This video titled "Laparoscopic Repair of Inguinal Hernia Using Intraperitoneal Onlay Mesh & Fibrin Glue" provides a step-by-step demonstration of a minimally invasive and atraumatic method of hernia repair that eliminates the need for tackers or sutures. Performed by expert surgeons at World Laparoscopy Hospital, this technique offers a modern alternative for inguinal hernia patients who seek a low-pain, low-recurrence, and quick-recovery solution.

What is the IPOM Technique for Inguinal Hernia?

Intraperitoneal Onlay Mesh (IPOM) involves placing a prosthetic mesh directly over the hernia defect on the peritoneal side, allowing for broad coverage and defect reinforcement. While more commonly used in ventral and incisional hernias, IPOM has shown excellent results in select inguinal hernia cases, particularly when preperitoneal dissection (as in TEP or TAPP) is not feasible due to previous surgeries, adhesions, or anatomical limitations.

In this technique, fibrin glue is used instead of mechanical tackers, providing secure fixation of the mesh while reducing postoperative neuralgia, bleeding, and mesh-related complications.

Key Surgical Steps Demonstrated in the Video

Creation of pneumoperitoneum and insertion of laparoscopic ports
Inspection and reduction of hernia sac back into the abdominal cavity
Identification of vital structures such as vas deferens, spermatic vessels, and inferior epigastric vessels
Introduction of a dual-layer, anti-adhesive composite mesh
Even spreading of the mesh over the myopectineal orifice to cover direct, indirect, and femoral defects
Application of fibrin glue along the mesh borders to fix it without damaging nerves or vessels
Final inspection and closure of port sites

Benefits of Using Fibrin Glue in Mesh Fixation

Atraumatic fixation – No mechanical trauma to tissues or nerves
Reduced postoperative pain and neuralgia
Lower risk of bleeding and vascular injury
Biocompatible and absorbable adhesive
Excellent mesh incorporation and minimized foreign body response

Ideal Candidates for This Technique

Patients with recurrent inguinal hernia where previous preperitoneal repairs were done
Individuals with coagulopathies or high risk of bleeding
Patients seeking minimal postoperative pain and rapid recovery
Those with adhesions or previous pelvic surgeries making TAPP or TEP difficult

Conclusion

The laparoscopic IPOM repair for inguinal hernia using fibrin glue offers a safe, effective, and patient-centered alternative to conventional tack or suture-based mesh fixation. As seen in this video from World Laparoscopy Hospital, the use of biological glue for mesh anchoring ensures gentle yet firm fixation, reducing complications while promoting faster healing.

Watch the full video to learn the technique, instrumentation, and surgical tips for mastering this advanced hernia repair method.
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