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Endoscopic Preperitoneal Mesh Repair (ePPM) for Concurrent Ventral Abdominal Wall and Groin Hernia: Initial Series
George Pei Cheung Yang1, Karen Lok Man Tung2, Davide Lomanto3,4
1Hong Kong Adventist Hospital, Hong Kong, China.
Background:
We report the long-term results of a novel technique, the totally endoscopic preperitoneal mesh (ePPM) repair, mesh placement between the posterior fascia and peritoneum (PP plane), combined with totally extraperitoneal (TEP) for patients with concurrent ventral abdominal wall and groin hernia.
Introduction:
Laparoscopic ventral abdominal wall hernia repair is one of the most dynamic areas in modern hernia surgery. In 2015, we introduced preperitoneal onlay mesh repair (PPOM), positioning the mesh in the PP plane. The ePPM represents the totally endoscopic counterpart of PPOM. Through a suprapubic approach after TEP groin hernia repair, the plane between the posterior fascia and the peritoneum is opened to repair the ventral hernia. This study presents the first case series with long-term follow-up of up to 38 months.
Method And Results:
This is a prospective cohort study from December 2022 to May 2025. In total, 19 patients received TEP and ePPM repair for their groin and ventral hernia. All patients were discharged the next day. The median follow-up was 31 months (15-38 months). There were no readmissions and no recurrence.
Conclusion:
The ePPM combined with TEP repair is feasible for concurrent ventral and groin hernias. Larger studies are needed to evaluate its full potential.
