Study to evaluate ventral hernias regarding their epidemiologic aspects, clinical features and various surgical methods employed for their repair: an observational study

Abstract

Aim: The aim of the present study was to evaluate ventral hernias regarding their epidemiologic aspects, clinical features, and various surgical methods employed for their repair.

Methods: This was a prospective observational study conducted in the Department of Trauma & Emergency Medicine for 2 years. A total of 100 patients were included in the current study.

Results: The incidence of incisional hernia (30%) was the highest followed by umbilical (26%) and epigastric hernias (25%). Overall, the incisional hernias were even more common in females but umbilical hernias were more frequent among males. Most ventral hernias were found in 40-60 year age group patients (56%) followed by 20-40 year age group patients (29%). The mean age of presentation was 48.12±5.75 years. Overall, most of the patients presented with painless swelling. In epigastric hernias, pain with or without visible swelling was the most common presentation. Emergency presentations like irreducibility or obstruction were less common. Incisional hernias were found to have occurred mainly after laparotomy (30%) and gynecological surgeries like hysterectomy and cesarean section (53.33%). Laparoscopic port site incisional hernias were uncommon (6.66%). In emergency cases, darning herniorrhaphy was the choice of repair instead of mesh repair. All elective incisional hernia repairs (100%) were open onlay repairs. Pain was the most common complaint following ventral hernia repairs followed by fever and seroma formation. Patients undergoing elective hernioplasty suffered fewer complications than emergency repair such as wound dehiscence, pelvic collection, etc. which were statistically highly significant (p<0.001).

Conclusion: We found ventral hernias to be more prevalent in the elderly and females. Incisional, umbilical, and epigastric hernias were the more common types. Laparotomy, gynecological procedures and midline incisions were found to be major risk factors for the development of incisional hernias.