Page 9 - World Journal of Laparoscopic Surgery

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