Extended Totally Extraperitoneal (eTEP) Technique vs. Laparoscopic Intraperitoneal Onlay Mesh (IPOM) in Ventral Hernia Repair: A Randomized Comparative Study

Repairing of ventral and incisional hernias is a frequently performed surgical intervention in the field of general surgery; this work aimed to compare the extended totally extraperitoneal (eTEP) technique to the intraperitoneal onlay mesh (IPOM) technique for ventral hernias regarding feasibility, cost, operative, and postoperative outcomes of both techniques. This randomized controlled study was conducted on 50 patients complaining of ventral hernia. These patients were admitted to Tanta University Hospitals, Egypt, from January 2021 to January 2023. Patients were divided according to the technique used into two2 equal groups: group eTEP (study group): 25 participants were submitted to eTEP repair. Group IPOM (control group): 25 patients were submitted to IPOM repair. Demographic data were insignificantly different between both groups. Operation time was significantly prolonged in group eTEP compared to group IPOM (P<0.001). Cost and hospital stay were significantly decreased in group eTEP compared with group IPOM (P<0.05). Pain at rest and restriction to normal activity were significantly lower on the first and 14th postoperative days in group eTEP compared with group IPOM (P<0.05). Cosmesis was insignificantly different on the first and 14th postoperative days between both groups. Postoperative seroma, postoperative recurrence, and postoperative ileus were insignificantly different between both groups. Both eTEP and IPOM demonstrated safety and efficacy in the treatment of de-novo ventral hernia repair (comparable few complications in both groups with no recurrence in this study) with superiority toward eTEP as evidenced by lower hospital stay, cost, postoperative pain, and early return to normal activity.