Abstract
Introduction: In the recent times, minimal access surgery for ventral hernias is becoming popular. However several issues like postoperative pain, recurrence, seroma formation arising due to the procedure are yet to be resolved. To find a solution to the above mentioned issues, closing the defect in the fascia laparoscopically along with reinforcement by mesh has been tried. About The Study: It was a prospective randomized study done at KEMPEGOWDA INSTITUTE OF MEDICAL SCIENCES BENGALURU from October 2018 to March 2020. Aims and Objectives: To compare between intra peritoneal onlay mesh repair (IPOM) V/S intra peritoneal onlay mesh repair with closure of fascial defect (IPOM PLUS) for ventral abdominal wall hernias. To study: 1) Postoperative bulge (pseudo hernia). 2) Seroma formation. 3) Pain in the postoperative period. 4) Recurrence. 5) Early return to normal activity especially forward bending. Materials and Methods: The study was conducted on 40 patients. All of them underwent surgery on an elective basis...A pneumoperitoneum of 12-15mmhg was built up by inflating through veress needle at the palmer’s point. A camera port and two working ports were inserted .The sac of the hernia was excised after cutting the adhesions. The defect was closed from within with self sustaining continuous /interrupted non absorbable sutures. A composite mesh was oriented with transfascial sutures. Additional tackers applied if required. Patients are divided into two groups of 20 each namely the closure and the non closure groups respectively. Each patient was assessed for pain, seroma, forward bending and pseudo bulge on postop day 1,3 and day of discharge. Patient is called for follow up after, 1 month and 6 months. Conclusion: Patients who underwent IPOM PLUS had a decreased incidence of seroma formation, recurrence, postoperative bulge and a early return to normal activity when compared to those who underwent IPOM.
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