Optimizing Ventral Hernia Repair: Our Experience With Laparoscopic Intra-Peritoneal Onlay Mesh Plus

Abstract

Background:Ventral hernias, particularly umbilical and incisional types, are frequently encountered in surgical practice and often require operative intervention. Laparoscopic intra-peritoneal onlay mesh plus (IPOM plus) repair has evolved as an effective technique combining defect closure with mesh reinforcement. This study evaluates the clinical outcomes of IPOM plus repair in a cohort of patients treated at a tertiary care hospital in North India.

Methods:A retrospective analysis was conducted on 84 patients who underwent laparoscopic IPOM plus repair for ventral hernias at Chalmeda Anand Rao Institute of MedicalSciences, Karimnagar between June 2023 and May 2025. Patient demographics, hernia characteristics, operative details, postoperative complications, length of hospital stay, and recurrence rates were analyzed. Data were compiled from medical records and statistically evaluated using SPSS version 26.

Results:Of the 84 patients, 58 were female (69.0%) and 26 were male (31.0%), with a mean age of 48.6 ± 11.3 years. The most common hernia types were umbilical (41.7%) and incisional (35.7%). The mean hernia defect size was 4.2 ± 1.1 cm, and the mean operative time was 96.4 ± 18.7 minutes. All defects were closed prior to mesh placement. Postoperative complications included seroma in 7 patients (8.3%), surgical site infection in 3 patients (3.6%), and postoperative ileus in 2 patients (2.4%). No intraoperative bowel injury or major mesh-related complications were noted. The average hospital stay was 3.2 ± 1.4 days. During a mean follow-up period of 11.5 months, only 2 cases (2.4%) of hernia recurrence were observed.

Conclusion:Laparoscopic IPOM plus repair is a safe and effective approach for ventral hernia management, offering low complication and recurrence rates when performed with proper technique. It is particularly advantageous in reducing postoperative pain and minimizing the risk of mesh-related bulging. This technique should be considered a preferred option in elective ventral hernia repair in appropriately selected patients.