Premium
Is fascial defect closure with intraperitoneal onlay mesh superior to standard intraperitoneal onlay mesh for laparoscopic repair of large incisional hernia?
Author(s) -
Suwa Katsuhito,
Okamoto Tomoyoshi,
Yanaga Katsuhiko
Publication year - 2018
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12471
Subject(s) - medicine , surgery , closure (psychology) , incisional hernia , surgical mesh , hernia , hernia repair , economics , market economy
The ideal surgical technique for large incisional hernia repair has not yet been identified. The aim of this study was to evaluate surgical outcomes of standard intraperitoneal onlay mesh (sIPOM) versus fascial defect closure with intraperitoneal onlay mesh (IPOM‐Plus) for large incisional hernia repair. Methods Of 49 patients who underwent laparoscopic incisional hernia repair between November 2005 and December 2016, 26 cases with large incisional hernia (transverse diameter ≥10 cm) were examined to compare surgical outcomes between sIPOM ( n = 12) and IPOM‐Plus ( n = 14). Statistical analysis was performed using the Mann–Whitney U ‐test and Fisher's exact test. P < 0.05 was considered to be statistically significant. Results We compared sIPOM with IPOM‐Plus for similar hernia types during median follow‐up periods of 53 and 21 months, respectively. The operation time was 150 min for sIPOM and 148 min for IPOM‐Plus ( P = 0.6220). Early postoperative complications including seroma formation were observed in four sIPOM patients (33%) and three IPOM‐Plus patients (21%) ( P = 0.6652). Significantly more mesh bulged with sIPOM than with IPOM‐Plus (50% vs 0%; P = 0.0082). Chronic pain lasting 3 months after the operation was found in two cases of IPOM‐Plus (14%), but this was not statistically significant. Postoperative hospital stay was longer for sIPOM patients than for IPOM‐Plus patients. Only one recurrence was observed in the sIPOM group (8%), but this was not statistically significant. Conclusion For large incisional hernia repair, IPOM‐Plus seems to be more effective than sIPOM in terms of reducing mesh bulging.