Comparison of the clinical effects of totally endoscopic sublay and intraperitoneal onlay mesh repair for midline ventral hernia treatment

doi:10.3877/cma.j.issn.1674-392X.2026.05.004

Abstract

Abstract:

Objective

To evaluate the clinical efficacy of totally endoscopic sublay (TES) and intraperitoneal onlay mesh (IPOM) for midline ventral hernia.

Methods

A retrospective analysis was conducted on the clinical data of patients diagnosed with midline ventral hernia who underwent either TES (25 cases) or IPOM (26 cases) at Guangzhou Huadu District People's Hospital from November 2018 to May 2025. Operative time, intraoperative blood loss, postoperative pain, hospital stay, complication rates, recurrence rates, total hospitalization costs, and surgical material expenses were compared between the two groups.

Results

The TES group demonstrated significantly lower total hospitalization costs [20 657.06 (19 267.34, 22 103.42) yuan vs 38 853.24 (37 657.86, 45 291.49) yuan, P<0.001] and surgical material expenses [8943.24 (7929.24, 9976.84) yuan vs 27 776.17 (26 270.58, 29 915.35) yuan, P<0.001] compared to the IPOM group. However, there were no significant differences in intraoperative blood loss, postoperative pain, hospital stay, complication rates, operation time or recurrence rates between the two groups (P>0.05).

Conclusion

TES is equally effective as IPOM for midline ventral hernia repair. It has lower total treatment costs and surgical material expenses, making it one of the preferable surgical option for treating midline ventral hernias.

Key words: Ventral hernia, Totally endoscopic sublay, Intraperitoneal onlay mesh, Clinical effects

Jianbin Huang, Qilin Chen, Hongsheng Wu, Shengmin Zhang. Comparison of the clinical effects of totally endoscopic sublay and intraperitoneal onlay mesh repair for midline ventral hernia treatment[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2026, 20(05): 501-505.

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Figures/Tables 4

References 21

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组别	例数	年龄(岁,±s)	身高(m,±s)	体重[kg,M(Q₁,Q₃)]	体重指数[kg/m²,M(Q₁,Q₃)]	性别[例(%)]		疝分类[例(%)]
组别	例数	年龄(岁,±s)	身高(m,±s)	体重[kg,M(Q₁,Q₃)]	体重指数[kg/m²,M(Q₁,Q₃)]	女性	男性	脐疝并白线疝	白线疝	脐疝
IPOM组	26	46.88±13.19	1.65±0.08	74.50(61.75, 83.75)	27.23(24.17, 28.97)	10(38.46)	16(61.54)	2(7.69)	2(7.69)	22(84.62)
TES组	25	43.92±9.89	1.65±0.08	72.00(64.00, 75.00)	26.22(23.66, 26.73)	7(28.00)	18(72.00)	0(0.00)	3(12.00)	22(88.00)
统计值		t=0.91	t=-0.42	Z=-1.01	Z=-1.72	χ²=0.63
P值		0.370	0.677	0.313	0.085	0.428		0.668^a
组别	例数	腹直肌分离[例(%)]	腹直肌分离面积[cm,M(Q₁,Q₃)]	疝缺损面积[cm²,M(Q₁,Q₃)]	补片大小[例(%)]
组别	例数	腹直肌分离[例(%)]	腹直肌分离面积[cm,M(Q₁,Q₃)]	疝缺损面积[cm²,M(Q₁,Q₃)]	15 cm×10 cm	15 cm×20 cm	15 cm×9 cm	15 cm×9 cm×2张
IPOM组	26	18(69.23)	24.00(18.00, 36.50)	4.00(2.25, 9.00)	22(84.62)	4(15.38)	0(0.00)	0(0.00)
TES组	25	21(84.00)	21.00(16.88, 45.75)	2.25(1.50, 5.00)	0(0.00)	0(0.00)	23(92.00)	2(8.00)
统计值		χ²=1.55	Z=-0.68	Z=-1.63
P值		0.214	0.500	0.103

组别	例数	年龄(岁,±s)	身高(m,±s)	体重[kg,M(Q₁,Q₃)]	体重指数[kg/m²,M(Q₁,Q₃)]	性别[例(%)]		疝分类[例(%)]
组别	例数	年龄(岁,±s)	身高(m,±s)	体重[kg,M(Q₁,Q₃)]	体重指数[kg/m²,M(Q₁,Q₃)]	女性	男性	脐疝并白线疝	白线疝	脐疝
IPOM组	26	46.88±13.19	1.65±0.08	74.50(61.75, 83.75)	27.23(24.17, 28.97)	10(38.46)	16(61.54)	2(7.69)	2(7.69)	22(84.62)
TES组	25	43.92±9.89	1.65±0.08	72.00(64.00, 75.00)	26.22(23.66, 26.73)	7(28.00)	18(72.00)	0(0.00)	3(12.00)	22(88.00)
统计值		t=0.91	t=-0.42	Z=-1.01	Z=-1.72	χ²=0.63
P值		0.370	0.677	0.313	0.085	0.428		0.668^a
组别	例数	腹直肌分离[例(%)]	腹直肌分离面积[cm,M(Q₁,Q₃)]	疝缺损面积[cm²,M(Q₁,Q₃)]	补片大小[例(%)]
组别	例数	腹直肌分离[例(%)]	腹直肌分离面积[cm,M(Q₁,Q₃)]	疝缺损面积[cm²,M(Q₁,Q₃)]	15 cm×10 cm	15 cm×20 cm	15 cm×9 cm	15 cm×9 cm×2张
IPOM组	26	18(69.23)	24.00(18.00, 36.50)	4.00(2.25, 9.00)	22(84.62)	4(15.38)	0(0.00)	0(0.00)
TES组	25	21(84.00)	21.00(16.88, 45.75)	2.25(1.50, 5.00)	0(0.00)	0(0.00)	23(92.00)	2(8.00)
统计值		χ²=1.55	Z=-0.68	Z=-1.63
P值		0.214	0.500	0.103

组别	例数	住院天数(d,±s)	住院总费用[元,M(Q₁,Q₃)]	耗材费用[元,M(Q₁,Q₃)]	手术时间(min,±s)
IPOM	26	4.54±1.94	38 853.24(37 657.86,45 291.49)	27 776.17(26 270.58,29 915.35)	164.88±76.81
TES	25	5.72±3.22	20 657.06(19 267.34,22 103.42)	8943.24(7929.24,9976.84)	155.92±45.09
统计值		t=-1.59	Z=-5.61	Z=-5.70	t=0.51
P值		0.118	<0.001	<0.001	0.615
组别	例数	出血量(ml,±s)	放置引流管[例(%)]	疼痛视觉模拟评分[例(%)]
组别	例数	出血量(ml,±s)	放置引流管[例(%)]	2分	3分	4分	6
IPOM	26	8.62±10.84	9(34.62)	19(73.08)	4(15.38)	2(7.69)	1(3.85)
TES	25	4.48±2.83	16(64.00)	18(72.00)	6(24.00)	1(4.00)	0(0.00)
统计值		t=1.85	χ²=4.40
P值		0.071	0.036	0.790^a

组别	例数	住院天数(d,±s)	住院总费用[元,M(Q₁,Q₃)]	耗材费用[元,M(Q₁,Q₃)]	手术时间(min,±s)
IPOM	26	4.54±1.94	38 853.24(37 657.86,45 291.49)	27 776.17(26 270.58,29 915.35)	164.88±76.81
TES	25	5.72±3.22	20 657.06(19 267.34,22 103.42)	8943.24(7929.24,9976.84)	155.92±45.09
统计值		t=-1.59	Z=-5.61	Z=-5.70	t=0.51
P值		0.118	<0.001	<0.001	0.615
组别	例数	出血量(ml,±s)	放置引流管[例(%)]	疼痛视觉模拟评分[例(%)]
组别	例数	出血量(ml,±s)	放置引流管[例(%)]	2分	3分	4分	6
IPOM	26	8.62±10.84	9(34.62)	19(73.08)	4(15.38)	2(7.69)	1(3.85)
TES	25	4.48±2.83	16(64.00)	18(72.00)	6(24.00)	1(4.00)	0(0.00)
统计值		t=1.85	χ²=4.40
P值		0.071	0.036	0.790^a

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