Modified Laparoscopic Intraperitoneal Onlay Mesh in Complicated Inguinal Hernia Surgery

Hernia. 2015 Jun;19(3):433-6. doi: 10.1007/s10029-014-1256-2. Epub 2014 Apr 29.


Purpose: To analyse the recurrence rate and postoperative complications in inguinal hernia patients where the laparoscopic intraperitoneal onlay mesh technique (IPOM) was used due to preperitoneal fibrosis.

Methods: Patients who had undergone inguinal herniotomy with the IPOM technique at Horsens Regional Hospital during the calender years of 2004 through 2010 filled out a questionnaire specific for recurrence and postoperative complications and had a clinical examination. Furthermore the medical records and national databases were analysed for reoperations for recurrent hernias.

Results: 37 patients (38 hernias) were operated. Two patients had a recurrent hernia (5 %), four patients (11 %) reported chronic pain and six patients (16 %) reported various bowel symptoms after the operation.

Conclusions: The optimal treatment of these relatively rare and complicated patients is still an issue of debate, but in the light of the present study it seems that the IPOM technique is equal to or has a better profile compared to Lichtenstein in terms of re-recurrence and chronic pain. We believe that the IPOM technique has a place in the treatment of these patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fibrosis
  • Hernia, Inguinal / complications
  • Hernia, Inguinal / surgery*
  • Herniorrhaphy / methods
  • Humans
  • Laparoscopy
  • Male
  • Middle Aged
  • Pain, Postoperative / etiology
  • Peritoneum / pathology
  • Peritoneum / surgery
  • Recurrence
  • Reoperation
  • Retrospective Studies
  • Surgical Mesh*
  • Surveys and Questionnaires