Trial reportHernia : the journal of hernias and abdominal wall surgery2026
Intraperitoneal Onlay mesh - non-closure (IPOM) vs. fascial closure (IPOM-Plus) vs. peritoneal bridging (IPOM-Pb) in laparoscopic ventral hernia repair: a randomized controlled trial.
Trial report in Hernia : the journal of hernias and abdominal wall surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeIntraperitoneal onlay mesh (IPOM) repair without defect closure and IPOM with primary fascial closure (IPOM-Plus) are established techniques for laparoscopic ventral hernia repair. In contrast, evidence for IPOM with peritoneal bridging is limited and mainly comes from single-group studies. This randomized controlled trial compared these three methods regarding early postoperative outcomes in moderate midline ventral hernias.
methodsThis study was a single-center, prospective, randomized trial involving 120 adult patients with midline ventral hernias, with horizontal defect widths ranging from 3 to 6 cm (4.6 ± 1.2 cm). Participants were evenly divided into IPOM, IPOM-Plus, or IPOM-Pb groups. A single surgeon performed all procedures, using the same mesh, fixation, and perioperative protocols. Primary outcomes were postoperative seroma formation, pain scores at 48 h and on postoperative days 5 and 10, and short-term recurrence at six months. Secondary outcomes included operative time, conversion to open surgery, and length of hospital stay.
resultsEarly postoperative seroma was significantly more frequent in the IPOM-Pb group at 48 h and postoperative day 5 compared with IPOM-Plus (12.5% vs. 2.5%; risk difference 10%, 95% CI 0.1–19.9; p = 0.025). Pain scores at all assessed time points were similar across groups. One hernia recurrence occurred in the IPOM group at six months. Operative time was significantly longer for IPOM-Pb compared with IPOM and IPOM-Plus (p < 0.001). Conversion rates and hospital stay length did not show significant differences.
conclusionsIPOM-Pb had higher early seroma rates and longer operative times without clear short-term benefits, supporting IPOM Plus as a balanced and reliable standard technique for laparoscopic repair of moderate midline ventral hernias.
trial registrationCTRI No. CTRI/2023/08/056745
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