IPOM and IPOM-plus repair
Laparoscopic repair of incisional and ventral hernias using an intraperitoneal mesh, with defect closure when the IPOM-plus technique is used.
Indications
- Selected incisional hernias
- Ventral hernias where extraperitoneal repair is not feasible
- Recurrent hernias after previous repair
- Cases where adhesions or anatomy favour an intraperitoneal approach
IPOM vs IPOM-plus
IPOM places the mesh over the defect without closing it. IPOM-plus closes the defect with sutures before placing the mesh, which may improve the functional outcome and reduce recurrence.
The choice depends on the defect size, the tissue quality, the patient's anatomy and the surgeon's preference.
Advantages
IPOM is a well-established laparoscopic technique that allows adhesiolysis, inspection of the whole abdomen and repair of multiple defects through the same access.
Considerations
Because the mesh is placed inside the abdomen, careful technique and appropriate mesh selection are needed to minimise the risk of adhesions and bowel-related complications.
