Quality of life, postoperative outcomes and hernia recurrence following laparoscopic intracorporeal rectus aponeuroplasty (LIRA) for incisional and primary ventral hernia repair.

Abstract

The purpose of this study was to evaluate the quality of life (QoL), early post-operative complications, and hernia recurrence rate following Laparoscopic Intracorporeal Rectus Aponeuroplasty (LIRA) for incisional and primary ventral hernia repair. A prospective cohort study of patients operated for primary or incisional hernia of midline by Laparoscopic Intracorporeal Rectus Aponeuroplasty (LIRA) was performed. The study was conducted from September 2023 to May 2024 to evaluate the LIRA technique performed on patients with ventral hernias type M2-M3, W2. The data analyzed included patient demographics, operative parameters, pain, outcomes, bulging, seroma and recurrence rates and quality of life (QoL). A computerized tomography was performed preoperatively and at the sixth postoperative month to evaluate recurrence. QoL was assessed using the EuraHS-QoL scale preoperatively and at the first and sixth months after the surgery. Thirty-eight patients were included. Mean width of the defect was 4.96 cm. Average visual analogue scale of pain (VAS) was 10.06 ± 6.17 at the preoperative time, 6.68 ± 1.83 at the first day, 2.66 ± 1.26 at the seventh day and 0.75 ± 2.55 at the thirtieth postoperative day. Pre-operative and post-operative EuraHS-QoL questionnaire scores were available for 97.4% of the patients enrolled and showed significant improvement in pain (10.06 vs. 0.75, p < 0.001), restrictions (average 13.2 vs. 0.69, p < 0.001) and cosmetic appearance (10.36 vs. 1.64, p < 0.001). The recurrence rate was 2.7%. The mean follow-up was 6 months. So far, this is the first prospective cohort study that evaluates the impact of LIRA technique on patient´s quality of life with primary ventral hernia (PVH) or incisional ventral hernia (IVH) types M2-M3, W2. Our results show significant improvement in all parameters of the EuraHS-QOL scores (pain, activity, and cosmetic discomfort) for patients undergoing LIRA, with an acceptable postoperative outcome and hernia recurrence rate at a short-term follow-up.