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Less Invasive Hernia Repair Safer for Obese

Fri, 06/14/2013 - 10:20am
Crystal Phend

Laparoscopic repair of ventral hernias cuts complications and hospital stay for obese patients, a national study showed.

The less invasive procedure had less than half as many complications as open surgery (6 percent versus 14 percent, P<0.001), Justin Lee, MD, of Tufts University in Boston, and colleagues reported online in JAMA Surgery.

Hospital stays dropped to a median three days versus four with the conventional surgery, yielding lower total hospital charges of $40,387 versus $48,513 (both P<0.001).

"Laparoscopy continues to be a safe and cost-effective surgical approach," Lee's group concluded. "Further studies are needed to define clinical criteria that may identify which obese patients with ventral hernias will benefit the most from a laparoscopic approach."

The laparoscopic approach has seen rapid uptake in this population, rising from 7 percent of all ventral hernia repairs in 2008 to 28 percent in 2009.

Open repair declined by the same proportion in the study among the 47,661 cases of ventral hernia repair in obese patients recorded in the National Inpatient Sample database for 2008 to 2009.

"This increase may be a function of improved laparoscopic training and high-quality, minimally invasive equipment," Lee and colleagues suggested. "As public awareness of minimally invasive procedures increases, the use of laparoscopy will become an even more integral part of the surgical armamentarium."

Currently, it seems that socioeconomics are playing a role in who gets minimally invasive surgery, they noted.

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