Laparoscopic intraperitoneal onlay mesh with fascial repair (IPOM plus) for ventral and incisional hernia

Abstract

Abdominal wall surgery for ventral hernia is one of the commonest procedures performed by the surgeons. The aim of the study is to evaluate short- and long-term outcomes in patients who underwent laparoscopic IPOM plus approach. Materials and methods. This study describes 70 patients who underwent laparoscopic intraperitoneal onlay mesh repair plus (IPOM plus) for ventral and incisional hernia. These were then followed up for a period of a minimum of 12 months and a maximum of 5 years. Results. Of the 70 patients, 8 (11.43 %) linea alba hernias, 28 (40.00 %) umbilical hernias, 34 (48.57 %) had incisional hernias. The distribution based on ASA score: I – 23 (32.86 %) patients, II – 39 (55.71 %), III – 8 (11.43 %). The mean age was 50.21 ± 0.89 years (M ± m). Male to female ratio was 1.19:1.00. Average defect size was 4.77 ± 0.21 cm (M ± m). Mean operating time was 58.27 ± 0.52 minutes (M ± m). Mean post-op hospital stay was 1.84 ± 0.06 days (M ± m). Intensity of pain by VAS pain score was 5.11 ± 0.92, 4.47 ± 0.31, 2.90 ± 0.72, 0.92 ± 0.81 (M ± m) after 6 hours, 24 hours, 1 week, 6 weeks respectively. No conversion to open laparotomy was required. Reported complications were port-site seroma 3 (4.29 %), port-site hematoma 1 (1.43 %) over one year of follow-up. 62 (88.57 %) patients were evaluated over 21 months follow-up period, no complications have been reported. Conclusions. Obtained results showed that the IPOM plus repair is safe and may be used for routine laparoscopic ventral and incisional hernia repair, the closure of fascial defect appears to give chance for good fixation of the mesh and decrease postoperative morbidity.