Publication:

Comparison of outcomes between onlay and intraperitoneal onlay mesh plus ventral hernia repair: a prospective study

Introduction Ventral hernias are common surgical conditions requiring either open (Onlay) or laparoscopic (Intraperitoneal Onlay Mesh (IPOM) Plus) repair. This study compares their outcomes to guide clinical decision-making.

Methods A prospective study was conducted at Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur and Jeevanshree Hospital, Maharashtra, randomized 94 patients with ventral hernias (defect size 3-7 cm, age 18-60 years) into Onlay (n=47) or IPOM Plus (n=47) groups. Outcomes included operative time, hospital stay, surgical site infection (SSI), hematoma, seroma, pain (Visual Analog Scale (VAS)), return to activities/work, and recurrence. Data were analyzed using T-tests and chi-square tests (p<0.05).

Results IPOM plus resulted in longer operative times (94.19±12.34 vs. 53.85±10.56 min, p<0.001), but shorter hospital stays (2.09±0.87 vs. 4.18±1.23 days, p<0.001) and faster return to daily activities (8.34±2.01 vs. 11.40±2.56 days, p<0.001) and work (14.72±3.12 vs. 18.36±3.89 days, p=0.030). The IPOM Plus group had lower rates of hematoma (0% vs. 25.5%, p<0.001), seroma (10.6% vs. 34%, p=0.006), and SSI (4.3% vs. 27.7%, p=0.002). Acute postoperative pain was lower in IPOM plus, while chronic pain and recurrence rates were comparable.

Conclusions IPOM plus offers reduced complications and faster recovery, despite longer operative times, making it preferable for suitable patients. Recurrence rates are comparable.