Kerima (Czechia)

Abstract Aim It is known from experience that adhesions of the small intestine and bands forming adhesions of the omentum are especially potentially dangerous (ileus, fistulas, chronic pain). Therefore, with this technique, we create a space where the mesh and the small intestine come into no contact and the omentum adhesion is controlled to form flat. The aim of our work was to verify this assumption and include this method as safe and effective. Materials and methods We perform this by fixind the omentum to the abdominal wall in a line below the hernia defect. The next step is to perform a standard IPOM, but with the use of a lightweight large-pore mesh without anti-adhesive surface treatment and fixing it with stitches. We called it omentum protected IPOM (OpIPOM). We included three departments in the initial multicenter comparative study. From 2017 to 2020, we selected a group of 80 patients originály indicated for retromuscular hernioplasty according to Rives-Stoppa(RS). For comparison of RS and OpIPOM, the method of surgery was dedicated by lot just before the operation in a ratio 1:1. Results The average operating time, duration of postoperative drainage,the length of hospitalization, occurence of surgical site infection and complicated seroma favor OpIPOM. Hernia recurrence within two years was for the both methods the same. Conclusion The technique is simple, safe, cheaper then IPOM, faster then RS and with a shorter recovery. From our experience controlled adhesion is also not a technical problem of redo laparotomy.