Long-term outcomes of IPOM plus and eTEP Rives-Stoppa techniques for midline incisional ventral hernias

Area of Science:

• Abdominal Wall Reconstruction Surgery
• Minimally Invasive Surgery
• Hernia Repair Techniques

Background:

• Incisional ventral hernia repair is a complex surgical challenge.
• The extended-view totally extraperitoneal (eTEP) approach has advanced hernia repair concepts.
• Long-term outcomes of the eTEP Rives-Stoppa (eTEP RS) technique require further investigation.

Purpose of the Study:

• To compare the long-term outcomes of IPOM plus and eTEP RS for midline incisional ventral hernias.
• To evaluate hernia recurrence rates using CT scans.
• To assess patient quality of life (QoL) post-surgery.

Main Methods:

• A retrospective cohort study of 117 patients undergoing IPOM plus (n=42) or eTEP RS (n=75).
• Long-term outcomes assessed via physical examination and CT scans (rest and Valsalva) with >1.5-year follow-up.
• QoL measured using Carolinas Comfort Scale (CCS) and EuraHS-QoL score.

Main Results:

• eTEP RS demonstrated a significantly lower hernia recurrence rate (2% vs. 19.3%, p=0.012).
• Normal postoperative CT scans were more frequent with eTEP RS (89.8% vs. 58.1%, p=0.0009).
• eTEP RS group showed significantly better CCS and EuraHS-QoL scores (p<0.05).

Conclusions:

• eTEP RS offers reduced hernia recurrence and improved QoL compared to IPOM plus for midline incisional ventral hernias without component separation.
• Bulging is a significant adverse event, impacting QoL similarly to recurrence.
• Further prospective trials are needed to establish optimal minimally invasive techniques.