Hybrid IPOM: A Novel Technique for the Management of Incisional Hernia ()
ABSTRACT
Background and Aim: The
incidence of incisional hernias has been reported to be around 15%. In the
present scenario, a wide array of surgical procedures are available for their
better management. In this study, we intend to share our experience with one novel
technique, “Hybrid IPOM (Intraperitoneal onlay meshplasty)” as a management
option for a selected cohort of patients. Methods: This prospective
study was undertaken during January 2019 to July 2023 at King Abdullah medical
city, Makkah. A total of 51 cases were selected for Hybrid IPOM repair as per
inclusion criteria; medium sized (4 - 10 cm) hernia defects; uncomplicated hernias; age more than 18 years.
The follow-up period of the patients varied from 6 months to 4 years. The
operation commenced with open hernia dissection, mesh deployment into abdomen,
defect closure and then conversion to laparoscopy for the posterior mesh
placement. Results: A total of 51 cases were
repaired successfully with this technique. 48 out of 51 cases were incisional
hernias secondary to some primary procedure done either for hernias itself or
some other intra-abdominal pathology. The three cases were primary hernias
falling in medium to large category with unaesthetic overlying skin. The age
range was 19 to 72 years. The mean (range) operative time was 135 (90 - 240) min, and the average blood loss was 70 ml. The mean (range)
hospital stay was 3 (2 - 11) days. All patients
returned to routine work within 2 - 3 weeks of surgery. The median follow-up
was 15 (6 - 48) months. Of the
51 cases, 3 patients developed seroma (managed conservatively), 1 patient
developed a large hematoma (needed evacuation), and 1 patient developed
superficial wound infection (managed with antibiotics). Two patients had
recurrences; one patient had previously failed multiple repairs, and the other
developed a postoperative hematoma. None of our patients had an iatrogenic
bowel injury. Conclusion: Hybrid IPOM technique is a safe, feasible and easily
reproducible technique. It may prove easier especially for beginners in
laparoscopy, as it achieves faster and easy adhesiolysis thereby reducing
operative time and easier establishment of the pneumoperitoneum. Besides, it
gives the chance to excise ugly scars and improve the cosmesis.
Share and Cite:
Yamin, S. , Ahangar, S. , Albadawi, F. , Alqarni, A. and Alzahrani, A. (2024) Hybrid IPOM: A Novel Technique for the Management of Incisional Hernia.
Surgical Science,
15, 125-134. doi:
10.4236/ss.2024.153014.
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