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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...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206818/ https://www.ncbi.nlm.nih.gov/pubmed/30406110 http://dx.doi.org/10.3389/fsurg.2018.00066 |
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author | Köckerling, Ferdinand Lammers, Bernhard |
author_facet | Köckerling, Ferdinand Lammers, Bernhard |
author_sort | Köckerling, Ferdinand |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-6206818 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-62068182018-11-07 Open Intraperitoneal Onlay Mesh (IPOM) Technique for Incisional Hernia Repair Köckerling, Ferdinand Lammers, Bernhard Front Surg Surgery 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. Frontiers Media S.A. 2018-10-23 /pmc/articles/PMC6206818/ /pubmed/30406110 http://dx.doi.org/10.3389/fsurg.2018.00066 Text en Copyright © 2018 Köckerling and Lammers. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Surgery Köckerling, Ferdinand Lammers, Bernhard Open Intraperitoneal Onlay Mesh (IPOM) Technique for Incisional Hernia Repair |
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 | Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6206818/ https://www.ncbi.nlm.nih.gov/pubmed/30406110 http://dx.doi.org/10.3389/fsurg.2018.00066 |
work_keys_str_mv | AT kockerlingferdinand openintraperitonealonlaymeshipomtechniqueforincisionalherniarepair AT lammersbernhard openintraperitonealonlaymeshipomtechniqueforincisionalherniarepair |