This video demonstrate laparoscopic inguinal hernia by IPOM. Dr R K Mishra report their experience on laparoscopic hernioplasty using the Intraperitoneal Onlay Mesh Repair (IPOM). Many patients had a bilateral hernia, and many of which were recurrent and some had recurrent hernia. Overall, a total of 85 hernias were treated. The hernia repair was performed utilizing Polyurathane Dual Mesh. The prostheses were fixed with titanium spiral tacks (Protack, AutoSuture, Tyco Healthcare). No intraoperative complications occurred and no conversion was necessary. Mean resumption of normal activity was 10 days with return to work within two weeks. At an average 24 months follow-up, were recorded. The results of this study as well as the meta-analysis of the series presented in the Literature, indicate that the IPOM may be a feasible, safe and effective procedure in the treatment of inguinal hernia repair is performed during other laparoscopic procedures. The IPOM has infact been shown to be faster and easier than the other more commonly performed laparoscopic hernioplasties (TAPP and TEP). These data may also suggest to utilize this technique in particular cases of primitive hernia such as very active young males or heavy duty workers. However the limited experience and the short follow-up ask for long term studies to definitely ascertain the true incidence of recurrence and therefore the effectiveness of this attractive procedure.

Inguinal hernia repair is one of the most common surgical procedures worldwide, and laparoscopic techniques have revolutionized the way surgeons manage these cases. Among the various laparoscopic approaches, Intraperitoneal Onlay Mesh (IPOM) repair using Dual Mesh has gained attention for its safety, effectiveness, and faster recovery for patients.

What is Laparoscopic IPOM Repair?

IPOM (Intraperitoneal Onlay Mesh) is a minimally invasive technique in which a prosthetic mesh is placed inside the abdominal cavity to cover the hernia defect. Unlike traditional open repair, the laparoscopic approach uses small incisions and a camera-guided technique, reducing tissue trauma, post-operative pain, and hospital stay.

The procedure involves:

1. Patient positioning and anesthesia – Typically, general anesthesia is administered, and the patient is positioned supine.

2. Trocar placement – Small ports are inserted through the abdominal wall to allow passage of laparoscopic instruments and camera.

3. Hernia sac reduction – The hernia contents are carefully reduced back into the abdominal cavity.

4. Mesh placement – A dual-layer mesh is positioned over the defect.

Why Dual Mesh?

Dual Mesh is designed specifically for intraperitoneal use. It has two distinct surfaces:

• Visceral side: Smooth and coated to minimize adhesion formation with intestines and other organs.

• Parietal side: Rougher texture for secure fixation to the abdominal wall.

This design allows the mesh to safely reside inside the peritoneal cavity while promoting tissue integration and reducing the risk of complications such as adhesions or bowel obstruction.

Advantages of Laparoscopic IPOM with Dual Mesh

1. Minimally invasive – Small incisions result in less pain, quicker recovery, and better cosmetic outcomes.

2. Reduced recurrence rates – The dual mesh provides strong coverage of the defect.

3. Early return to activity – Patients can resume normal activities sooner than after open repair.

4. Lower post-operative complications – The specialized coating reduces adhesions and inflammation.

5. Better for bilateral or recurrent hernias – Laparoscopic approach allows repair of both sides with minimal additional trauma.

Potential Risks and Considerations

While IPOM with dual mesh is safe, some risks remain:

• Seroma or hematoma formation

• Infection at the port sites

• Rare adhesion or bowel obstruction

• Chronic post-operative pain

Careful patient selection, precise surgical technique, and proper mesh fixation are essential to minimize complications.

Postoperative Care

Patients typically experience minimal pain and can start walking the same day. Most are discharged within 24–48 hours. Doctors recommend:

• Avoiding heavy lifting for 4–6 weeks

• Gradual return to normal activities

• Follow-up visits to monitor healing and mesh integration

Conclusion

Laparoscopic inguinal hernia repair using IPOM with Dual Mesh represents a significant advancement in hernia surgery. With reduced post-operative pain, faster recovery, and excellent long-term outcomes, it is an ideal choice for suitable candidates. Surgeons trained in advanced laparoscopic techniques can offer this approach as a safe, effective, and patient-friendly alternative to traditional open surgery.