Related Experiment Video
Updated: Apr 1, 2026
Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
A Systematic Review and Meta-Analysis of Randomized Controlled Trials on Fascial Defect Closure Versus Bridged Repair
Moadh Hwessa1, Wajeeh Ullah Mahmood1, Omar Lubbad1
1Brighton and Sussex Medical School, Brighton, UK.
Introduction:
This study compares the outcomes in patients undergoing ventral hernia repair using intraperitoneal underlay mesh (IPUM) without facial defect closure versus intraperitoneal underlay mesh following fascial defect closure (IPUM+).
Methods:
To search for randomized controlled trials comparing outcomes of patients with ventral hernias who were managed surgically with either IPUM or IPUM+, standard medical databases such as MEDLINE, Embase, PubMed, and Cochrane Library were used, covering studies published up to and including September 2025. The meta-analysis was performed with a random effect model analysis, and all data was analyzed using Review Manager Software 5.4.
Results:
Five randomized controlled trials (n = 549) were included, involving adult patients who underwent laparoscopic ventral hernia repair with IPUM or IPUM+. The pooled analysis showed no significant difference in hernia recurrence (Risk Ratio [RR]: 0.82, 95% CI: [0.29, 2.27], p = 0.70), seroma formation (RR: 0.78, 95% CI: [0.32, 1.88], p = 0.58), operating times (Standard Mean Difference [SMD]: 0.26, 95% CI [-0.17, 0.69], p = 0.23) and pain scores (SMD: 0.26, 95% CI [-0.17, 0.69], p = 0.23) between the two approaches.
Conclusion:
IPUM and IPUM+ are both associated with similar postoperative morbidities for the treatment of ventral hernia repair.
