Laparoscopic ventral hernia repair with intraperitoneal onlay mesh-results from a general surgical unit

Ir J Med Sci. 2019 Nov;188(4):1357-1362. doi: 10.1007/s11845-019-02012-9. Epub 2019 Apr 4.

Abstract

Background: Symptomatic ventral herniation is a common clinical presentation. The treatment, whether elective or as an emergency, can be difficult and a variety of surgical repairs are utilised. Intraperitoneal onlay mesh (IPOM) involves the placement of a reinforcing prosthesis, usually supported by primary closure of the defect. Intra-abdominal adhesions have been highlighted as a potential complication in utilising this form of mesh placement. Several methods of laparoscopic mesh placement outside of the peritoneal cavity are gaining prominence as potential alternatives to IPOM.

Aims: This study reviews our experience with IPOM in the repair of ventral hernia by a single surgical team.

Methods: A prospectively maintained electronic database of all laparoscopic ventral hernia repair (LVHR) performed within the study period was analysed and reported. Follow-up questionnaires were sent to patients to follow long-term outcomes.

Results: One hundred eight patients underwent LVHR over a 7-year period. Demographics demonstrated an obese patient group (BMI 30.89 ± 4.9 kg/m2), with a variety of hernia sizes and morphologies. Hernia recurrence was found in two patients (1.8%). Twenty-nine (26.8%) patients suffered a complication, but only eight (7.4%) of those required intervention beyond pharmacotherapy. Two patients required mesh explantation.

Conclusions: IPOM for the general surgeon is a relatively safe and effective method of repairing ventral hernias, with a low recurrence rate.

Keywords: Intraperitoneal onlay mesh; Laparoscopy; Recurrence; Ventral hernia.

MeSH terms

  • Adult
  • Aged
  • Elective Surgical Procedures
  • Female
  • Hernia, Ventral / surgery*
  • Herniorrhaphy / methods*
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Obesity / epidemiology
  • Prospective Studies
  • Prostheses and Implants
  • Recurrence
  • Surgical Mesh*
  • Treatment Outcome