Background Intraperitoneal Onlay Mesh (IPOM) and IPOM plus are well-established techniques for the repair ventral hernias. IPOM plus could reduce recurrence but evidence regarding the post-operative Quality of Life (QoL) is still missing. This retrospective observational study aims to evaluate the difference in terms of recurrence rate, complication rate and postoperative QoL outcomes in patients who underwent IPOM or IPOM plus repair. Materials and Methods 110 patients who underwent laparoscopic ventral hernia repair from 2011 to 2023 have been included in this analysis. All procedures were conducted following the standard IPOM procedure using polypropylene composite meshes (1) fixated with resorbable takers. In cases where IPOM Plus was performed, the defect was closed using transparietal sutures. Baseline characteristics and data for all patients were gathered from hospital medical records. QoL was evaluated using the EuraHS-QoL questionnaire. The primary endpoints of the study were the recurrence rate and the post-operative QoL in two subgroups: IPOM (na = 37) and IPOM Plus (nb = 80) Results The two groups didn’t show significant differences in baseline and hernia characteristics. With a comparable follow-up time, recurrence was significantly higher in the IPOM group (na = 10,8% vs. nb = 0% p <0.001) without any difference regarding the complications rate. Both techniques show comparable improvements in the post-operative QoL. Conclusion Our clinical experience showed that both IPOM or IPOM plus techniques utilizing polypropylene composite meshes are safe and effective approaches for the treatment of primary and incisional hernias. We recommend prioritizing IPOM Plus over IPOM alone due to the lower recurrence rate and comparable QoL outcomes. (ClearMesh-Composite, Dipromed srl)
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Pepe et al. (2024) studied this question.
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