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Corresponding Author

Ayman Helmy Ibrahim

Document Type

Original Article

Abstract

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.

Keywords

Incisional hernia; Recurrent hernia; Laparoscopic hernia repair; IPOM

Subject Area

General Surgery

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