Laparoscopic (IPOM And IPOM Plus) Versus Open Para-Umbilical Hernia Mesh Repair

Abstract

Background: One of the most common surgical problems is Para-Umbilical Hernia (PUH). We compared the short-term results of open mesh repair versus laparoscopic mesh repair of PUH. Significant advantages offered to patients with laparoscopic mesh repair over open PUH repair. The clinical and economic results were compared as a cost–benefit analysis for both laparoscopic and open procedures.

Methods: Our study was conducted on 60 patients as a prospective randomized comparative study for PUH repair. We divided them into 3 groups, group A
(laparoscopic intraperitoneal on lay mesh repair plus closure of the defect (IPOM plus))  28 patients, group B (laparoscopic intraperitoneal on lay mesh repair (IPOM)) 14 patients and group C (open hernia repair) 18 patients from November 2021 to November 2022 in our surgical department in Theodor Bilharz Research Institute (TBRI) .

Results: In our study, the operating Time (min) was significantly higher in IPOM plus group A than open repair group C (115.63±2.47 vs 76.44±2.09; P<0.001). Wound complication rates were better in laparoscopic 14.2% than open hernia repair 22.3%. The median length of hospital stay was highly significantly shorter with laparoscopic surgery (1 vs 7 days; p = 0.001). Also, time off work is stastically better in the laparoscopic repair groups compared with open mesh repair group (p<0.01). Post-operative pain was highly stastically significant in the laparoscopic repair groups compared with open mesh repair group (p = 0.001). Recurrence rates were more in IPOM technique over comparable period of follow-up. The mean Cost of IPOM plus surgery was 2850.35±30.73 LE, while in IPOM was 2697.92 ± 80.13LE and in open mesh repair was 2584.22±44.38 LE (p=0.01).

Conclusions: IPOM plus is better than IPOM and open repair as it is more anatomical, closing the defect with sutures with insertion of mesh. With lower complication rate and provide more financial benefits^.