Advancements in technology and medicine have rendered laparoscopic ventral hernia repair (LVHR) more favourable than open ventral hernia repair (OVHR). Albeit associated with risk of postoperative seroma, LVHR may reduce wound infection rates and hospital stays. However, LVHR requires accurate technique and careful patient selection.
Study I was a retrospective study conducted at the Karlskoga Hospital Hernia Centre. From January 2017 to June 2020, 876 ventral hernia operations were performed. We analysed 213 patients who underwent ventral hernia repair with Intraperitoneal Onlay Mesh without defect closure (sIPOM), IPOM with defect closure (IPOM-P), and IPOM with peritoneal bridging (IPOM-pb) and compared the incidence of postoperative seroma, discomfort, recurrence, and complications.
Study II was a randomized controlled trial with 112 participants who underwent laparoscopic ventral hernia repair between November 2018 and December 2020. The participants underwent ultrasonography at 1, 3, 6 and 12 months postoperatively. Postoperative seroma, discomfort, and complications following IPOMpb and sIPOM were analysed.
Study III was a registry-based study of the impact of COVID-19 on emergency and planned hernia repair procedures, divided into two periods; the pre non COVID-19 Period Januari 2016 - December 2019 as a control group and the COVID-19 Period Januari 2020 to December 2021 as the study group.
Study IV was a population-register study based on a retrospective cohort evaluating risk factors for postoperative pain, nausea and vomiting in 4795 patients who underwent ventral hernia repair between 2016 and 2021, with 2409 of them undergoing open ventral hernia repair surgery. Data were assembled from the Swedish ventral hernia register and Swedish perioperative register.
Study I showed that the IPOM-pb approach was as safe and feasible as conventional IPOM, requiring no additional effort from the surgeon or staff.
Study II showed lower incidence of postoperative seroma and discomfort in IPOM with peritoneal bridging in early-stage follow-ups, with no significant difference in subsequent follow-ups.
In study III the pandemic planned surgeries were impacted but the result in this study showed that there was no increase in emergency hernia operations due to delayed planned surgery. Careful observation and caution are crucial during a pandemic.
Study IV showed that postoperative pain, nausea and vomiting are more common in women, emergency surgery, younger age patients, and those who had surgery with inhalation anesthesia compared to total intravenous anesthesia.