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Incisional hernia following obstetrics and gynaecological surgeries: a hospital based prospective observational study

Author: 
Dr. Anjum Malik, Dr. ZahidahAkhter and Dr. Tanveer Ahmad Yatoo
Subject Area: 
Health Sciences
Abstract: 

Background and Objectives: Incisional hernia is the most common complication following abdominal surgery that requires reoperation. Incisional hernia is more common in females following obstetrics and gynaecological surgeries. Laparoscopic incisional hernia repair has been gaining popularity for small and medium sized ventral hernias.The aim of this study was to analyze the clinical details of incisional hernia following obstetrics and gynaecological surgeries and early outcomes of laparoscopicintraperitonealonlay mesh hernia repair using composite mesh. Methods: A prospective hospital based observational study in which 36 females with incisional hernia following obstetrics and gynaecological surgeries were enrolled and clinical details were taken. Laparoscopic intraperitonealonlay mesh hernioplasty using composite mesh with or without primary closure of defect was done. Results: Thirty six females with a mean age of 49.2years with incisional hernia through previous midline (63.88%), pfannensteil(36.12%) incisions presented with swelling(80.5%), pain(16.6%) over incision sites. There was previous history of previous hysterectomy(47.2%), caesarean section(38.8%),myomectomy(5.6%),ectopic rupture(5.6%) and ovarian cyst rupture(2.7%) with comorbidities like obesity(19.4%),diabetes(11.1%),COPD(2.7%),smoking(2.7%) and history of postoperative wound infection following previous surgery(5.6%).Patients underwent laparoscopic intraperitonealonlay mesh hernioplasty using composite mesh with introduction of mesh in 4-170 sec, adjusting and fixation of mesh in 30 -60min using tacks and transfascial sutures. Hospital stay was a mean of 2.1days with complications of seroma formation(8.3%) and recurrence(5.6%). Conclusion: Incisional hernia following obstetrics and gynaecological procedures is a common problem which can be effectively treated with laparoscopic onlay mesh hernioplasty.

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