Abstract

Abstract Background There are two conventional approaches to abdominal wall hernia repairs which aim to achieve anatomical restoration. Open approaches have the advantage of complete hernial sac excision and more freedom with mesh placement. In comparison, laparoscopic approaches benefit by shorter hospital stays, less post-operative pain and fewer post-operative complications. Recently a hybrid approach which combines the two techniques has gained popularity. Our aim was to validate if such hybrid approach can still achieve the same benefits, irrespective of hernia size, age, and BMI, with acceptable low complication and recurrence rates. Method The medical record of all patients who underwent hybrid laparoscopic hernia repair (HLHR) from 2017 to 2023 was retrieved from a prospectively maintained institutional database and retrospectively analysed. Intra- and post-operative complications, as well as hernia recurrence at 6 months were assessed. Results There were 37 patients (21 females: 56.8%) with a mean age of 66 years and BMI of 34.2 kg/m2 who underwent hybrid hernia repair. Thirty-four (91.9%) were incisional hernias, of which 50% were recurrent. Mean hernia size was 96.8 cm2. Twelve (32.4%) patients had preoperative chemical component separation with botulinum toxin A (BTA); this group had a significantly higher BMI and hernia size compared to no BTA (37.7 vs. 32.5; P=0.048; 174.5 cm2 vs. 59.5 cm2; P=0.0002). There was no intra-operative, but eight (21.6%) minor postoperative complications. There was no hernia recurrence at 6 months follow-up. Conclusions HLHR with TAPE mesh fixation is safe with satisfactory outcome, irrespective of hernia size and BMI.