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Laparoscopic intraperitoneal onlay inguinal herniorrhaphy
D Kingsley1, D M Vogt, M T Nelson
1Department of Surgery, University of New Mexico School of Medicine, and Albuquerque Veterans Affairs Medical Center, 87131, USA.
American Journal of Surgery
|February 2, 1999
Summary
The intraperitoneal onlay mesh (IPOM) technique for inguinal hernia repair showed excessively high recurrence rates (43%) at intermediate follow-up. Conventional anterior inguinal herniorrhaphy (CH) demonstrated significantly lower recurrence rates, suggesting IPOM is not suitable for inguinal hernia repair.
Area of Science:
- General Surgery
- Surgical Innovation
- Hernia Repair
Background:
- A randomized prospective study compared modified laparoscopic intraperitoneal onlay mesh (IPOM) herniorrhaphy with conventional anterior inguinal herniorrhaphy (CH).
- The study included patients with primary or recurrent inguinal hernias from two university-affiliated hospitals.
Purpose of the Study:
- To evaluate intermediate follow-up outcomes of IPOM versus CH for inguinal hernia repair.
- To assess recurrence rates and complications associated with both surgical techniques.
Main Methods:
- Patients were randomized to either the IPOM technique using a soft tissue patch or CH.
- Follow-up data were collected through clinic visits, telephone surveys, and mail surveys.
Main Results:
- At a mean follow-up of 41 months, IPOM showed a recurrence rate of 43% (10/23) compared to 15% (4/27) for CH (P=0.053).
- IPOM had delayed complications including port site hernias and neuromas; CH had delayed testicular atrophy.
- Contralateral hernias developed in 1 IPOM patient versus 5 CH patients.
Conclusions:
- Intermediate follow-up reveals excessively high recurrence rates for IPOM in inguinal hernia repair.
- Conventional anterior inguinal herniorrhaphy (CH) demonstrates superior long-term outcomes regarding recurrence.
- The IPOM technique is not recommended for inguinal hernia repair based on these findings.