Laparoscopic Enhanced-view Totally Extraperitoneal (eTEP) Repair versus Intraperitoneal Onlay Mesh (IPOM) Repair for Ventral Hernia: A Prospective Randomized Controlled Study.

Background: Ventral hernias represent dehiscence of the musculoaponeurotic plane, which ensures the abdominal wall’s solidity and tone. The aim of this work was to compare laparoscopic enhanced view totally extraperitoneal (eTEP) versus laparoscopic intraperitoneal mesh placement (IPOM) in ventral hernia. Methods: This prospective randomized interventional study was carried out on 60 patients aged > 18 years old, both sexes, with ventral hernias less than 8 cm width. Patients were randomly allocated using computer generated randomization tables into two equal groups: Group Ӏ (n = 30): Patients who underwent laparoscopic eTEP approach, and group II (n = 30): Patients who underwent traditional laparoscopic IPOM. Results: Significant increase in eTEP compared to IPOM was found regarding operative time, intra-operative complications (No, peritoneal tear, bowel injury, and bleeding through inferior epigastric controlled laparoscopic), conversion to open (P <0.001, 0.01, 0.01, respectively), but lower in eTEP than IPOM regarding pain VAS score, and return to work (days) (P= 0.006, <0.0001, respectively)Conclusions: Overall, eTEP-RS was found to be a better procedure for the management of primary ventral hernias than IPOM Plus.