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Peritoneal Bridging Versus Nonclosure in Laparoscopic Ventral Hernia Repair
Örebro University, School of Medical Sciences. Faculty of Medicine and Health, Department of Surgery, Örebro University, Örebro, Sweden; Department of Surgery, Karlskoga Hospital, Karlskoga, Sweden .ORCID iD: 0000-0002-2090-4563
Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Department of Surgery, Southern Hospital (Södersjukhuset), Stockholm, Sweden.
Örebro University Hospital. Örebro University, School of Medical Sciences. Department of Radiology.ORCID iD: 0000-0003-0627-1795
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Surgery.
2023 (English)In: Annals of Surgery Open, E-ISSN 2691-3593, Vol. 4, no 1, article id e257Article in journal (Refereed) Published
Abstract [en]

Introduction: Postoperative seroma and pain are common problems following laparoscopic intraperitoneal onlay mesh (IPOM) repair of ventral hernias. These advers outcomes may be avoided by dissecting and using the peritoneum in the hernial sac to bridge the hernia defect.

Methods: This was a patient- an and outcome assesor-blinded, parallel-design, randomized controlled trial compairing nonclosure and peritoeal bridging approaches in patients schedueled for elective midline ventral hernia repair. The primary end point was seroma volume on ultrasonography. The secondary end points were postoperative pain, recurrence, and complications.

Results: Between November 2018 and December 2020, 112 patients were randomized of whom 60 were in the nonclosure group and 52 were in the peritoneal bridging group. The seroma volume in the nonclosure and peritoneal bridging groups were 17cm3(6-53cm3) versus 0cm3(0-26cm3) at 1-moth follow-up (P=0.013). The median volume was zero at 3-, 6-, and 12-month follow-ups in both groups. No significant differences were observed in early postoperative pain (P=0.447) and in recurrencerate (P=0.684). There were 4(7%) and 1(2%) perioperative complictions that lead to reoperations in simple IPOM(sIPOM) and IPOM with peritoneal bridging (IPOM-pb), respectively.

Conclusion: Seroma was less prevalent after IPOM-pb at 1-month follow-up compaired with sIPOM, with simillar posoperative pain 1 week after index of surgery in both groups. At subsequent follow-ups, the differences in seroma were not statiscally significant. Further studies are required to confirm these results. Trial registration (NCT04229940)

Keywords: epigastric hernia, incisional hernia, IPOM with fascia closure, IPOM with peritoneal bridging, laparoscopic hernia repair, simple IPOM, umblical hernia, ventral hernia

Place, publisher, year, edition, pages
Wolters Kluwer, 2023. Vol. 4, no 1, article id e257
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-105903DOI: 10.1097/as9.0000000000000257PubMedID: 37600866OAI: oai:DiVA.org:oru-105903DiVA, id: diva2:1756190
Available from: 2023-05-10 Created: 2023-05-10 Last updated: 2024-01-02Bibliographically approved

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Ali, FathallaForgo, BiankaWallin, Göran

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