Laparoscopic Intraperitoneal Onlay Mesh Plus (IPOM Plus) With Mobilizing the Urinary Bladder for Suprapubic Incisional Hernia Repair: A Case Report

Ventral hernias represent a prevalent surgical complication in contemporary medical practice, with incisional hernias being a common long-term outcome following abdominal surgery. There are many risk factors for abdominal incisional hernias, including surgical history, malnutrition, obesity, chronic obstructive pulmonary disease, abdominal closure technique, and surgical site infection. Laparoscopic repair of incisional hernias is the optimal surgical approach, as it is associated with reduced hospital stays, fewer perioperative complications, and lower recurrence rates. This report details a case of suprapubic incisional hernia managed via laparoscopic surgery utilizing adual mesh placed intraperitoneally. The bladder is displaced from the rectus abdominis muscle to form a compartment for the placement of the mesh, which is then anchored to the pubic bone, after which the bladder is sutured back into position. Laparoscopic intraperitoneal onlay mesh plus (IPOM plus) surgery is a feasible alternative to open ventral hernia repair for defects smaller than 10 cm. There is less chance of seroma formation and recurrence with transfascial sutures, which makes them an easy method for defect closure. Using a mesh improves muscle function and reduces the likelihood of hernia recurrence. Recurrence rates are lower and mechanical stability is better with mesh utilization compared to initial suture repair. For us, getting the abdominal wall to approximation and inserting the mesh comfortably require mobilizing the urine bladder.