Introduction: Since its introduction in the early 1990s, laparoscopic ventral hernia repair has gained popularity Over 400,000 ventral hernia repairs (VHRs) are performed each year world-wide. Purpose of this study to evaluate open repair versus laparoscopic approach to offer best possible and effective hernia management.4,11,12,15,24 Methods: Between January 2018 and December 2020, 30 patients with primary ventral hernia were randomized to receive either open retro-rectus mesh repair (OHR, Group 1) or laparoscopic mesh repair (LVHR, Group 2). These patients were followed up at 2,4 and 6 months intervals thereafter annually for both groups. Results: Primary ventral hernia are common in age range 41–50 years. In the group 1, majority of patient opting OHR were females (53.3%) while in group 2, males opted for LVHR (66.7%). Swelling was a common presentation in group 2, where as pain was common in group 1. Duration of complaints were similar in both groups. Precipitating factor in group 1 was multiparity (46.7%),whereas in group 2 it was obesity (46.7%). The majority of defect sizes was less than 2x4cm2 in the open (group 1) and 3x1 to 3x3 cm2 in laparoscopic group (group 2). In group 1, 60% infra-umbilical location,whereas in group 273.3% had supra-umbilical location of hernia. 66.7% showed reducibility in group 1, whilst 73.3% showed reducibility in group 2. Cough impulse was positive in both groups. Both groups had a diagnosis of para-umbilical hernia. Hypertension (13.3%) was mostly associated with group 1, where as Diabetes mellitus (13.3%) was mostly associated with group 2. Both groups underwent their respective surgeries as planned. Seroma collection and wound-related infectious complications were common in group 1 and post-operative respiratory distress was common in group 2. Patient compliance and follow-up was more in group 2 when compared to group 1.There were no cases of recurrence until the time frame of follow-up. Conclusions: Laparoscopic repair of Primary ventral hernias is superior to open mesh repair in terms of fewer complications, recurrence, and patient compliance outcome.

Keywords: Incisional hernia; Laparoscopic mesh repair; Open mesh repair; Primary ventral hernia; Seroma; Wound complications.