Ventral Mesh Hernioplasty : Laparoscopic Versus Open Sublay

Study Overview
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Brief Summary
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To compare between laparoscopic ventral hernia repair and open sublay technique (recurrence ,operative time ,bleeding ,rate of complication and injury , seroma, post operative pain)

Detailed Description
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A hernia usually happens in abdomen or groin, when one of your organs pushes through the muscle or tissue that contains it. Most hernias eventually will need surgical repair. sublay mesh repair has the lowest recurrence and surgical site infection in open anterior abdominal hernia repair it is a perfect choice for the repair of ventral abdominal hernia the principles included two main steps: (1) mesh placement deep into the recti muscles and (2) mesh extension beyond the hernia defect. Laparoscopic ventral hernia repair (LVHR) has established itself as a well-accepted option in the treatment of hernias. Clear benefits have been established regarding the superiority of LVHR in terms of fewer wound infections compared with open repairs. Meticulous technique and appropriate patient selection are critical to obtain the reported results. • In the laparoscopic technique, a prosthetic mesh is inserted through a trocar into the abdominal cavity and fixed against the abdominal wall. After reducing the hernia contents, the hernia sac is left unresected, and most surgeons do not place additional sutures for closing the hernia orifice. A specific risk of laparoscopic hernia repair lies in freeing adhesions between intestine and abdominal wall, which may result in (sometimes unrecognised) bowel perforation . The mesh should overlap the hernia orifice by at least 5 cm and is anchored to the abdominal wall with tacks, transfascial sutures, or a combination of the two methods. In laparoscopic abdominal hernia repair, mesh placement methods are generally classified into intraperitoneal onlay mesh (IPOM), transabdominal abdominal preperitoneal (TAPP)

Official Title
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Ventral Mesh Hernioplasty : Laparoscopic Versus Open Sublay

Conditions
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Ventral Hernia

Intervention / Treatment
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* Procedure: hernioplasty


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All cases of midline ventral hernia fit for surgery Exclusion Criteria: Surgically unfit cases Complicated hernia (obstructed ,irreducible, strangulated) incisional ,massive ,recurrent hernias

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: sublay<br>patients with ventral hernia operated as sublay mesh repair positioning of mesh under sheath | Procedure: hernioplasty<br>* ventral hernia repair with mesh<br>|
| Experimental: laparoscopic<br>patients with ventral hernia operated as laparoscopic repair positioning TAPP mesh | Procedure: hernioplasty<br>* ventral hernia repair with mesh<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| recurrence rate | compare between laparoscopic ventral hernia repair and open sublay technique in how long the hernia take to occur again | baseline |