ABSTRACT 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.
Hwessa et al. (Mon,) studied this question.