Surgical Synergy: Concurrent Laparoscopic Cholecystectomy for Cholelithiasis with Laparoscopic Mesh Hernioplasty for Ventral Hernia - Possibility & Feasibility

Abstract

Background: Laparoscopic cholecystectomy (LC) is a standard procedure for treating benign biliary pathology, while laparoscopic hernia repair is the preferred approach for managing ventral and inguinal hernias. Traditionally, these procedures were performed separately due to concerns about mesh infection and surgical complexity. This study evaluates the feasibility, safety, and outcomes of concurrent LC (laparoscopic cholecystectomy) and laparoscopic mesh hernioplasty. Minimally invasive surgical procedure for patients with concomitant gallbladder stones and inguinal hernia. The procedure can decrease the number of hospitalizations and reduce the length of hospital stay, and economic burden, early return to normal life. Methods: A retrospective observational study was conducted on 10 patients who underwent simultaneous LC and laparoscopic hernioplasty at Dr. M K Shah Medical College & Research Centre, SMS Multispecialty Hospital. In our study, we have included all patients who have gallstones (asymptomatic/symptomatic) with a ventral hernia. Preoperative risk factors, intraoperative findings, and postoperative recovery were analyzed over a three-month follow-up period. The hernia repair techniques included Transabdominal Preperitoneal (TAPP), Totally Extraperitoneal (TEP), and Transabdominal Retrorectus Mesh (TARM) hernioplasty for inguinal/umbilical/incisional hernia with Laparoscopic cholecystectomy. All Complications, like surgical site infections (SSI) or mesh-related complications related to long anesthesia, recurrence, or mortality, were analyzed. Results: All 10 patients successfully underwent Laparoscopic cholecystectomy with Laparoscopic hernia repair. One patient required conversion to open surgery due to bile spillage. The mean operative time was 3.8 hours (range: 3–5 hours). Postoperatively, 90% of patients reported a pain score of 3–4 on the Visual Analog Scale (VAS), and all were mobilized within 8 hours. Drain removal was done on postoperative day (POD) 1 in 90% of cases, except for one patient with bile leakage. No surgical site infections (SSI) or mesh-related complications, no complications related to long anesthesia recurrence, or mortality were observed during the six-month follow-up. Conclusion: Simultaneous laparoscopic cholecystectomy and hernioplasty are safe and effective approaches in selected patients. Proper patient selection, meticulous surgical techniques, and strict infection control protocols are essential for preventing mesh-related complications. This combined approach reduces the number of surgeries and hospital admissions, shortens recovery time, and ensures favorable outcomes.