Incisional Lumbar Hernias: Current role of Laparoscopic Approach with Intraperitoneal Onlay Mesh (IPOM) procedure. Report of 10 cases.

Abstract Purpose Lumbar incisional hernias are a defect of the posterolateral region on the abdominal wall frequently originated on previous surgical incisions in the area. Surgical approach is challenging due to low incidence and the lack of enough publications on the topic, which generates controversies among surgeons. The purpose of this paper is to show our laparoscopic approach experience using the IPOM and IPOM Plus procedures for the treatment of lumbar incisional hernias. Materials and Methods A descriptive analysis of ten patients with lumbar/posterolateral incisional hernias, diagnosed by computer tomography (CT) scan and surgically treated with the IPOM laparoscopic technique in one case and IPOM Plus in nine cases between 2014–2021. Demographic data and baselines characteristics of enrolled patients were assessed, as well as perioperative data, surgical time, length of hospital stay and relapse during an average 38,6 month follow-up. Results In the series assessed, the defect size ranged between 24–72 cm2. Surgery lasted 120–180 minutes. There were no cases of conversion or intraoperative visceral lesion. Nine patients were discharged on an average 40,3 hours after admission, and one patient stayed for 64 hours. Postoperative morbidity was a case of hematoma and postoperative acute pain. There was one case of relapse. Conclusion The results of our experience have shown the benefits of the laparoscopic approach with the IPOM Plus method for the treatment of lumbar incisional hernias, including short hospital stay and low incidence of postoperative complications. Accordingly, this mainstream technique, which has shown good outcomes both for the short and the long term, appears to be a simple and safe procedure.