Retrospective Comparative Study of Modified Stoppa Hernioplasty (MSH) vs. Laparoscopic Ventral Intraperitoneal Hernioplasty (LVIH)

Author(s): Galal Fattha Alla Sharaf, Mohamed Mostafa Albadry, Mohamed Tawfik, Abdelmalek Altaf, Abdulrahman Marzouq AlMutiri, Khalid Ahmed Almaghrabi, Ahmed Rafid Alhuwaysi and Abdulrahman Saad Alsubhi

Background: An incisional hernia is a common long-term complication of abdominal surgery and is estimated to occur in 3% to 13% of laparotomy incisions. However, its incidence is greater than 23% in patients who have developed an infection in the laparotomy wound. Aim: What we aim from such a study is to compare laparoscopic ventral intraperitoneal hernioplasty (LVIH) done in KAU hospitals (KAUH) during the period from 2005 till 2015 and our cases done through the modified Stoppa Hernioplasty (MSH) in CUH & BEH. Materials and Methods: The 77 of laparoscopic ventral intraperitoneal hernioplasty (LVIH) done in King Abdul-Aziz University Hospital (KAUH) during the past 10 years were done by using meshes liable to be put on the intestine without inducing adhesion or fistulae formation as PTFE, vicryl and composite meshes. Results: Laparoscopic hernioplasty was used in 77 cases out of 245 (32%) abdominal wall hernias, while 58 cases of incisional hernia were treated by MSH (96.33%) and 2 cases (3.33%) were treated by sandwich technique; MSH and only mesh in one case and intraperitoneal mesh reinforced by subcutaneous proline mesh in the second case. The range of operative blood loss in KAUH was from 50 to 300 cc while it was from 80 to 200 in cases of BEH and CUH. The post-operative seroma was detected in 29 cases (21%) in KAUH in only those cases treated by only proline mesh, while 2 cases (3.33%) only were detected in the 60 cases done by MSH in BEH and CUH and it was in the form of mild hematoma due to clot obstruction of the drainage tube. The range of post-operative stay in hospital was from 1-30 days in KAUH with 29% of laparoscopic cases of hernioplasty discharged after one day while it was 2-15 cases in BEH and CUH with 32% of cases discharged within 2 days. Conclusion: To conclude, Open ventral hernioplasty with MSH is a safe, easy and rapid surgical technique, with negligible post-operative seroma, very low incidence of recurrence, short post-operative hospital stay, and suitable for all types of ventral hernia (complicated vs. non-complicated, recurrent vs. virgin, single defect vs. multiple defects), with minimal intraoperative blood loss and the most important advantage of such technique is the gain of all these benefits with comparative very low cost. LIH has becoming increasingly advanced with the progress of technology in laparoscopic field and non-adhesible new mesh production. The best advantage is that other synchronous intraperitoneal surgical procedures can also be done in the same sitting. One of great advantage in our opinion is that it can be used instead of MSH in cases with very wide defects. Also, it is the solution for ventral hernioplasty in patients with chronic pulmonary diseases with defective pulmonary functions. It is a more cosmetic procedure than MSH.


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