To investigate the application of various mesh fixation methods in laparoscopic intraperitoneal onlay mesh (IPOM) for the treatment of abdominal wall hernia.

A retrospective analysis was conducted using data of 52 patients with abdominal wall hernia, who underwent IPOM surgery in the Department of Hernia and Abdominal Wall Surgery, Shengzhou People's Hospital from July 1, 2015 to July 31, 2020. According to different mesh fixation methods, they were divided into Group A, Group B, and Group C. Group A used hernia tack fixation method (20 cases), Group B used suture fixation method (15 cases), and Group C used tack-suture combination method (17 cases). The surgical time, mesh fixation time, total hospitalization cost, postoperative hospitalization time, and postoperative complications of each group of patients were compared and analyzed.

All 52 patients with abdominal wall hernia successfully completed the operation. The surgical time of Group A was shorter than that of Group B and Group C, and the surgical time of Group B was shorter than that of Group C, with statistical significance (P<0.05). The mesh fixation time of Group A was shorter than that of Group B and Group C, while the mesh fixation time of Group B was longer than that of Group C, with statistical significance (P<0.05). The postoperative hospitalization time of Group B was shorter than that of Group A and Group C, and the postoperative hospitalization time of Group A was shorter than that of Group C, with statistical significance (P<0.05). The total hospitalization expenses of Group B were lower than that of Group A and Group C. The total hospitalization cost of Group A was lower than that of Group C, and the difference was statistically significant (P<0.05). There were 8 cases of postoperative pain, 5 cases of fever, and 8 cases of cough. There were no complications such as abdominal compartment syndrome, bleeding, intestinal fistula, intestinal obstruction, mesh infection, and recurrence. There was no statistically significant difference in the incidence of postoperative pain, fever, and cough among the three groups of patients (P>0.05).

This study found that in the treatment of abdominal wall hernia with IPOM, several mesh fixation methods have their own characteristics. The operation and mesh fixation time in group A are short, but the cost is high. Group B had less damage, faster recovery and lower cost, but the time was longer than group A. Group C has no advantage in time and cost, but it is suitable for patients with large abdominal wall defects. Due to individual differences in patients, the optimal mesh fixation method should be selected individually and reasonably in clinical practice, in order to ensure surgical efficacy and improve patients' quality of life and satisfaction.