version1: Laparoscopic IPOM technique for DynaMesh® IPOM in 7 steps

DynaMesh®-IPOMStep 1.Step 2.Step 3.Step 4.Step 5.Step 6.Step 7.

Presented by the International IPOM Group (IIG)

Steps Description Animation OP-Video Expert Advice
1. Preparation of the patient/procedure Aus PPT Prof. Berger OK OK x
2. Access to the abdominal cavity Aus PPT Prof. Berger OK OK x
3. Placement of the trocars Aus PPT Prof. Berger x OK x
4. Adhesiolysis Aus PPT Prof. Berger OK OK x
5. Preparation and placement of the mesh Aus PPT Prof. Berger OK OK x
6. Closure of trocar access Aus PPT Prof. Berger x x x
7. Postoperative rehabilitation Aus PPT Prof. Berger x x x




The following literature is important for the laparoscopic IPOM technique:

General overview of incisional hernia Advantages of laparoscopic versus open
  1. Henriksen NA, Mortensen JH, Lorentzen L, et al. Abdominal wall hernias-A local manifestation of systemically impaired quality of the extracellular matrix. Surgery 2016; 160(1): 220-7.
  2. Henriksen NA. Systemic and local collagen turnover in hernia patients. Dan Med J 2016; 63(7):B5265.
  3. Helgstrand F. National results after ventral hernia repair. Dan Med J 2016; 63(7):B5258.



  1. Arita NA, Nguyen MT, Nguyen DH, et al. Laparoscopic repair reduces incidence of surgical site infections for all ventral hernias. Surg Endosc 2015; 29(7): 1769-80.
  2. Al Chalabi H, Larkin J, Mehigan B, McCormick P. A systematic review of laparoscopic versus open abdominal incisional hernia repair, with meta-analysis of randomized controlled trials. Int J Surg 2015; 20: 65-74.
  3. Sauerland S, Walgenbach M, Habermalz B, Seiler CM, Miserez M. Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst Rev 2011; (3): CD007781.

The following literature is important for the laparoscopic IPOM technique:

Importance and experiences with mesh material PVDF
  1. Baker JJ et al (2021) Reoperation for Recurrence is Affected by Type of Mesh in Laparoscopic Ventral Hernia Repair: A Nationwide Cohort Study. Ann Surg.
    includes data on primary ventral hernia (n = 416, FU: median 114 months) and incisional ventral hernia (n = 610, FU: median 110 months)
  2. Berger D, Bientzle M (2009) Polyvinylidene fluoride: a suitable mesh material for laparoscopic incisional and parastomal hernia repair! A prospective, observational study with 344 patients.
    Hernia 13:167–172.
    includes data on incisional ventral hernia (n = 297, FU: median 24 months) and parastomal hernia (n = 47, FU: median 20 months)
  3. Bertoglio C et al (2021) From keyhole to sandwich: change in laparoscopic repair of parastomal hernias at a single centre.
    Surg Endosc 35:1863–1871.
    includes data on parastomal hernia (n = 13, FU: median 26 months)
  4. Sánchez-Arteaga A et al (2021) Use of polyvinylidene fluoride (PVDF) meshes for ventral hernia repair in emergency surgery.
    Hernia 25:99–106.
    includes data on primary ventral hernia (n = 78, FU: 12 months) and incisional ventral hernia (n = 45, FU: 12 months)
  5. Muysoms F et al (2018) Prospective cohort study on mesh shrinkage measured with MRI after laparoscopic ventral hernia repair with an intraperitoneal iron oxide-loaded PVDF mesh.
    Surg Endosc 32:2822–2830.
    includes data on mesh shrinkage in primary ventral hernia (n = 14, FU: 13 months)
  6. Roberts DG (2012) Laparoscopic Intraperitoneal Onlay Repair of Abdominal Incisional and Ventral Hernias wth Polyvinylidene Fluoride-Coated Polypropylene Mesh; A Retrospective Study with Short to Medium Term Results.
    Science Journal of Clinical Medicine 1:10.
    includes data on primary and incisional ventral hernia (n = 40, FU: mean 15 months)
  7. Verbo A et al (2016) Polyvinylidene Fluoride Mesh (PVDF, DynaMesh®-IPOM) in The Laparoscopic Treatment of Incisional Hernia: A Prospective Comparative Trial versus Gore® ePTFE DUALMESH® Plus.
    Surg Technol Int 28:147–151
    includes data on incisional ventral hernia (n = 35, FU: > 6 months)
  8. Zhou Z, Bilkhu A, Anwar S (2017) The use of a composite synthetic mesh in the vicinity of bowel - For repair and prophylaxis of parastomal hernias. Does it increase the risk of short term infective  complications?
    Int J Surg 45:67–71. includes data on parastomal hernia (n = 20, FU: mean 27 months)

Step 1.:  Preparation of the patient

The following points should be considered during the preparation of the patient:

1.1 Possible epidural catheter for large hernias
1.2 Gastric tube – to avoid puncture of the stomach during air filling
1.3 Bladder catheter - safer pre-peritoneal preparation in the lower abdomen
1.4 Positioning of the patient - limited space with extended arm
1.5 Sufficient coverage - Adequate placement of trocars (up into the flank), especially if large meshes are required.
1.6 Marking of the hernia and the mesh (overlap of the defect and the original scar by at least 5 cm, better 7 cm) (in case of asymmetric hernias move the mesh and overlap far beyond the bones)


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