Intraperitoneal Onlay Mesh Plus Repair Versus Transabdominal Preperitoneal Mesh Plus Repair in Patients with Primary Midline Ventral Hernia: A Prospective Randomized Controlled Study.
Varnik Goel, Devender Singh, Yashwant Rathore et al.
✦ AI-curated · Sources linked
In 30 seconds
This prospective, single-centre randomized controlled trial compared laparoscopic IPOM Plus with vTAPP Plus in adults with small-to-medium primary ventral hernias measuring 2–4 cm. Among 68 analyzed patients, vTAPP Plus was associated with significantly lower postoperative pain at 6, 12, 24, and 48 hours and at 14 and 30 days (P < .001); the difference was not significant at 6 months. Hospital stay was shorter with vTAPP Plus, while complication rates were comparable. No mesh infection or recurrence was observed during follow-up.
Key findings
- Pain scores were significantly lower with vTAPP Plus at 6, 12, 24, and 48 hours and at 14 and 30 days (P < .001).
- The pain difference diminished by 3 months and was not significant at 6 months.
- Hospital stay was significantly shorter with vTAPP Plus; operative time was marginally longer.
- Complication rates were comparable, with no mesh infection or hernia recurrence observed during follow-up.
Why it matters
The trial provides randomized comparative evidence that an extraperitoneal repair may reduce pain during the early recovery period for selected patients with primary midline ventral hernias. The lack of a significant pain difference at 6 months and the absence of observed recurrence or mesh infection during follow-up mean that longer-term comparative outcomes remain important to assess.
What to keep in mind
This was a single-centre trial with 68 analyzed patients. Follow-up findings were short-term, and no recurrence or mesh infection was observed during that period.