Comparative analysis of Sublay and IPOM techniques in the treatment of ventral hernias (MW1—MW2): clinical and economic review of the literature

Background. Despite the progress of laparoscopic surgery, the optimal repair technique for ventral hernias (MW1—MW2) remains debated. The Sublay and IPOM approaches differ in their surgical philosophy, complication profiles, and cost-effectiveness. Objective. To perform a comparative clinical and economic analysis of Sublay and IPOM techniques in the treatment of ventral hernias (MW1—MW2), assessing complication rates, quality of life, and treatment costs. Material and methods. A literature review covering 1998—2024 was conducted, including the Cochrane review, Herniamed and EVEREG registries, and Russian Ministry of Health surgical data. Parameters assessed included postoperative complications (Clavien—Dindo), hospital stay, recurrence rate, quality of life, and cost structure. Results. The Sublay method shows higher rates of minor complications (Clavien—Dindo I—II), such as seromas and superficial infections, but almost no severe visceral injuries. The IPOM technique offers faster recovery and lower SSI rates but carries increased risks of enterotomy and high material costs. In Russia, the share of IPOM repairs remains around 6.8—7.2%. Economic analysis demonstrates the cost-efficiency of the Sublay technique due to low-priced polypropylene meshes and higher profitability under public insurance tariffs. Conclusion. Sublay and IPOM are complementary, not competing, surgical techniques. The choice should be individualized based on defect morphology, hospital resources, and cost factors. Sublay ensures anatomic reconstruction and durable outcomes, while IPOM provides minimal invasiveness and faster recovery at higher expense.