Clinical Presentations, Predisposing Factors and Methods Of Surgical Repair Of Ventral Hernias in Tertiary Teaching Hospital: A Prospective Study

Abstract

Background: A ventral hernia is a protrusion of abdominal viscus through the anterior abdominal wall occurring at any site other than the inguinal and femoral areas and is a common problem encountered by surgeons. Objective: to know the clinical presentations of the ventral hernias, predisposing factors (risk factors) for the development of ventral hernias , different methods of surgical repair of the ventral hernias, complications following surgery and their follow-up. Methods: This was a prospective study was at Department of General Surgery, S S institute of Medical Sciences Davangere Karnataka between August 2020 and August 2021..Results: The youngest patient was 12 years old and the oldest was 76 years old. The mean age at presentation was 47 years. paraumbilical hernia (49%) was the most common variety followed by epigastric hernia (22%) and umbilical hernia (18%). Highest incidence is found in the 41-50 age group. Majority of the patients presented with swelling & Pain over& around the umbilicus or in the line of the scar of previous surgery. Paraumbilical hernia was the most common amongst the ventral hernias with an incidence of 46%. Of which, most occurred in infra-umbilical region. There is significant association between constipation smoking, obesity and occurrence of ventral hernia (p<0.001). 6% recurrence rate was observed after 1 year of follow up. Wound infection rate was 4%.3% with only repair and 1% with sublay repair.
Conclusions: Apart from recurrence, other postoperative complications like seroma formation
and wound infection attributed largely to extensive dissection and tissue handling during hernia repair.8 In present study, there was slightly more chance of seroma formation in onlay group, which may be due to extensive tissue dissection and increased blood loss.