Open Intraperitoneal Onlay Mesh (IPOM) Technique for Incisional Hernia Repair
In an Expert Consensus Guided by Systematic Review the panel agreed that for open elective incisional hernia repair sublay mesh location is preferred, but open intraperitoneal onlay mesh (IPOM) may be useful in certain settings. Accordingly, the available literature on the open IPOM technique was se...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2018-10-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fsurg.2018.00066/full |
| _version_ | 1819239810717450240 |
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| author | Ferdinand Köckerling Bernhard Lammers |
| author_facet | Ferdinand Köckerling Bernhard Lammers |
| author_sort | Ferdinand Köckerling |
| collection | DOAJ |
| description | In an Expert Consensus Guided by Systematic Review the panel agreed that for open elective incisional hernia repair sublay mesh location is preferred, but open intraperitoneal onlay mesh (IPOM) may be useful in certain settings. Accordingly, the available literature on the open IPOM technique was searched and evaluated.Material and Methods: A systematic search of the available literature was performed in July 2018 using Medline, PubMed, and the Cochrane Library. Forty-five publications were identified as relevant for the key question.Results: Compared to laparoscopic IPOM, the open IPOM technique was associated with significantly higher postoperative complication rates and recurrence rates. For the open IPOM with a bridging situation the postoperative complication rate ranges between 3.3 and 72.0% with a mean value of 20.4% demonstrating high variance, as did the recurrence rate of between 0 and 61.0% with a mean value of 12.6%. Only on evaluation of the upward-deviating maximum values and registry data is a trend toward better outcomes for the sublay technique demonstrated. Through the use of a wide mesh overlap, avoidance of dissection in the abdominal wall and defect closure it appears possible to achieve better outcomes for the open IPOM technique.Conclusion: Compared to the laparoscopic technique, open IPOM is associated with significantly poorer outcomes. For the sublay technique the outcomes are quite similar and only tendentially worse. Further studies using an optimized open IPOM technique are urgently needed. |
| first_indexed | 2024-12-23T13:58:02Z |
| format | Article |
| id | doaj.art-9ac354467f1f4c9190c839f10b4808df |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-12-23T13:58:02Z |
| publishDate | 2018-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-9ac354467f1f4c9190c839f10b4808df2022-12-21T17:44:24ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2018-10-01510.3389/fsurg.2018.00066421194Open Intraperitoneal Onlay Mesh (IPOM) Technique for Incisional Hernia RepairFerdinand Köckerling0Bernhard Lammers1Department of Surgery and Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Berlin, GermanyDepartment of Surgery I – Section Coloproctologie and Hernia Surgery, Lukas Hospital, Neuss, GermanyIn an Expert Consensus Guided by Systematic Review the panel agreed that for open elective incisional hernia repair sublay mesh location is preferred, but open intraperitoneal onlay mesh (IPOM) may be useful in certain settings. Accordingly, the available literature on the open IPOM technique was searched and evaluated.Material and Methods: A systematic search of the available literature was performed in July 2018 using Medline, PubMed, and the Cochrane Library. Forty-five publications were identified as relevant for the key question.Results: Compared to laparoscopic IPOM, the open IPOM technique was associated with significantly higher postoperative complication rates and recurrence rates. For the open IPOM with a bridging situation the postoperative complication rate ranges between 3.3 and 72.0% with a mean value of 20.4% demonstrating high variance, as did the recurrence rate of between 0 and 61.0% with a mean value of 12.6%. Only on evaluation of the upward-deviating maximum values and registry data is a trend toward better outcomes for the sublay technique demonstrated. Through the use of a wide mesh overlap, avoidance of dissection in the abdominal wall and defect closure it appears possible to achieve better outcomes for the open IPOM technique.Conclusion: Compared to the laparoscopic technique, open IPOM is associated with significantly poorer outcomes. For the sublay technique the outcomes are quite similar and only tendentially worse. Further studies using an optimized open IPOM technique are urgently needed.https://www.frontiersin.org/article/10.3389/fsurg.2018.00066/fullincisional herniaopen intraperitoneal onlayIPOMsurgical site infectionseromawound complication |
| spellingShingle | Ferdinand Köckerling Bernhard Lammers Open Intraperitoneal Onlay Mesh (IPOM) Technique for Incisional Hernia Repair Frontiers in Surgery incisional hernia open intraperitoneal onlay IPOM surgical site infection seroma wound complication |
| title | Open Intraperitoneal Onlay Mesh (IPOM) Technique for Incisional Hernia Repair |
| title_full | Open Intraperitoneal Onlay Mesh (IPOM) Technique for Incisional Hernia Repair |
| title_fullStr | Open Intraperitoneal Onlay Mesh (IPOM) Technique for Incisional Hernia Repair |
| title_full_unstemmed | Open Intraperitoneal Onlay Mesh (IPOM) Technique for Incisional Hernia Repair |
| title_short | Open Intraperitoneal Onlay Mesh (IPOM) Technique for Incisional Hernia Repair |
| title_sort | open intraperitoneal onlay mesh ipom technique for incisional hernia repair |
| topic | incisional hernia open intraperitoneal onlay IPOM surgical site infection seroma wound complication |
| url | https://www.frontiersin.org/article/10.3389/fsurg.2018.00066/full |
| work_keys_str_mv | AT ferdinandkockerling openintraperitonealonlaymeshipomtechniqueforincisionalherniarepair AT bernhardlammers openintraperitonealonlaymeshipomtechniqueforincisionalherniarepair |