Intraperitoneal mesh open repair without dissection technique for large ventral hernia repair: an alternative to component separation technique

Abstract

Background: Incisional hernias (IH) are one of the major complications following abdominal surgery and the treatment of large abdominal hernias represents a challenge for the surgeon. We present our own modified open intraperitoneal mesh technique, named "IPOW technique" (intra-peritoneal mesh open repair without dissections).

Methods: We analyzed early postoperative complications (seroma, wound infection, hematoma) and the late ones (recurrence, chronic pain), in 50 unselected patients treated for IH and primary hernia (PH) larger than 5 cm using the proposed laparotomic technique.

Results: From January 2019 to September 2021, 50 unselected patients with, at least, one year of follow-up, with hernias ranging from 5 to 25 cm in width, were surgically repaired using IPOW technique. Mean Body Mass Index (BMI) was 29 (range 22-44). In our series, we report 2 (4%) complications and, after a mean follow-up of 847 days (range 481-1357), 2 (4%) recurrences. No patients reported chronic pain.

Conclusions: In our experience, we consider IPOW technique easily reproducible, ensuring excellent results with a reduction of invasiveness, comparing to other techniques. Anyway, definitive conclusions require a larger number of patients.