Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec;26(6):1521-1530.
doi: 10.1007/s10029-022-02586-x. Epub 2022 Mar 23.

A propensity-score matched analysis of ventral-TAPP vs. laparoscopic IPOM for small and mid-sized ventral hernias. Comparison of perioperative data, surgical outcome and cost-effectiveness

I-F Megas  1 , C Benzing  1 , A Winter  1 , J Raakow  1 , S Chopra  1 , J Pratschke  1 , P Fikatas  2
Affiliations

A propensity-score matched analysis of ventral-TAPP vs. laparoscopic IPOM for small and mid-sized ventral hernias. Comparison of perioperative data, surgical outcome and cost-effectiveness

I-F Megas et al. Hernia. 2022 Dec.

Abstract

Purpose: Laparoscopic techniques have been used and refined in hernia surgery for several years. The aim of this study was to compare an established method such as laparoscopic intra-peritoneal onlay mesh repair (lap. IPOM) with ventral Transabdominal Preperitoneal Patch Plasty (ventral-TAPP) in abdominal wall hernia repair.

Methods: Patient-related data of 180 laparoscopic ventral hernia repairs between June 2014 and August 2020 were extracted from our prospectively maintained database. Of these patients, 34 underwent ventral-TAPP and 146 lap. IPOM. After excluding hernias with a defect size > 5 cm and obtaining balanced groups with propensity-score matching, a comparative analysis was performed in terms perioperative data, surgical outcomes and cost-effectiveness.

Results: Propensity-score matching suggested 27 patients in each of the two cohorts. The statistical evaluation showed that intake of opiates was significantly higher in the lap. IPOM group compared to ventral-TAPP patients (p = 0.001). The Visual Analogue Scale (VAS) score after lap. IPOM repair was significantly higher at movement (p = 0.008) and at rest (p = 0.023). Also, maximum subjective pain during hospital stay was significantly higher in the lap. IPOM group compared to ventral-TAPP patients (p = 0.004). No hernia recurrence was detected in either group. The material costs of ventral-TAPP procedure (34.37 ± 0.47 €) were significantly lower than those of the lap. IPOM group (742.57 ± 128.44 € p = 0.001). The mean operation time was 65.19 ± 26.43 min in the lap. IPOM group and 58.65 ± 18.43 min in the ventral-TAPP cohort. Additionally, the length of hospital stay in the lap. IPOM cohort was significantly longer (p = 0.043).

Conclusion: Ventral-TAPP procedures represent an alternative technique to lap. IPOM repair to reduce the risk of complications related to intra-peritoneal position of mesh and fixating devices. In addition, our study showed that postoperative pain level, material costs and hospital stay of the ventral-TAPP cohort are significantly lower compared to lap. IPOM patients.

Keywords: IPOM; Laparoscopic ventral hernia repair; Preperitoneal; Propensity-score matching; Ventral-TAPP.

PubMed Disclaimer

Conflict of interest statement

Fikatas P is inventor of patent WO2016/005118 A1. All other authors declare no conflict of interest nor any competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of patient selection
Fig. 2
Fig. 2
a Paramedian incision of the peritoneum, b release of hernia sac, c closure of the hernia defect with the slipknot, d mesh placement, e closure of the peritoneum, f final complete coverage of the mesh
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Sauerland S, Walgenbach M, Habermalz B, Seiler CM, Miserez M (2011) Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst Rev [Internet] (3). https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007781.pub2/.... Accessed 28 Sep 2020 - DOI - PubMed
    1. Köckerling F, Simon T, Adolf D, Köckerling D, Mayer F, Reinpold W, Weyhe D, Bittner R. Laparoscopic IPOM versus open sublay technique for elective incisional hernia repair: a registry-based, propensity score-matched comparison of 9907 patients. Surg Endosc. 2019;33(10):3361–3369. doi: 10.1007/s00464-018-06629-2. - DOI - PMC - PubMed
    1. Van Hoef S, Tollens T. Primary non-complicated midline ventral hernia: is laparoscopic IPOM still a reasonable approach? Hernia J Hernias Abdom Wall Surg. 2019;23(5):915–925. doi: 10.1007/s10029-019-02031-6. - DOI - PubMed
    1. Sajid MS, Bokhari SA, Mallick AS, Cheek E, Baig MK. Laparoscopic versus open repair of incisional/ventral hernia: a meta-analysis. Am J Surg. 2009;197(1):64–72. doi: 10.1016/j.amjsurg.2007.12.051. - DOI - PubMed
    1. Natarajan S, Meenaa S, Thimmaiah KA. A randomised prospective study to evaluate preperitoneal mesh repair versus onlay mesh repair and laparoscopic IPOM in incisional hernia surgery. Indian J Surg. 2017;79(2):96–100. doi: 10.1007/s12262-015-1430-5. - DOI - PMC - PubMed

Publication types