S. L. Whitney1, M. Simhon1, C. Divino1 1Mount Sinai School Of Medicine,Surgery,New York, NY, USA
Introduction: Ventral and umbilical hernias are a common pathology in our population given increasing obesity rates and increasing rates of abdominal surgeries. We aimed to assess quality of life (QOL) improvement following repair of these hernias using a validated, the Carolina Comfort Scale (CCS), and compare these QOL outcomes between patients.
Methods: The CCS was tailored to assess symptoms and quality of life related to hernia repair. Patients undergoing repair were consented and completed three CCS surveys: pre-operatively, within 1 month after surgery, and greater than 1 month after. Questions on the CCS survey assessed severity of symptoms related to the hernia on a scale of 1-5 by asking if various positions and activities could result in worsening of pain, movement limitations and sensation of mesh post-procedure. Secondary outcomes measured were re-admission, complications, and blood loss.
Results: 43 patients consented to participate and filled out the 3 required surveys. The average age was 49.2 years with an average BMI of 29.7. 24 patients had a history of previous abdominal surgery with 13 of these being classified as incisional ventral hernias. 42 of 43 were reported to be symptomatic, with pain and movement limitations being present. All 43 cases were performed electively. 24 surgeries were performed laparoscopically, 13 were performed open, and 6 were performed robotically. Mesh was used in all laparoscopic cases and all robotic cases, and 3 of the 13 open cases. The average length of hernia duration was 38.5 months. On the CCS survey, all patients who underwent repair showed significant symptomatic improvement (p ≤ 0.05) between the pre-op symptoms and 2nd post-op visit symptoms in all 9 categories regarding pain and movement limitations. All patients who received mesh reported mild sensation of mesh that did mildly diminished by the second post-operative visit, but this change was not significant in any of the categories (p < 0.05). Of all patients who underwent repair, the mean rating of satisfaction on a scale of 1-5 was 3.93 at the second post-operative visit. The mean number of days to return to work was 25.7 days as reported at the second post-operative visit. The mean surgery time was similar in both laparoscopic and open cases (p 0.11). There were no recurrences during the follow-up period.
Conclusion: Patients reported significant improvement in pain and functional status following ventral and umbilical hernia repair surgery, with improved pain and diminished movement limitations. Sensation of mesh did not significantly diminish as time progressed post-operatively.