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Year : 2021  |  Volume : 27  |  Issue : 2  |  Page : 157-163

Hybrid surgery in hernias: Our experience

1 Department of Minimally Invasive Surgery, Keyhole Clinic, VPS Lakeshore Hospital, Verwandeln Institute, Kochi, Kerala, India
2 Department of Minimally Invasive Surgery, VPS Lakeshore Hospital, Verwandeln Institute, Kochi, Kerala, India

Correspondence Address:
Dr. Madhukara Pai
Department of Minimally Invasive Surgery, Keyhole Clinic, VPS Lakeshore Hospital, Kochi - 682 024, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ksj.ksj_45_21

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Introduction: Hybrid surgery is a procedure in which laparoscopic and open surgical steps are used for a better outcome to the patient. The aim of this study is to identify the factors that necessitated hybrid surgery in cases of hernia. Materials and Methods: It is a retrospective narrative study of 69 patients with hernia, who underwent hybrid surgery. Deciding factors and outcomes were analysed. Results: Of the 69 cases, 32 were open surgery followed by laparoscopy (OL)/open surgery followed by laparoscopy and then by open surgery again (OLO) and 37 were laparoscopy followed by open surgery (LO)/laparoscopy followed by open surgery and then by laparoscopy once more (LOL). Incorporating laparoscopic steps during open surgery helped in combining multiple surgeries, intra-abdominal adhesiolysis, etc., without enlarging the incision. Open surgical steps incorporated during laparoscopy, helped in reduction of irreducible hernia, darning of defects from outside, etc., Ventral hernia with apron and need for combining other surgeries had an association with OLO (P < 0.001). Inguinal hernia or ventral hernia without apron, irreducibility and need for omentectomy had an association with LO/LOL (P < 0.001). Factors having statistically significant association with sandwich repair were large defect size, multiple previous open surgeries, presence of precipitating factors and recurrent hernias. Conclusion: Hybrid surgery offers definite benefits in select cases of hernias. Case-to-case planning is needed preoperatively and should be based on the difficulties anticipated. It will help the surgeon perform a safe procedure.

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