Background: Ventral hernia repair has changed over the past years by the introduction of laparoscopy and prosthetic materials. The laparoscopic approach is now broadly done because it offers its advantages for the patients. The broad acceptance of laparoscopic surgery has afforded an alternative to open repair of incisional hernia.
Objective: To compare the intraperitoneal onlay mesh (IPOM) repair vs the transabdominal retromuscular (TARM) repair as regards the periprocedural data.
Patients and methods: This prospective study was conducted on 60 patients with a ventral hernia in the period from May 2018 to August 2019. All eligible fit cases, who were 18-year-old and on with non-complicated ventral hernia (the size defect, ≤60 mm), were included. They were simply randomized between the two techniques to compare operative time, intraoperative complications, postoperative pain, postoperative hospital stay, postoperative complications, and cosmetic results.
Results: The IPOM repair (1st group) was done in 24 patients, while TARM repair was completed in 36 patients. The operative time of group I was significantly shorter than that of group II. The repair in group I was cheaper than that in the other one. There was no significant injury to viscera or vessel and no recurrence in either group. The hospital stay was shorter for both groups (28.0 ± 9.2 vs 26.0 ± 6.93 hours; p = 0.527) as well as return to normal daily activity. More wound infection occurred in group II (16.7%) than in the other group (8.3%) (p = 0.511). No important difference statistically was observed between the two groups regarding postoperative pain (p = 0.885).
Conclusion: Laparoscopic hernia repair by either of both techniques has less postoperative pain, shorter hospital stays, faster return to normal daily activity, a lower rate of postoperative complications as regard wound infection, and ileus. The TARM repair technique is more time-consuming than the other technique, but early results indicate that it can be performed as a cheaper alternative to the other one.
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