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Comparison of Types of IPOM
            Table 4: Distribution of seroma/hematoma vs type of mesh used
                             Seroma/hematoma
             Mesh types   Yes (n = 12)  No (n = 88)  Total
             PPV              0           50          50
             Composite       12           38          50
             Total           12           88         100

            Table 5: Chi-square tests for seroma/hematoma
                              Value  df    Asymp. sig. (two-sided)
             Pearson Chi-square  13.636  1       0.000



                                                               Fig. 5: Intestinal obstruction distribution
                                                               Table 7: Chi-square tests for recurrence
                                                                                  Value    df   Asymp. sig. (two-sided)
                                                                Pearson Chi-square  6.250  1          0.012

                                                               Table 8: Distribution of intestinal obstruction vs type of mesh used
                                                                                   Intestinal obstruction
                                                                Mesh types         Yes          No          Total
                                                                PPV                40           10            50
                                                                Composite          10           40            50
            Fig. 3: Frequency of seroma/hematoma                Total              50           50          100

                                                               Table 9: Chi-square tests for intestinal obstrution
                                                                                  Value    df   Asymp. sig. (two-sided)
                                                                Pearson Chi-square  36.000  1         0.000

                                                                  Five (10%) of patients in the PPV group had recurrence while
                                                               15% of patients in the composite group had recurrence (p = 0.012)
                                                               as shown in Figures 3 to 5 and Tables 4 to 9.
                                                                  For the patients who presented with intestinal obstruction,
                                                               simple conservative management resolved the obstruction. An
                                                               ultrasonography scan was used to confirm patients who clinically
                                                               had hematoma/seroma, and this occurred in the early postoperative
                                                               period and settled spontaneously in follow-up and required no
                                                               further intervention. In the laparoscopic repair, mesh fixation was
                                                               by the use of proTack™, while in the open repair, unobservable
            Fig. 4: Showing recurrence distribution            nylon suture wan used.
                                                                  There was no mortality in the study. There was no history of
            Table 6: Distribution of recurrence vs type of mesh used
                                                               chest infection, peritonitis, wound infection, or sinus formation.
                                   Recurrence                  Standard aseptic protocol and proper coverage of the patient
             Mesh types        Yes          No          Total  with broad-spectrum prophylactic antibiotics were instituted in
                                                               all the cases.
             PPV                 5          45            50
                                                                  The average operation time was 2 hours in the open procedure
             Composite         15           35            50   and 2.5 hours in the laparoscopic procedure.
             Total             20           80          100       The mean duration of hospital stay was 72 hours in the open
                                                               procedure and 48 hours in the laparoscopic approach.
            Forty (80%) of patients in the PPV group had intestinal obstruction
            secondary to adhesions, while no patient in the composite group   dIscussIon
            had intestinal obstruction (p = 0.0001). No patient in the PPV group   The introduction of polypropylene mesh repair by an usher in 1958
            had seroma/hematoma, while 12 (24%) of patients in the composite   opened a new era of tension-free herniorrhaphy. Recurrence rates
            group had seroma/hematoma (p = 0.0001).            with prosthetic mesh decreased to 10–20%. Subsequently, it was

                                                        World Journal of Laparoscopic Surgery, Volume 15 Issue 2 (May–August 2022)  105
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