The Feasibility And Efficacy Of Tapp Versus Ipom Plus In The Treatment Of Ventral Hernia In Obese Patients.
DOI:
https://doi.org/10.36283/ziun-pjmd15-2/002Abstract
BACKGROUND
Ventral hernias are more frequent in obese patients. Open ventral hernia repair carries considerable morbidity in the form of seroma formation and surgical site infection. Laparoscopic IPOM (Intraperitoneal only mesh) repair is associated with severe postoperative pain and adhesion obstruction. Ventral TAPP (transabdominal pre-peritoneal) repair has reduced postoperative pain and adhesion formation but has a long learning curve. The aim of our study was to compare the feasibility and efficacy of ventral TAPP repair with IPOM plus repair in the treatment of ventral hernia in obese patients.
MATERIALS AND METHOD
This prospective and comparative study was carried out in surgical department of Bahawal Victoria Hospital Bahawalpur. Group A included 22 patients in whom laparoscopic ventral TAPP repair was performed, and group B also included 22 patients in whom laparoscopic IPOM plus repair was performed. Data was collected on a pro forma and analysed using SPSS Statistics version 27.
RESULTS
Mean operating time was significantly longer in group A than in group B (p value < .001). Postoperative pain (VAS score) at days 1, 2, and 15 was more severe in group B than in group A. The complication rate was higher in group B than in group A. (13.65% vs. 4.55%). Mean hospital stay was shorter in group A than in group B (2.545 ± 1.01 vs. 3.73 ± 1.08).
CONCLUSION
Regarding the feasibility of ventral TAPP in obese patients, it is technically demanding and has a long learning curve. In efficacy as compared to IPOM plus in terms of postoperative pain, complications, recurrence, hospital stay, and cost-effectiveness, ventral TAPP is better than IPOM plus.
KEY WORDS:
Ventral Hernia, Obesity, Laparoscopic IPOM plus, Laparoscopic Ventral TAPP
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