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A Journal on Surgery

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Minerva Chirurgica 2003 December;58(6):783-90

language: Italian

Laparoscopic inguinal hernia repair ''IPOM'' vs ''open tension free''. Preliminary results of a prospective randomized study

Catani M., De Milito R., Spaziani E., Chiaretti M., Manili G., Capitano S., Di Filippo A., Simi M.


Aim. The authors report the preliminary results of a prospective comparison of IPOM (group A) and ''open tension free'' (group B) hernioplasty in 50 patients having a mono or bilateral primitive hernia.
Method. In group A (26 patients) hernia repair was performed using ''Gore-Tex® DualMesh Plus biomaterial with holes Corduroy'' and in group B (24 patients) using the patch and plug technique with Marlex prosthesis.
Results. No intraoperative complications occur-red and, in group A, no conversion was necessary. Four minor complications were obser-ved in group A (10.8%): 3 seromas and 1 transient paresthesia; 5 in group B (16%): 4 hematomas and 1 wound infection (p=n.s.). In group A only 2 patients (7.6%) needed analgesics after the first 24 hours and 12 patients (50%) in group B (p<0.001). Mean resumption of normal activity was 8 days in group A and 17 days in group B (p<0.001). At a 12-month-follow-up, no recurrence was reported in both groups.
Conclusions. The results of this prospective randomized study show that IPOM may be not only a feasible and effective procedure in the treatment of recurrent and bilateral hernia or when hernia repair is performed during other laparoscopic procedures, but also in particular cases of primitive hernia such as in very active young males or heavy duty workers. However it is necessary to definitely ascertain the true incidence of recurrence in non limited series and in longer follow-up and the preliminary results of this study encourage the authors to complete the randomized study.

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