title: Is there a place for intraperitoneal onlay mesh repair (IPOM) of inguinal hernia among laparoscopic techniques?
abstract: OBJECTIVE
  The Authors report their experience on laparoscopic hernioplasty using the intraperitoneal onlay mesh repair in 56 patients.
  
  
  METHODS
  Thirty patients had a monolateral hernia, 9 of which were recurrent and 26 had a bilateral hernia, 6 of which were recurrent. Overall, a total of 90 hernias were treated. The hernia repair was performed by using "GORETEX Dual Mesh Plus biomaterial with holes" in the first 32 cases and the latest "Corduroy" type in the following 24 cases. The prostheses were fixed with titanium spiral tacks (Protack, Auto Suture, Tyco Healthcare).
  
  
  RESULTS
  No intraoperative complications occurred and no conversion was necessary. Five minor postoperative complications (5.5%), 2 seromas and 3 transient paresthesias, were observed. Four patients (7.1%) needed analgesics after the first 24 hours. Mean hospital stay was 36 hours with a minimum of 24 and a maximum of 48. Mean resumption of normal activity was 8 days with return to work within two weeks. At an average 18 months follow-up, 3 recurrences were recorded (3.3%).
  
  
  CONCLUSIONS
  The results of this study as well as the meta-analysis of the series presented in the literature, indicate that the intraperitoneal onlay mesh repair may be a feasible, safe and effective procedure in the treatment of recurrent and bilateral hernias or when a hernia repair is performed during other laparoscopic procedures. The intraperitoneal onlay mesh repair has in fact been shown to be faster and easier than the other more commonly performed laparoscopic hernioplasties (trans-abdominal preperitoneal repair and total extra-peritoneal repair). These data may also suggest utilizing this technique in particular cases of primitive hernia such as very active young males or heavy-duty workers. However the limited series and the short follow-up ask for randomized prospective long-term studies to definitely ascertain the true incidence of recurrence and therefore the effectiveness of this attractive procedure.
authors.affiliation: Department of Surgery, Paride Stefanini University of Rome La Sapienza, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Catani
authors.forename: Ritanna
authors.initials: R
authors.lastname: De Milito
authors.forename: Renato
authors.initials: R
authors.lastname: Pietroletti
authors.forename: Massimo
authors.initials: M
authors.lastname: Chiaretti
authors.forename: Erasmo
authors.initials: E
authors.lastname: Spaziani
authors.forename: Sergio
authors.initials: S
authors.lastname: Leardi
authors.forename: Mario
authors.initials: M
authors.lastname: Simi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D005240:Feasibility Studies; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000209:etiology; D011474:Prosthesis Design; D019919:Prosthesis Implantation; D012008:Recurrence; D012086:Reoperation; D013526:Surgical Mesh; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene