Efficacy of laparoscopic IPOM for paraumbilical hernia using polypropylene mesh and comparison with open mesh repair

Introduction: Umbilical hernias are encountered at the umbilical ring and may be present at birth or develop subsequently in later part of life. Adults having asymptomatic and small defects need to be followed clinically. Surgical treatment needs to be offered if the hernia enlarges or symptoms occur or if incarceration occurs.Laparoscopic repair of ventral hernias including umbilical hernias is gaining popularity in the recent times. Further the choice of mesh for laparoscopic repair is controversial. Material and Methods: This was a prospective study conducted at BLDEU’s shri B. M. Patil Medical College, Vijayapur from Oct 2015 to Aug 2017 and included 68 patients with umbilical/ paraumbilical hernia. All 34 patients in the laparoscopic group underwent intraperitoneal onlay mesh repair (IPOM) and 34 in the open mesh repair underwent onlay mesh repair. Polypropylene mesh was used in both the groups. Result: The laparoscopic repair (LR) group had a mean operative time of 74.4 min which was significantly more than the operative time of 52.5 min in open mesh repair group. The mean length of hospital stay at 6.9 days was higher in the open mesh repair (OR) group compared to 3.9 in laparoscopic group. There was no significant difference in the rate of complications among the two groups. Further the laparoscopic group showed advantages to the patient in terms of early post-operative mobilization and less post-operative pain. Conclusion: Although the use of mesh fixation device contributes to the higher cost of laparoscopic IPOM repair and the operating time is also longer laparoscopic repair of umbilical and paraumbilical hernia using polypropylene mesh offers advantage to the patient in terms of reduced hospital stay, decreased postoperative pain and a comparable complication rate to the widely practiced open mesh repair. Laparoscopic IPOM with polypropylene mesh is technically safe, effective and feasible with a better clinical outcome in patients requiring treatment for umbilical and paraumbilical hernia.