A retrospective study to assess postoperative pain levels among patients undergoing IPOM and E TEP hernia repair

A retrospective study to assess postoperative pain levels among patients undergoing IPOM (intra peritoneal on lay mesh) and E TEP (extended totally extra peritoneal) hernia repair

Rajeshwari*

Senior Staff Nurse – OT, Kauvery Hospital , Salem, Tamil Nadu

*Correspondence

Background: Hernia repair is commonly performed using IPOM and e TEP techniques.

Aim: To compare post-operative pain levels in patients who underwent IPOM and e TEP hernia repair.

Objectives

To assess post-operative pain score in IPOM patients
To assess post-operative pan score in e TEP patients
To compare pain levels between the two surgical techniques
To evaluate analgesic requirements in both groups
To assess duration of hospital, stay related to pain

Hypothesis

H1: No significant difference
H2: significant difference exists

Review of literature

Chuah et al. (2025)- Systematic review and Meta analysis

IPOM patients had significantly higher postoperative pain scores at postoperative day 7. e TEP showed reduced hospital stay. No significant difference in complications or recurrence.

Binthaf & Gupta (20250- Randomized Prospective study

e TEP group had significantly lower postoperative pain score. Reduced analgesics requirements. Shorter hospital stays in e TEP patients.

Wieland et al. (2024)- Retrospective Cohort Study

eTEP patients reported lower postoperative pain. Shorter hospital stay in eTEP group. Lower complication rates in eTEP

Methodology

Study design	Retrospective comparative study
Study setting	Tertiary Hospital (Kauvery hospital, Salem.)
Study population	Patients who underwent laparoscopic ventral/ umbilical hernia repair.

Inclusion criteria

Patients who underwent IPOM and eTEP surgery
Age > or = 18years
Complete medical records available

Exclusion criteria

Recurrent hernia cases
Patient’ with chronic pain disorders
Incomplete records

Data collection variables

Demographic data (Age and Gender)
Types of surgery (IPOM/ e TEP)
Pain score (Visual Analog Scale)
Analgesics requirements
Duration of hospital stay
Complications

Tools of data collection

Patient’s records
VAS

Data collection procedure

Collect records from MRD/ Summary
Extract pain score and details

Ethical consideration

Institutional approval
Confidentiality maintained

Data collection

IPOM

Patient ID	Pain score
POD	0	1	2	3
174710	8	6	5.5	3
8006	7.5	7	5	3.5
174418	9	8	7.5	4
123464	8.5	7	5.5	4
178036	7.5	7	4.5	3

e TEP

Patient ID	Pain score
POD	0	1	2
156431	7	5.5	3
157572	6	4.5	2.5
8857	6.5	4.5	3
155763	7	5.5	2.5
137827	7.5	5	2

Results

Category – Patient

Series – pain score level

IPOM

e TEP

Discussion

IPOM

Mesh location	Places the mesh intra peritoneal (inside the abdominal cavity)
Pain and recovery	High pain score level and hospitalization more
Complication	Post-operative paralytic ileus higher incidence comparing to e TEP
Operating time	Faster, less complex procedure
Adhesion risk	Slightly more adhesions will occur.

e TEP

Mesh location	Places the mesh in the extraperitoneal (Preperitoneal retromuscular) space
Pain and Recovery	Comparatively less pain score level and hospitalization more
Complication	Post-operative paralytic ileus minimal incidence comparing IPOM
Operating time	Longer operating time, complex procedure
Adhesion risk	Less adhesion risk.

Conclusion

eTEP repair may be associated with reduced post-operative pain and improved patient comfort compared to IPOM repair.

Reference

Pub Med Central (PMC)
https://jounals.com
https://www.ijsurgery.com

A retrospective study to assess postoperative pain levels among patients undergoing IPOM and E TEP hernia repair

A retrospective study to assess postoperative pain levels among patients undergoing IPOM (intra peritoneal on lay mesh) and E TEP (extended totally extra peritoneal) hernia repair

Rajeshwari*

Nightingale Journals