BACKGROUND

As the Laparoscopic Intraperitoneal Implant (LapIPOM) technique is currently being challenged by new minimally invasive extraperitoneal ventral hernia repair techniques, it seems worthwhile to follow up on the previous publication with a detailed analysis of the long-term results of LapIPOM, which we hope will provide a more sober look at the “power balance” in modern herniology.

PURPOSE OF THE STUDY

Detailed analysis of long-term results of LapIPOM.

MATERIAL AND METHODS

247 patients were followed up, 28.3% of them were men, mean age 56 years. 253 IPOM laparoscopic hernioplasties were performed: for postoperative median ventral hernias — 80 operations were performed in 78 patients (of which 15 were for relapses); primary median hernias were in 169 patients, they underwent 173 operations. The results were followed up for 22—91 months (mean follow-up period 42.4±36.7 months). Telephone surveys were conducted at intervals of 1 year. At the same time, postoperative pain was assessed on a ten-rank analog scale and quality of life. In doubtful cases, patients were invited for face-to-face examination and ultrasound examination.

RESULTS

After 6 months, the index of chronic pain was 3.70%, and by 3 years it had decreased to 0.80%. The recurrence rate after 3 years was 11.63% for postoperative hernias, 1.22% for primary ones (average 4.80%), with a frequency of newly formed trocar hernias of 0.79. The incidence of seromas 3 months after surgery was also low — 4.68%. Not a single negative clinical episode associated with the contact of the implant and the intestine was recorded. Protrusions, “pseudo-relapses” became a problem in the long-term period, which 30% of the interviewed patients complained about a year after the operation.

CONCLUSION

Until the publication of large evidence-based datasets comparing the immediate and long-term results of LapIPOM and endoscopic interstitial techniques, the first technique should remain the basis for the treatment of ventral hernias within the indications.