University of Oulu

Ahonen-Siirtola, M., Nevala, T., Vironen, J. et al. Laparoscopic versus hybrid approach for treatment of incisional ventral hernia: a prospective randomised multicentre study, 1-year results. Surg Endosc 34, 88–95 (2020).

Laparoscopic versus hybrid approach for treatment of incisional ventral hernia : a prospective randomised multicentre study, 1-year results

Saved in:
Author: Ahonen‑Siirtola, Mirella1,2; Nevala, Terhi3; Vironen, Jaana4;
Organizations: 1Department of Surgery, Oulu University Hospital, Oulu, Finland
2Division of Gastroenterology, Department of Surgery, Oulu University Hospital, OYS, PL 21, 90029 Oulu, Finland
3Department of Radiology, Oulu University Hospital, Oulu, Finland
4Department of Surgery, Helsinki University Hospital, Helsinki, Finland
5Department of Surgery, Päijät-Häme Central Hospital, Lahti, Finland
6Department of Surgery, Seinäjoki Central Hospital, Seinäjoki, Finland
7Department of Surgery, Valkeakoski Regional Hospital, Valkeakoski, Finland
8Department of Surgery, Kymenlaakso Central Hospital, Kotka, Finland
9Department of Surgery, Turku University Hospital, Turku, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.9 MB)
Persistent link:
Language: English
Published: Springer Nature, 2020
Publish Date: 2020-04-01


Purpose: Laparoscopic incisional ventral hernia repair (LIVHR) is often followed by seroma formation, bulging and failure to restore abdominal wall function. These outcomes are risk factors for hernia recurrence, chronic pain and poor quality of life (QoL). We aimed to evaluate whether LIVHR combined with defect closure (hybrid) follows as a diminished seroma formation and thereby has a lower rate of hernia recurrence and chronic pain compared to standard LIVHR.

Methods: This study is a multicentre randomised controlled clinical trial. From November 2012 to May 2015, 193 patients undergoing LIVHR for primary incisional hernia with fascial defect size from 2 to 7 cm were recruited in 11 Finnish hospitals. Patients were randomised to either a laparoscopic (LG) or a hybrid (HG) repair group. The main outcome measure was hernia recurrence, evaluated clinically and radiologically at a 1-year follow-up visit. At the same time, chronic pain scores and QoL were also measured.

Results: At the 1-year-control visit, we found no difference in hernia recurrence between the study groups. Altogether, 11 recurrent hernias were found in ultrasound examination, producing a recurrence rate of 6.4%. Of these recurrences, 6 (6.7%) were in the LG group and 5 (6.1%) were in the HG group (p > 0.90). The visual analogue scores for pain were low in both groups; the mean visual analogue scale (VAS) was 1.5 in LG and 1.4 in HG (p = 0.50). QoL improved significantly comparing preoperative status to 1 year after operation in both groups since the bodily pain score increased by 7.8 points (p < 0.001) and physical functioning by 4.3 points (p = 0.014).

Conclusion: Long-term follow-up is needed to demonstrate the potential advantage of a hybrid operation with fascial defect closure. Both techniques had low hernia recurrence rates 1 year after operation. LIVHR reduces chronic pain and physical impairment and improves QoL.

see all

Series: Surgical endoscopy
ISSN: 0930-2794
ISSN-E: 1432-2218
ISSN-L: 0930-2794
Volume: 34
Pages: 88 - 95
DOI: 10.1007/s00464-019-06735-9
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Funding: Open access funding provided by University of Oulu including Oulu University Hospital.
Copyright information: © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.