Is there a place for intraperitoneal onlay mesh repair ( IPOM) of inguinal hernia among laparoscopic techniques?

ABSTRACT Background Aims: The Authors report their experience on laparoscopie hernioplasty using thè intraperitoneal onlay mesh repair in 56 patients. Methodology: Thirty patients had a monolateral hernia, 9 of which were recurrent and 26 had a Dilaterai hernia, 6 of which were recurrent. Overall, a total of 90 hernias were treated. The hernia repair was performed by using "GORETEX® Dual Mesh Plus biomuterial with holes" in thè first 32 cases and thè latest "Corduroy" type in thè following 24 cases. The prostheses were fixed with titanium spirai tacks (Protack®, Auto Suture, Tyco Healthcare). Results: No intraoperative complications occurred and no conversion was necessary. Five minor postoperative complications (5.5%), 2 seromas and 3 transient paresthesias, were observed. Four patients (7.1%) needed analgesica after thè first 24 hours. Mean hospital stay was 36 hours with a minimum of 24 and a maximum of 48. Mean resumption of norma! activity was 8 days with return to work within two weeks. At an average 18 months follow-up, 3 recurrences were recorded (3.3%). Conclusions: The results of this study as well as thè meta-analysis of thè series presented in thè literature, indicate that thè intraperitoneal onlay mesh repair may be a feasible, safe and effective procedure in thè treatment of recurrent and bilateral hernias or when a hernia repair is performed during other laparoscopie procedures. The intraperitoneal onlay mesh repair has in fact been shown to be faster and easier than thc othcr more commonly pertòrmed laparoscopie hemioplasties (trans-abdominal preperitoneal repair and total extra-peri toneal repair). These data may also suggest utilizing this technique in particular cases of primitive hernia sucri as very active young males or heavy-duty workers. However thè limited series and thè short follow-up ask for randomized prospective long-term studies to defìnitely ascertain thè true incidence of recurrence and therefore thè eftectiveness of this attractive procedure.

Abstract BACKGROUND/AIMS: The Authors report their experience on laparoscopic hernioplasty using the intraperitoneal onlay mesh repair in 56 patients. METHODOLOGY: Thirty patients had a monolateral hernia, 9 of which were recurrent and 26 had a bilateral hernia, 6 of which were recurrent. Overall, a total of 90 hernias were treated. The hernia repair was performed by using "GORETEX Dual Mesh Plus biomaterial with holes" in the first 32 cases and the latest "Corduroy" type in the following 24 cases. The prostheses were fixed with titanium spiral tacks (Protack, Auto Suture, Tyco Healthcare). RESULTS: No intraoperative complications occurred and no conversion was necessary. Five minor postoperative complications (5.5%), 2 seromas and 3 transient paresthesias, were observed. Four patients (7.1%) needed analgesics after the first 24 hours. Mean hospital stay was 36 hours with a minimum of 24 and a maximum of 48. Mean resumption of normal activity was 8 days with return to work within two weeks. At an average 18 months follow-up, 3 recurrences were recorded (3.3%). CONCLUSIONS: The results of this study as well as the meta-analysis of the series presented in the literature, indicate that the intraperitoneal onlay mesh repair may be a feasible, safe and effective procedure in the treatment of recurrent and bilateral hernias or when a hernia repair is performed during other laparoscopic procedures. The intraperitoneal onlay mesh repair has in fact been shown to be faster and easier than the other more commonly performed laparoscopic hernioplasties (trans-abdominal preperitoneal repair and total extra-peritoneal repair). These data may also suggest utilizing this technique in particular cases of primitive hernia such as very active young males or heavy-duty workers. However the limited series and the short follow-up ask for randomized prospective long-term studies to definitely ascertain the true incidence of recurrence and therefore the effectiveness of this attractive procedure.