Comparison of Laparoscopic Intraperitoneal Onlay Mesh Repair (IPOM plus) vs Open Rives-Stoppa (RS) Repair for Ventral and Incisional Hernia.

Abstract

Aim: To compare the effects of laparoscopic intraperitoneal onlay mesh plus repair versus open Rives-Stoppa repair for abdominal wall hernias.

Materials and methods: A total of 99 patients with midline primary, umbilical or incisional hernias who underwent surgery in "Medikom" clinic and Kyiv city hospital #5 in the period from 2016 to 2022 were involved in the study. The group I included 50 patients who underwent intraperitoneal onlay mesh (IPOM) plus, and the group II 49 patients who underwent open Rives-Stoppa (RS) repair.

Result: Both groups were comparable in mean age, gender, body mass index, patient distribution based on hernia type, defect size, ASA score distribution (p > 0.05).The operating time in minutes was 75.36 ± 4.99 in group I and 97.85 ± 6.5 in group II (p < 0.05). The blood loss in IPOM plus approach group is on average in 2 times less than in open RS technique (p < 0.05). The pain score 12 hours after surgery was 5.5 ± 0.64 in group I comparing to 7.26 ± 0.78 in group II (p < 0.05). The pain score 24 hours after surgery was 4.46 ± 0.7 in group I comparing to 4.95 ± 0.61 in group II (p < 0.05). The pain score 8 days after surgery in group I was on average in 1.46 times less than in group II (p < 0.05).No significant difference was found in incidence of early complications between two groups (p > 0.05).47 (94%) patients of group I and 46 (93.87%) patients of group II were evaluated over 22 months follow-up period. No one complication was noted.

Conclusions: IPOM plus approach for the ventral and incisional hernias repair is a viable and relatively more safe operation by comparing with open RS repair. IPOM plus approach takes significantly in 1.3 less time as compared open RS technique.