DefinePK

Abstract

Background: Ventral hernia, a common surgical condition, can significantly impair quality of life. Laparoscopic Intraperitoneal Onlay Mesh (IPOM) hernioplasty has become a preferred technique due to reduced postoperative pain, lower wound infection rates, and faster recovery. However, concerns such as seroma formation and recurrence limit its efficacy. A modified technique, IPOM-Plus, which includes fascial defect closure before mesh placement, has shown promise in addressing these limitations, but comparative evidence remains limited.
Methods: This prospective comparative study was conducted at Chettinad Hospital and Research Institute over two years. A total of 22 patients aged 30–70 years with midline ventral hernias were randomized into two groups. Group 1 underwent IPOM-Plus with fascial defect closure, while Group 2 underwent traditional IPOM without defect closure. Outcomes were assessed through clinical evaluations, ultrasonography, and patient-reported satisfaction. Statistical analysis included t-tests, chi-square tests, Kaplan-Meier survival analysis, and p-values <0.05 were considered significant.
Results: Seroma formation was significantly lower in the IPOM-Plus group (9%) compared to the IPOM group (45%, p = 0.03). No recurrences were observed in the IPOM-Plus group, while 27% of patients in the IPOM group experienced recurrences (p = 0.02). Kaplan-Meier analysis confirmed superior recurrence-free survival in IPOM-Plus (log-rank test, p = 0.01). Operative time was slightly longer for IPOM-Plus (94 ± 12 vs. 84 ± 10 minutes, p = 0.04), but hospital stay was comparable (p = 0.52). Patient satisfaction was higher in IPOM-Plus (82% vs. 55%, p = 0.08).
Conclusion: IPOM-Plus demonstrates superior outcomes, including lower recurrence and seroma rates, compared to traditional IPOM, with comparable recovery times. These findings support the routine use of IPOM-Plus in selected patients to improve ventral hernia repair outcomes