This video demonstrate IPOM is indicated for incisional hernia repair of large defects when a sublay technique is no longer feasible, this mainly involves a bridging situation. Accordingly, most of the studies published report on an open intraperitoneal onlay mesh technique with bridging.

Incisional hernia is a common complication that occurs at the site of a previous abdominal surgical incision due to weakness of the abdominal wall. With advancements in minimally invasive surgery, laparoscopic repair has become the preferred method for managing incisional hernias because of reduced postoperative pain, faster recovery, and lower complication rates. At World Laparoscopy Hospital (WLH), laparoscopic Intraperitoneal Onlay Mesh (IPOM) repair using dual or composite mesh is performed with advanced technology, expert surgical protocols, and global training standards.

The IPOM technique involves placing a mesh inside the abdominal cavity over the hernia defect. In modern practice, surgeons commonly use dual-layer or composite mesh. One surface of the mesh promotes tissue ingrowth to provide strong fixation to the abdominal wall, while the other surface is specially coated to prevent adhesion of bowel loops and internal organs. This dual design improves long-term safety and reduces complications related to intra-abdominal adhesions.

The surgical procedure begins with laparoscopic access using small ports, allowing visualization of the hernia defect. Adhesions are carefully released, and the hernia sac contents such as omentum or bowel are reduced back into the abdominal cavity. Many surgeons at WLH prefer closing the fascial defect before mesh placement (IPOM-Plus technique), which helps restore abdominal wall anatomy, reduce seroma formation, and prevent postoperative bulging. After defect preparation, the mesh is introduced through a trocar, unfolded, and positioned to cover the defect with at least 3–5 cm overlap on all sides to ensure durability of repair.

Mesh fixation is a crucial step in preventing recurrence. At WLH, fixation is commonly performed using a combination of transfascial sutures and absorbable tackers arranged in a “double crown” pattern. This method provides strong and tension-free fixation, minimizing the risk of mesh migration. Alternative fixation methods such as tacks alone or combined with sutures are also used depending on patient condition and defect size.

One of the major advantages of laparoscopic IPOM repair is improved patient recovery. Patients usually experience less postoperative pain, smaller scars, early mobilization, and shorter hospital stays. Many patients can resume oral intake the same day and are discharged within 24–48 hours after surgery. Studies comparing laparoscopic IPOM with open techniques have shown reduced postoperative complications and shorter hospital stays while maintaining comparable recurrence rates.

World Laparoscopy Hospital is internationally recognized for its excellence in laparoscopic training and surgical innovation. Surgeons are trained using high-definition imaging systems, advanced energy devices, and structured simulation-based learning. The hospital emphasizes not only surgical technique but also complication management, patient safety, and evidence-based practice. Through hands-on training and live surgical exposure, WLH continues to contribute to global advancement in minimally invasive hernia surgery.

In conclusion, incisional hernia IPOM repair with dual mesh represents a highly effective and modern approach for abdominal wall reconstruction. The combination of minimally invasive access, advanced mesh technology, and standardized surgical protocols provides excellent functional and cosmetic outcomes. At World Laparoscopy Hospital, this procedure reflects a commitment to surgical excellence, patient safety, and global leadership in laparoscopic education.