Clinical Study and Different Modalities of Treatment in Ventral Hernias

Abstract

Background: Ventral hernias are common abdominal wall defects with a multifactorial etiology, often requiring surgical intervention to prevent complications such as obstruction or strangulation. While various surgical modalities exist—including open mesh repair, laparoscopic mesh repair, and primary suture repair—the optimal approach remains a topic of debate. This study aimed to evaluate and compare the outcomes of these different treatment modalities.

Methods: A prospective clinical study was conducted over 12 months, involving 80 patients diagnosed with ventral hernias. Patients were divided into three groups based on the surgical intervention: Group A (Open Mesh Repair, n=30), Group B (Laparoscopic Mesh Repair, n=30), and Group C (Primary Suture Repair, n=20). Preoperative evaluation included clinical assessment and imaging. Outcomes measured were operative time, postoperative complications (infection, seroma, hematoma, chronic pain), hospital stay, recurrence rate at 12 months, and patient satisfaction. Data were analyzed using SPSS version 26.0.

Results: The mean operative time was longest in the laparoscopic group (95 ± 18 minutes) and shortest in the suture repair group (60 ± 10 minutes). Postoperative complications were most frequent in the open mesh group (46.7%), primarily wound infections, though inter-group differences were not statistically significant. Laparoscopic repair was associated with the shortest mean hospital stay (3.1 ± 0.8 days) and the fastest return to normal activity (10.4 ± 2.8 days). The recurrence rate was lowest in the laparoscopic group (3.3%) and highest in the primary suture group (15%). Patient satisfaction was highest for laparoscopic repair (90%), followed by open mesh (80%) and suture repair (70%).

Conclusion: Laparoscopic ventral hernia repair offers the most favorable outcomes, characterized by a faster recovery, shorter hospital stay, low recurrence rate, and high patient satisfaction. Open mesh repair remains a vital option for large or complex hernias, while primary suture repair should be reserved for small, uncomplicated defects. The findings support a patient-tailored approach and reinforce minimally invasive, mesh-based repair as the modern standard of care for most ventral hernias.