Evaluating Surgical Techniques in Appropriate Patients Undergoing Emergency Surgery for Incarcerated Incisional Hernia: Comparison of Laparoscopic vs. open or Retro-Muscular Repair

Background: Emergency surgery for incarcerated incisional hernia remains a challenging clinical entity, with surgical outcomes depending significantly on the chosen operative technique. This study aimed to compare outcomes of laparoscopic versus open or retro-muscular repair in appropriately selected patients.

Methods: A prospective observational study was conducted on 100 patients undergoing emergency surgery for incarcerated incisional hernia over a 3-year period. Patients were categorized into two groups: laparoscopic repair (n=48) and open/retro-muscular repair (n=52). Demographic data, intraoperative findings, postoperative complications, hospital stay, and recurrence rates were compared.

Results: The laparoscopic group had shorter operative times (85±15 vs 110±20 min), reduced intraoperative blood loss, shorter hospital stay (5.2±1.8 vs 8.1±2.2 days), and lower wound infection rates (6.2% vs 17.3%). Recurrence at 12 months was lower in the laparoscopic group (4.1% vs 9.6%). However, conversion to open repair occurred in 3 cases due to dense adhesions.

Conclusion: Laparoscopic repair of incarcerated incisional hernia in selected emergency cases is safe, effective, and associated with better short-term outcomes compared to open or retro-muscular repair. Larger randomized controlled trials are warranted.

Keywords: Incarcerated Incisional Hernia, Emergency Hernia Repair, Laparoscopic Repair, Open Repair, Retro-Muscular Repair, Surgical Outcomes, Postoperative Complications.