Laparoscopic Intra-Peritoneal Onlay Mesh Repair (IPOM) for Ventral Recurrent and Incisional Hernias

Background: Recurrent incisional hernia repair is debatable as regard suitable approach. Laparoscopy offers better choice of hernia repair but still recording high failure and complication rates.Aim: To assess Efficacy and safety of laparoscopic intra-peritoneal only mesh repair (IPOM) for recurrent ventral and incisional hernia with evaluation of operative and postoperative findings.Patients and methods: A prospective study was conducted on 23 patients with recurrent ventral and incisional hernia after open repair treated by IPOM and postoperative follow-up was done for 18 months. Preoperative, operative and postoperative data were collected and statistically analyzed.Results: The study involved 13 females and 10 males; the mean age was 40.82±8.46 years, 18 patients (78.26 %) had a recurrent paraumbilical hernia, two patients (8.9%) had recurrence after post-CS incisional hernia, three patients (12.8%) had recurrent incisional hernia after other surgeries. 4 patients (17.4%) were converted to open surgery. The mean operative time was 115.78±26.1 minutes, and the mean blood loss was 46.52±18.18 ml; no significant bleeding or bowel injuries were reported. Mean pain on VAS score was 6.33±5.13; mild pain was reported in 63.1%, and mean hospital stay was 2.08±0.8 days. Postoperative complications were reported in 26.3%; 2 patients (10.5%) had seroma, three patients (15.8%) showed surgery site infection, and no reported cases of hematoma or missed injuries. The recurrence rate was 10.5% (two patients).Conclusion: IPOM is a feasible and safe procedure with acceptable outcomes, however, it requires experienced surgeon and proper patient selection. Larger studies of long term outcomes are required for more reliable results.