Evaluation of quality of life and recurrence rate after intraperitoneal onlay mesh laparoscopic repair of ventral hernia with or without closure of the defect (pIPOM vs. sIPOM)

Purpose: We want to evaluate the influence of defect closure in either primary or secondary laparoscopic ventral hernia repair in terms of both recurrence rate and peri- or postoperative hernia-related QoL. Methods: In this retrospective, non-randomized single-center trial, we analyzed 124 patients who underwent a laparoscopic repair for either a primitive or incisional ventral hernia with sIPOM(Group 1) or pIPOM(Group2) between February 2018 and May 2024. All patients were subjected to a specific questionnaire for the assessment of postoperative QoL in hernia-related patients (Eura-HS QoL) prior to surgery and at 6 months after the hernia repair. Results: The two groups did not show significant differences in key baseline and hernia-related characteristics. The median time of follow-up was 49.5 months for the sIPOM group, and 30.5 months for pIPOM Group (P value < 0.001). Recurrence occurs only in the sIPOM group (11.9% vs. 0%, p value=0.001). Postoperative QoL scores show an important improvement in every patient. While both techniques demonstrated similar post-operative pain levels, pIPOM had a significantly higher rate of aesthetic satisfaction. Subgroup analysis within the pIPOM group did not show significant differences based on the addition of diastasis repair. Conclusion: In conclusion we believe the closure of the defect to be an effective and safe method to improve the clinical and functional outcomes in laparoscopic repair of ventral hernia.