Effect of Defect Closure (IPOM-Plus) versus PeTEP on Functional Outcomes

3,050+350Background Primary ventral hernias, especially umbilical and paraumbilical hernias, are frequently encountered surgical problems that cause pain, poor quality of life and impaired functionality. Current hernia repair not only seeks to avoid recurrence but also to restore abdominal wall function and patient quality of life. Both Intraperitoneal Onlay Mesh with defect closure (IPOM-Plus) and Preperitoneal Enhanced-view Totally Extraperitoneal Repair (PeTEP) are key minimally invasive repair techniques. The aim of this study was to compare the functional results of IPOM-Plus and PeTEP in the repair of primary ventral hernias. Materials and Methods We undertook a comparative observational study of 40 adult patients with primary umbilical and paraumbilical hernias, 20 patients were repaired using IPOM-Plus and 20 using PeTEP. There were no significant differences in demographics and clinical features. Primary outcomes were pain (Visual Analogue Scale [VAS]), time to normal activity, length of hospital stay and functional recovery of the abdominal wall. Secondary outcomes were operative time, seroma, hematoma, ileus, mesh-related complications and recurrence. Data were analysed using SPSS V26.0 with a significance level of p < 0.05. Results PeTEP was superior to IPOM-Plus in terms of function. At 24 hours postoperatively, VAS pain scores were significantly lower in the PeTEP group (1.86 ± 0.51 vs 2.41 ± 0.66; p = 0.006). Hospital stay was shorter (1.50 ± 0.51 vs 2.25 ± 0.44 days; p < 0.001), and return to normal activity was significantly earlier (10.30 ± 2.34 vs 14.05 ± 3.22 days; p < 0.001). While PeTEP surgery had a longer operative time (157.95 ± 15.58 vs 90.05 ± 15.42 minutes; p < 0.001), there was no difference in complications and early recurrence. Conclusion PeTEP results in better short-term abdominal wall function than IPOM-Plus in primary ventral hernia repair. Despite a longer operative time, the anatomical retromuscular reconstruction provided by PeTEP is associated with decreased pain, better rehabilitation, shorter hospital stay and superior abdominal wall function. PeTEP may be the ideal minimally invasive technique when postoperative function and quality of life are surgical objectives.