Laparoscopic Ventral Hernia Repair is Safer than Open Repair: Analysis of the NSQIP Data

Introduction. Previous single institutional studies have demonstrated fewer complications in laparoscopic ventral hernia repair (LVHR) compared to open ventral hernia repair (OVHR). We questioned whether or not these data were supported in large cross-sectional studies. Materials and Methods. We evaluated the National Surgical Quality Improvement Program (NSQIP) database comparing all LVHR versus primary OVHR for patients from 2005 to 2006. We compared demographic data, ASA class, wound classification, and outcome data. We also evaluated recurrent open repair (R-OVHR) data. Differences were considered significant for P <= 0.05. No statistical comparisons were made with the R-OVHR group. Results. There were no differences in demographic data, except older age, between the LVHR and OVHR groups. Wound and ASA classifications were not different. There were fewer total complications (5.7% versus 9.8%, P < 0.001), and fewer superficial (1.5% versus 4.1%, P < 0.001) and deep (0.5% versus 1.6%, P = 0.001) infections in the laparoscopic group. There were more total and infectious complications in the R-OVHR group. Conclusion. Despite no differences in ASA class or wound classification, there were more total and infectious complications in the OVHR group. This large cross-sectional study supports single institutional studies that demonstrate fewer complications and infections in patients with laparoscopic versus open ventral hernia repair. (C) 2009 Elsevier Inc. All rights reserved.