Please select the eligibility criteria that correspond to the clinical trial below.
Title: Prospective Randomized Evaluation of Open vs. Laparoscopic Operation of Ventral Incisional Eventrations. A Swedish Multicenter Study
Brief Summary: This purpose of this study is to compare the recovery after an operation of an incisional hernia within the limits of the rectus muscles of the abdominal wall. The use of a mesh in the repair of a postoperative hernia is considered obligatory. Placement of a retromuscular mesh is done by open or laparoscopic surgery. Focus is on the recovery phase assuming a less painful recovery after a laparoscopic procedure.


Options:
A: Inclusion Criteria:

* Age: 18-85 years and Danish speaking
* Umbilical hernia Ø 1.5 - 5 cm at preoperative clinical examination
* ASA group I-III

Exclusion Criteria:

* Former laparoscopic umbilical herniotomy
* Incarceration
* Drug/alcohol abuse/ongoing use of strong analgesic
* Bad compliance
* Liver disease Child-Pugh stage B/C
* Immunodeficiency (ex. steroid use)
* Pregnancy
* Other hernias recognized perop. and operated on at the same operation
* Lack of consent
B: Inclusion Criteria:

* During the two-year randomization period at the joined centres all patients were included who were admitted with abdominal wall or umbilical hernia and who suited the requirements.
* All the patients with primer or first recurrence of postoperative abdominal or primer or first recurrence of umbilical hernia were randomized into this study.
* For involvement into the study good patient compliance, signed consent form, normal local circumstances were needed.

Exclusion Criteria:

* Ages fewer than 18 or above 70 years
* Hernia orifice under 5 cm2.
* Planned or accidental intraoperative opening of any bowel.
* Unstable parameters of circulation, uncontrollable diabetic or autoimmune disease.
* Severe renal or hepatic failure
* Advanced stage of tumours or currently treated malignancies.
* Inflamed or muddy content of hernia sac.
* If the patient did not signed the consent form.
C: Inclusion Criteria:

Table 1: Inclusion criteria Hernia site\*

* M2
* M3
* M4
* L2
* L3 Hernia width\*
* W1
* W2
* No previous vnetral/incisional hernia repair (R0)\*
* No incarcerated/strangulated hernia
* No contaminated field or bowel resection during repair
* BMI \< 35
* Age between 18 and 75 years old
* No severe COPD
* No autoimmune disease under corticosteroids treatment
* No cirrhosis Child B or C
* No uncontrolled diabetic (Glycated Hemoglobin \< 7)

  * According to: Muysoms FE, et al. Classification of primary and incisional abdominal wall hernias: Hernia 2009; 13: 407-414

Exclusion Criteria:

-
D: Inclusion Criteria:

* Age over 18 years
* Postoperative hernias in the region of the recti abdomini muscles with a defect of less than 10 cm transversal width
* No contraindications to laparoscopic procedure
* The patient should be able to adequate ventilation/respiration after reduction of hernia contents
* Indications for elective surgery

Exclusion Criteria:

* Pregnant women
* Prior operation of abdominal hernia with mesh placement in the compartment of the rectus abdominus muscle (i.e. prior onlay mesh is acceptable)
* Need of an interpreter
* Current drug abuse, mental disorder or other condition which makes the patient incapable of postoperative follow up
* Body Mass index (BMI) \>40
* Other planned concurrent operation
* Current oral steroid treatment, or other immune system modulating treatment
* Incarcerated incisional hernias
* Parastomal hernias
* Prior history of open abdomen
* Enterocutaneous fistula or cutaneous infection
* Hepatic cirrhosis or ascites
* Generalized malignancy
* History of radiation treatment in the abdomen.
* ASA \>III

Answer: D