Are mesh anchoring sutures necessary in ventral hernioplasty? Multicenter study

Witkowski, Piotr; Abbonante, Francesco; Fedorov, Iu N; Śledziński, Zbigniew; Pejcic, V.; Slavin, L E; Adamonis, W.; Jovanovic, S; Śmietański, Maciej; Slavin, Daniela A; Trabucco, E. E.

doi:10.1007/s10029-007-0260-1

Cited by 13 publications

(4 citation statements)

References 8 publications

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“…The possible causes include irritation or damage of inguinal nerves by sutures or mesh inguinodynia, inflammatory reaction against the mesh, or simply scar tissue. 23 Some authors routinely divide the nerves if they are at risk of being incorporated within a nonabsorbable suture. This fear is taken care of by absorbable sutures.…”

Section: Discussionmentioning

confidence: 99%

Inguinal Hernia Repair using Prolene Hernia System – a Simplified Technique for Beginners

Mahajan¹,

Sharma²,

Gupta³

2020

IJCMR

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Introduction: Surgical repair of the inguinal hernia is the most common general surgery procedure performed today. Even today inguinal hernias pose a great burden on the healthcare system. Hence even modest improvements in clinical outcomes are warmly welcomed. This study describes the technique of Prolene Hernia System (PHS) in its simplified form for the beginners to learn it quickly. Material and methods: A prospective study was conducted in 50 patients in a tertiary centre from April 2010 to Oct 2011 for period of 18 months. Patients' demographic data was collected and patient selected as per the selection criteria. The PHS mesh repair was performed as described by Gilbert et al 3 with some simplification and modification as described. Absorbable sutures were used to fix the mesh in the described four stitch technique. All data collected from study were entered in the database for statistical analysis. Results: All participants were males and most of them were from manual labour background (38 patients (76%). Most of the patients belonged to 26-35 year age group (18 patients (36%). 40 participants were found to have indirect hernias (80%). Right sided hernia was found more common (33 patients (66%). The mean duration of surgery was 31.96 min (SD-2.303). Intraoperative complication included 2 cases of nerve damage (4%). The mean pain score in first 24 hours was 6.82/10 (SD-1.848). None of the patients reported recurrence of hernia (0% recurrence). Conclusion: The PHS mesh, consisting of an underlay patch, an overlay patch, and a joining connector, has potential benefits over the traditional Lichtenstein, Mesh Plug Repair (MPR) and Laparoscopic repairs. The PHS mesh provides complete coverage of the entire myopectineal orifice through the underlay placed in the preperitoneal space, the overlay placed in the inguinal canal and the connector which maintains the mesh in position. In our study we also found that use of absorbable sutures helped in relieving neuralgia and lessened chronic groin pain by causing less permanent nerve entrapment without affecting the recurrence rate.

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Section: Discussionmentioning

confidence: 99%

Inguinal Hernia Repair using Prolene Hernia System – a Simplified Technique for Beginners

Mahajan¹,

Sharma²,

Gupta³

2020

IJCMR

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“…Cuando no fue posible efectuar esta sutura sin tensión se procuró labrar un lecho omental y/o se instaló un parche de Vicryl ® . La malla se colocó extendiéndola sobre la hoja posterior de la vaina del recto, entre sus diedros laterales, evitando pliegues, sin fijación lateral (Figura 3), como ha sido recomendado por Wantz y por Witkowsky 29,18 . Para colocar la malla hacia proximal y distal (cefálico y caudal), ésta se incidió, en ambos extremos produciendo dos lengüetas de unos 7 cm de largo que se introdujeron bajo el músculo recto a ambos lados (Figura 4).…”

Section: Técnica Quirúrgicaunclassified

“…Él prescindió de la fijación y continuó haciéndolo durante todo su ejercicio profesional, quedando pendientes sus resultados a largo plazo por su fallecimiento. Witkowski, más recientemente 18 , realizó un estudio multicéntri-co poniendo a prueba la técnica de Rives sin fijación perimetral. Obtuvo buenos resultados, sin embargo, su seguimiento es también a corto plazo (Tabla 3).…”

Section: Comentariounclassified

“…La recurrencia de las eventraciones intervenidas con la técnica estándar de Rives-Stoppa se sitúa entre el 5 y el 10% en seguimientos a un plazo mayor a 5 años y si bien factores metabólicos influyen en estas tasas de recurrencia 16 , el hecho que se localicen predominantemente en la línea media, en posición cefálica o caudal respeto a la plastía, hace necesario considerar también factores técnicos [17][18][19][20][21][22] . La retracción que sufren las mallas de Prolene en su proceso de integración a los tejidos es considerable 23,24 , por lo que el solapamiento de la malla pasa a ser un elemento central de la técnica 25,26 .…”

Section: Introductionunclassified

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Técnica De Rives-Stoppa en Las Eventraciones De La Línea Media: Prescindencia De La Fijación Perimetral De La Malla

2014

Rev Chil Cir

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Rives-Stoppa repair without mesh fixation for midline incisional hernias. Long term follow upBackground: The Rives-Stoppa technique for midline incisional hernias places a Mersilene mesh in the retro rectal space, which is kept in place with transcutaneous sutures. Other forms of fixation have been proposed. Aim: To assess the long term results of the surgical technique without fixation of the mesh. Material and Methods: An observational, descriptive, prospective study performed in 64 patients aged 26 to 85 years (48 women) consecutively operated between 1995 and 2002. The standard Rives-Stoppa technique was used, except for the usage of a Prolene mesh without fixation. Ambulation was started on the first postoperative day and patients were discharged after removal of drains. Results: Eighty percent of patients were obese, 25% had high blood pressure and 9% were diabetic. Patients were discharged at a median of four (range two-16) days after surgery. Four superficial infections, one case of thromboembolic disease, one case of prolonged ileus and two pulmonary infections were recorded as complications. A long term follow-up was carried out in 48 patients (75%). Five patients had small recurrences (10%), localized at the cephalic or caudal borders of the mesh, and six patients (13%) reported slight abdominal pain. In spite of recurrences, 97% of patients were satisfied or very satisfied with the treatment. Conclusions: These results are similar to those obtained using mesh fixation. Increasing distal and proximal mesh overlap should enhance these results.

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Technische Prinzipien der Narbenhernienchirurgie

Dietz

Muysoms

Germer

et al. 2016

Chirurg

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Many publications are available on the best surgical techniques and treatment of incisional hernias with reports of experiences and randomized clinical studies at the two extremes of the evidence scale. The ultimate proof of the best operative technique has, however, not yet been achieved. In practically no other field of surgery are the variability and the resulting potential aims of surgery so great. The aim of surgery is to provide patients with the optimal recommendation out of a catalogue of possibilities from a holistic perspective. This article describes the surgical techniques using meshes for strengthening (in combination with an anatomical reconstruction) and for replacement of the abdominal wall (with bridging of the defect).

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Are mesh anchoring sutures necessary in ventral hernioplasty? Multicenter study

Abstract: Results of the study suggest that the sutureless sublay technique is safe and effective in the treatment of ventral abdominal hernia, especially in small and medium defects.

Cited by 13 publications

References 8 publications

Inguinal Hernia Repair using Prolene Hernia System – a Simplified Technique for Beginners

Inguinal Hernia Repair using Prolene Hernia System – a Simplified Technique for Beginners

Técnica De Rives-Stoppa en Las Eventraciones De La Línea Media: Prescindencia De La Fijación Perimetral De La Malla

Technische Prinzipien der Narbenhernienchirurgie

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