Evaluation of spike formation and quality of life in patients with primary midline ventral hernias after endoscopic eTEP Sublay and IPOM surgeries: a cohort study

Objective. Evaluation of adhesion formation at the mesh site and quality of life in patients with primary ventral hernias after eTEP and IPOM hernia repair. Material and methods. A retrospective multicenter cohort study included 80 patients with primary ventral hernias who had undergone eTEP or IPOM hernia repair 12 or more months previously. Ultrasound assessment of adhesion formation was performed in 9 abdominal wall locations. Quality of life was assessed using the EuraHS-QoL. Results. Adhesions at the mesh location were significantly less frequent after eTEP (7.5% versus 32.5% after IPOM, p=0.010). The odds ratio of adhesions at the mesh location after IPOM was 5.9 times statistically significantly higher than after eTEP. Adhesions in other areas of the abdominal cavity (outside the mesh location) were also significantly less common after eTEP (5.0% versus 22.5% after IPOM, p=0.048). The odds ratio for adhesions in other parts of the abdominal cavity after IPOM was 5.5 times statistically significantly higher than after eTEP. There were no differences in quality of life between the groups. Flatulence, constipation and periodic abdominal pain tended to decrease after both types of surgery. Conclusion. The use of the eTEP technique in patients with primary ventral hernias, when compared with the IPOM technique, is accompanied by lower risks of adhesion formation both at the mesh location and in other parts of the abdominal cavity. Despite the difference in the frequency and risks of adhesion formation when using these surgical techniques, no difference was found in the quality of life of patients and the number of negative reactions and complications associated with them.