Objective: To compare our results of open and laparoscopic mesh repair of incisional hernias. Design: Retrospective cohort study. Setting: Teaching hospitals, The Netherlands. Subjects: All patients who had had a laparoscopic (n = 25) or an open (n = 76) mesh repair of incisional hernia between January 1996 and January 2000. Interventions: Physical examination at the time of the study. Main outcome measures: Morbidity and recurrence. Results: The groups were comparable. 11 patients (14%) developed postoperative infections after open repair and 1 (4%) after laparoscopic repair (p = 0.29). Median hospital stay was 5 days (range 1-19) in the open group and 4 (range 1-11) in the laparoscopic group (p = 0.28). The 2-year cumulative incidence of recurrence was 18% after open repair (median follow-up of 17 months (range 1-46) and 15% after laparoscopic repair (median follow-up of 15 months, range 1-44). Recurrences in the laparoscopic group were all among the first 7 cases in which the mesh was fixed with staples alone. Conclusion: There were fewer infections and hospital stay was shorter in the laparoscopic group, but not significantly so. Recurrence rates were comparable.