OC-017 INTRAPERITONEAL ONLAY MESH (IPOM) TECHNIQUE FOR THE LAPAROSCOPIC TREATMENT OF PRIMARY AND INCISIONAL VENTRAL HERNIA IN DAY SURGERY REGIME. (13th October 2022)

• Record Type: Journal Article
• Authors: Bellino, R; Giaccone, M; Bertot, L; Rosati, S; Balestra, G; Sandrucci, S
• Is Part Of: British journal of surgery. Volume 109(2022)Supplement 7
• Publication Date: 2022-10-13
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znac308.029
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: IPOM technique is a well-established technique for the repair of primary and incisional ventral hernia; and outpatient regime is considered a cost-effective strategy without compromising the quality of care. In this retrospective observational study, we evaluated the application of IPOM technique through outpatient setting, with the use of a non-absorbable, transparent, light prostheses in polypropylene, composed of a macroporous monofilament mesh and a transparent polypropylene film. 179 consecutive procedures of primary and incisional hernia repair from 2011 to 2022 have been included in this study (149 with the above-mentioned composite meshes and 30 with other meshes, semi-absorbable and non-absorbable). All the procedures were performed through 3 abdominal trocars executing cold adhesiolysis to release the contents of the hernial sac without dissecting the latter. The abdominal wall was then prepared by blunt dissection to create the space for the mesh and to favor a prompt cell colonization. Mesh fixation was achieved using transparietal points and resorbable tackers. The primary outcomes of the study were the evaluation of any risk factors for conversion from outpatient regime to standard hospitalisation, and the hernia recurrence, in two subgroups: primitive hernias (n=72) and incisional hernias (n=107). Our clinical experience showed that IPOM technique through outpatient setting is a safe and effective approach. No statistically significant difference in the recurrence rate between the primitive and incisional hernias groups (5.9% vs 5.0%, p=0.80) was found. Moreover, we found a relationship between the rate of unexpected hospitalization and age of the patients, number of defects and hernia dimension.