Ipom Umbilical Hernia Repair By Vipro II Mesh
Umbilical hernia is a common condition where abdominal contents protrude through a defect in the umbilical region. While small, asymptomatic hernias may be managed conservatively, surgical repair is recommended for symptomatic, enlarging, or complicated hernias to prevent incarceration or strangulation.
Intraperitoneal Onlay Mesh (IPOM) repair has emerged as a minimally invasive, safe, and effective technique for umbilical hernia repair. The use of Vipro II mesh, a composite lightweight mesh, enhances repair strength while reducing complications such as adhesion formation, chronic pain, and recurrence.
Indications
IPOM umbilical hernia repair using Vipro II mesh is indicated in patients with:
Symptomatic umbilical or paraumbilical hernias
Hernias larger than 2 cm in diameter
Recurrent hernias after previous open repair
Patients at higher risk of infection, obesity, or multiple comorbidities where minimally invasive repair is advantageous
Contraindications include uncontrolled infection at the operative site, severe adhesions, or inability to tolerate general anesthesia.
Preoperative Preparation
Patient Evaluation: Thorough clinical examination, including hernia size, reducibility, and previous abdominal surgeries.
Imaging: Ultrasound or CT scan may be used for complex or recurrent hernias to delineate defect size and content.
Anesthesia: General anesthesia is preferred for optimal muscle relaxation.
Patient Counseling: Discuss risks, benefits, and postoperative care including early ambulation.
Surgical Technique
Dr. R. K. Mishra and other experts have refined the IPOM technique for umbilical hernia repair to enhance outcomes and reduce recurrence.
Laparoscopic Access
A pneumoperitoneum is established using a Veress needle or open (Hasson) technique.
Port placement typically includes:
Umbilical 10 mm port for the camera
Two or more 5 mm working ports depending on hernia size and surgeon preference
Hernia Sac Dissection
The hernia sac and surrounding adhesions are carefully dissected using laparoscopic instruments.
Hernia contents, such as omentum or bowel, are reduced safely into the peritoneal cavity.
Complete reduction ensures proper mesh placement and reduces recurrence risk.
Mesh Selection and Placement
Vipro II mesh, a lightweight composite mesh, is chosen for intraperitoneal placement.
The mesh is introduced laparoscopically and positioned over the defect, ensuring a 3–5 cm overlap beyond the margins of the hernia.
Vipro II’s dual-sided design prevents adhesion formation on the visceral side while promoting tissue ingrowth on the parietal side.
Mesh Fixation
Fixation techniques:
Sutures through the abdominal wall for secure anchoring
Optional use of laparoscopic tacks for additional stabilization
Dr. Mishra emphasizes tension-free placement to minimize postoperative pain and recurrence.
Final Inspection and Closure
Confirm mesh position and complete reduction of contents before releasing pneumoperitoneum.
Ports are removed, and skin incisions are closed with absorbable sutures or skin adhesive.
Advantages of IPOM Repair with Vipro II Mesh
Minimally invasive: Small incisions reduce postoperative pain and improve cosmetic outcomes.
Tension-free repair: Mesh reinforcement avoids stress on surrounding tissues.
Lower recurrence rates: Proper mesh overlap and fixation prevent hernia reformation.
Reduced adhesion formation: Vipro II’s dual-layer design minimizes risk of bowel adhesions.
Faster recovery: Patients resume normal activities sooner compared to open repair.
Ideal for complex cases: Suitable for recurrent, large, or multiple hernias.
Postoperative Care
Early ambulation and resumption of oral intake
Pain controlled with oral analgesics
Discharge typically within 24–48 hours for uncomplicated cases
Follow-up includes monitoring for seroma, hematoma, infection, or recurrence
Avoid heavy lifting for 4–6 weeks to allow complete healing
Outcomes
IPOM repair using Vipro II mesh has demonstrated:
Excellent long-term results with low recurrence rates
Minimal postoperative pain and faster return to normal activities
Safety in high-risk patients, including obesity and comorbid conditions
Reduced mesh-related complications due to the composite, lightweight design
Conclusion
IPOM umbilical hernia repair using Vipro II mesh is a safe, effective, and minimally invasive approach for patients with symptomatic, recurrent, or large umbilical hernias.
By combining secure mesh placement, dual-layer design, and tension-free technique, surgeons can achieve excellent patient outcomes, minimal complications, and faster recovery. This approach exemplifies the advantages of modern laparoscopic hernia surgery and represents a preferred technique in contemporary surgical practice.
Intraperitoneal Onlay Mesh (IPOM) repair has emerged as a minimally invasive, safe, and effective technique for umbilical hernia repair. The use of Vipro II mesh, a composite lightweight mesh, enhances repair strength while reducing complications such as adhesion formation, chronic pain, and recurrence.
Indications
IPOM umbilical hernia repair using Vipro II mesh is indicated in patients with:
Symptomatic umbilical or paraumbilical hernias
Hernias larger than 2 cm in diameter
Recurrent hernias after previous open repair
Patients at higher risk of infection, obesity, or multiple comorbidities where minimally invasive repair is advantageous
Contraindications include uncontrolled infection at the operative site, severe adhesions, or inability to tolerate general anesthesia.
Preoperative Preparation
Patient Evaluation: Thorough clinical examination, including hernia size, reducibility, and previous abdominal surgeries.
Imaging: Ultrasound or CT scan may be used for complex or recurrent hernias to delineate defect size and content.
Anesthesia: General anesthesia is preferred for optimal muscle relaxation.
Patient Counseling: Discuss risks, benefits, and postoperative care including early ambulation.
Surgical Technique
Dr. R. K. Mishra and other experts have refined the IPOM technique for umbilical hernia repair to enhance outcomes and reduce recurrence.
Laparoscopic Access
A pneumoperitoneum is established using a Veress needle or open (Hasson) technique.
Port placement typically includes:
Umbilical 10 mm port for the camera
Two or more 5 mm working ports depending on hernia size and surgeon preference
Hernia Sac Dissection
The hernia sac and surrounding adhesions are carefully dissected using laparoscopic instruments.
Hernia contents, such as omentum or bowel, are reduced safely into the peritoneal cavity.
Complete reduction ensures proper mesh placement and reduces recurrence risk.
Mesh Selection and Placement
Vipro II mesh, a lightweight composite mesh, is chosen for intraperitoneal placement.
The mesh is introduced laparoscopically and positioned over the defect, ensuring a 3–5 cm overlap beyond the margins of the hernia.
Vipro II’s dual-sided design prevents adhesion formation on the visceral side while promoting tissue ingrowth on the parietal side.
Mesh Fixation
Fixation techniques:
Sutures through the abdominal wall for secure anchoring
Optional use of laparoscopic tacks for additional stabilization
Dr. Mishra emphasizes tension-free placement to minimize postoperative pain and recurrence.
Final Inspection and Closure
Confirm mesh position and complete reduction of contents before releasing pneumoperitoneum.
Ports are removed, and skin incisions are closed with absorbable sutures or skin adhesive.
Advantages of IPOM Repair with Vipro II Mesh
Minimally invasive: Small incisions reduce postoperative pain and improve cosmetic outcomes.
Tension-free repair: Mesh reinforcement avoids stress on surrounding tissues.
Lower recurrence rates: Proper mesh overlap and fixation prevent hernia reformation.
Reduced adhesion formation: Vipro II’s dual-layer design minimizes risk of bowel adhesions.
Faster recovery: Patients resume normal activities sooner compared to open repair.
Ideal for complex cases: Suitable for recurrent, large, or multiple hernias.
Postoperative Care
Early ambulation and resumption of oral intake
Pain controlled with oral analgesics
Discharge typically within 24–48 hours for uncomplicated cases
Follow-up includes monitoring for seroma, hematoma, infection, or recurrence
Avoid heavy lifting for 4–6 weeks to allow complete healing
Outcomes
IPOM repair using Vipro II mesh has demonstrated:
Excellent long-term results with low recurrence rates
Minimal postoperative pain and faster return to normal activities
Safety in high-risk patients, including obesity and comorbid conditions
Reduced mesh-related complications due to the composite, lightweight design
Conclusion
IPOM umbilical hernia repair using Vipro II mesh is a safe, effective, and minimally invasive approach for patients with symptomatic, recurrent, or large umbilical hernias.
By combining secure mesh placement, dual-layer design, and tension-free technique, surgeons can achieve excellent patient outcomes, minimal complications, and faster recovery. This approach exemplifies the advantages of modern laparoscopic hernia surgery and represents a preferred technique in contemporary surgical practice.
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