Intraperitoneal onlay mesh – an analysis of the patient‘s cohort

Abstract

Introduction: Incisional hernias represent one of the most complex and widely discussed issues of abdominal wall surgery. 10–20% of the cases occur following abdominal surgery. The aim of this study is to describe our surgical experience and determine whether the intraperitoneal onlay mesh (IPOM) procedure is suitable for hernia surgery with minimal postoperative complications.
Method: The paper focuses on patients operated on by the IPOM technique between 2015 and 2016. The group involved 53 patients with median or paramedian defects after acute or elective abdominal surgery. In patients with comorbidities, thorough preoperative examination was completed including abdominal ultrasound, colonoscopy and spirometry. In the postoperative period, we evaluated pain using the visual analogue scale, wound healing, relapses and patient´s satisfaction with functional as well as aesthetic outcomes of the surgery.
Results: Our group comprised 53 patients operated on using the IPOM technique. They were 48−79 years old with a body mass index exceeding 30 kg/m2. 18 patients had a paramedian hernia and 35 patients median hernia. 4 patients suffered a perioperative iatrogenic injury of the intestine, 8 cases developed postoperative paralytic ileus. Wound infection or infection of the mesh was not recorded. 2 patients with hernia recurrence were followed up for one year.
Conclusions: Incisional hernias represent an important surgical issue. Management is often complex. IPOM as the treatment of choice for patients with incisional hernias appears to be beneficial. However, it requires careful patient selection, patient preparation for surgery and their compliance, the surgeon’s extensive experience as well as excellent postoperative care with limited postoperative pain. The success rate of this method is high in carefully selected patients.