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A Comparative Prospective Study of Open Method Repair Versus Laparoscopic Intraperitoneal On Lay Mesh (IPOM) Plus Repair For Small-Small-Ventral Hernia
Md. Atiqul Haque Sarder, Muhammad Alom, Sabran Uddin
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Background: Any hole in the abdominal wall in the midline (vertical center) is considered a small-ventral hernia. There are two types: natural (primary) and learned (secondary). Epigastric hernia, which affects the stomach area, Umbilical hernia, which affects the belly button, and Incisional hernia, which affects the abdominal wall, are the three most common types of small-ventral hernia. Objective: To conduct a comparative analysis between laparoscopic e-TEP and IPOM techniques for small-ventral hernia repair. Methods:The present investigation was conducted as a prospective observational comparative study. The study's sample size consisted of 30 participants, with 15 instances sourced from e-TEP and the remaining 15 cases sourced from IPOM. The trial duration spanned from December 2020 to December 2022. The study employed a stratified sample strategy, which involved establishing an age eligibility condition for the respondents. The participants who underwent hernia repair treatment were included in this study through a random selection process. Results: The e-TEP group had a shorter operative time of 105.32 ± 21.44 days compared to the IPOM group's 73.83 ± 6.35 days. There were no intraoperative problems and no drains were inserted. Patients in the e-TEP group experienced a significant reduction in pain levels at both 12-hour and 24-hour time points, while the IPOM Plus group had a higher cumulative parenteral analgesia demand. The mean hospital stay was 1.11 days, significantly less than the IPOM Plus group's 1.7 days. No surgical site infections, postoperative ileus, or mesh infections were observed. Three patients had asymptomatic postoperative seroma, and conservative management was employed. No readmissions occurred in the IPOM Plus group, but two patients in the e-TEP group were admitted due to recurrence within a 6-month follow-up period. Both patients were treated using the IPOM Plus technique, and adhesiolysis procedures were successfully performed without intestinal injury. Conclusion:The e-TEP treatment is a dynamic technique that can be likened to IPOM Plus in relation to factors like as postoperative discomfort, painkiller usage, mesh expenses, and duration of hospitalization.


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