Spectrum of ventral hernia in patients presenting at indira gandhi medical college shimla

Background: ventral hernia is one of the common complications encountered in surgery OPD day by day and is an important cause of morbidity. It can be repaired by following anatomical, mesh or laparoscopic methods. The incidence of these hernias is high even with recent advances in surgery, anaesthesiology, antibiotics, and suture materials used. We wanted to study the epidemiology, aetiology, mode of presentations, modalities of treatment and its outcome of ventral hernia repair.
Method: with the aim of studying spectrum of the ventral hernia in Indira Gandhi medical college, study was conducted on 207 patients who presented in IGMC Shimla with in two year period. History, clinical examination, radiological as well as laboratory investigations, comorbid conditions, operative techniques, post operative period was recorded on a preformed performa and analysed.
Results: 207 patients were studied age ranging from 10-88 with mean age was found to be 51.33 years with female predominance with ratio 1.5:1. Most of the patients who present in IGMC are from shimla district and Epigastric hernia (41.55%) was commonest variety followed by incisional hernia (30.43%), umbilical, paraumblical, recurrent incisional and spigelian hernia. 104 patients were symptomatic and prostatism (29.80%) was the most common comorbidity followed by hypertension, respiratory and diabetes. Majority of the patients underwent anatomical repair (37.68%) , open mesh hernioplasty 31.67% and laparoscopic ventral hernia was done in 19.8%. Patients followed for one month after surgery for post op complications and only 10 patients (4.8%) of operated patients had wound infection.
Conclusion: Ventral hernias are common surgical burden in Himalayan population. Better treatment strategies need to be devised to manage these. Presence of ventral hernia is an indication for surgery even in presence of co-morbid conditions like ascites, COPD, BPH as these patients are more prone for complications and of course these conditions need proper addressal.