clinical and functional outcomes after laparoscopic IPOM repair. a comparison between hybrid biosynthetic and concetional meshes

Background: Laparoscopic IPOM repair is widely used for ventral hernia treatment. Hybrid biosynthetic meshes have been developed to improve tissue integration and functional recovery; however, comparative clinical evidence remains limited. Methods: This was a single-center retrospective study conducted at a tertiary care institution between 2020 and 2025 including 95 consecutive patients undergoing laparoscopic IPOM repair. Forty-two patients received a hybrid biosynthetic mesh (SINECOR®) and 53 a conventional synthetic mesh. Demographic, clinical and surgical variables were analyzed, including defect size, mesh surface, operative time, complications, length of stay, functional and occupational recovery time, and quality of life (EuraHS-QoL). Hernia defects were classified as small (≤ 20 cm²), medium (21–100 cm²) and large (> 100 cm²). Mesh size was categorized as small (≤ 150 cm²), medium (151–400 cm²) and large (> 400 cm²). Delayed functional recovery was defined as occupational recovery > 30 days. Multivariable logistic regression was performed to identify independent predictors of delayed recovery; covariates included age > 65 years, BMI > 30 kg/m², defect size > 100 cm², mesh surface and mesh type (hybrid vs. conventional). Results: Groups were comparable in BMI (25.8 vs. 25.8 kg/m², p = 0.92), whereas patients in the hybrid group tended to be slightly older (63 vs. 58.5 years, p = 0.08). Follow-up was significantly longer in the control group (46.9 vs. 20.4 months, p < 0.001). No large defects (> 100 cm²) were observed in the hybrid mesh group, while they accounted for about one third of cases in the control group. Despite this imbalance, mean mesh surface did not differ significantly between groups (200.7 vs. 255.9 cm², p = 0.11). Hybrid mesh was associated with significantly shorter operative time (52.3 vs. 79.7 min, p < 0.001), reduced length of stay (2.0 vs. 2.8 days, p = 0.001), faster functional recovery (return to physical activity 10.5 vs. 13.5 days, p = 0.004; return to work 17.0 vs. 25.1 days, p < 0.001), and higher EuraHS-QoL scores (90.2 vs. 80.1, p < 0.001). Overall postoperative complication rates and seroma occurrence were comparable between groups. Recurrence was less frequent in the hybrid group (2.4% vs. 20.8%, p = 0.01) in the context of markedly shorter follow-up. On multivariable analysis, use of hybrid biosynthetic mesh remained the only independent predictor of faster functional recovery (OR 0.09; 95% CI 0.01–0.77; p = 0.028), with acceptable model calibration (Hosmer–Lemeshow p = 0.51; AUC = 0.73).