Early Clinical and Patient-Reported Outcomes of a New Hybrid Mesh for Incisional Hernia Repair

Rios-Diaz, Arturo J.; Hitchner, Michaela; Christopher, Adrienne N.; Broach, Robyn B.; Cunning, Jessica R.; Fischer, John P.

doi:10.1016/j.jss.2021.03.030

Cited by 9 publications

(8 citation statements)

References 28 publications

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“…With a median follow-up period of two years, Rios-Diaz et al did not record any hernia recurrence in patients undergoing incisional hernia repair. 9 This finding was consolidated by a study we have previously published, where no recurrence, nor surgical site infections were noted. 8 …”

Section: Discussionmentioning

confidence: 51%

“…On the other hand, hybrid meshes have offered low recurrence rates with an excellent safety profile in high-risk patients. 8 , 9 , 21 Therefore, this study focused on evaluating the clinical outcomes of hybrid material in contrast to synthetic meshes in patients undergoing rRS VHR.…”

Section: Discussionmentioning

confidence: 99%

“…Gore & Associates Inc., Newark, DE, USA) (Synecor TM Pre), a biosynthetic mesh, has been suggested to provide favorable midterm outcomes in high-risk patients. 8 , 9 It is composed of three layers: a monofilament polytetrafluoroethylene (PTFE) layer inserted between two bioabsorbable layers.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Hybrid Versus Synthetic Mesh in Robotic Rives-Stoppa Ventral Hernia Repair

Kudsi

Kaoukabani

Bou‐Ayash

et al. 2022

JSLS

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

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Comparison of Hybrid Versus Synthetic Mesh in Robotic Rives-Stoppa Ventral Hernia Repair

Kudsi

Kaoukabani

Bou‐Ayash

et al. 2022

JSLS

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“…Given that prior IHRWM was associated with increased postoperative surgical complications and reoperations, it is not surprising to observe a successive increased hospital length of stay, hospital charges, and unplanned readmissions. Therefore, our results suggest that the decreased IH recurrence benefit conferred by prosthetic reinforcement of the abdominal wall may be further counterbalanced not only by mesh-related complications after IHR but by the aforementioned adverse outcomes and increased longitudinal health care utilization at the time of a future abdominal surgical procedure. Furthermore, recurrence as the main clinical parameter of IHR success fails to encompass other patient-centered measures and exposes the need for routine incorporation of long-term patient-reported outcomes, which have been shown to have a devastating effect on quality of life when they occur .…”

Section: Discussionmentioning

confidence: 87%

Reoperation Through a Prosthetic-Reinforced Abdominal Wall and Its Association With Postoperative Outcomes and Longitudinal Health Care Utilization

et al. 2022

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ImportanceProsthetic reinforcement of critically sized incisional hernias is necessary to decrease hernia recurrence, but long-term prosthetic-mesh footprint may increase complication risk during subsequent abdominal operations.ObjectiveTo investigate the association of prior incisional hernia repair with mesh (IHRWM) with postoperative outcomes and health care utilization after common abdominal operations.Design, Setting, and ParticipantsThis was a population-based, retrospective cohort study of patients undergoing inpatient abdominal surgical procedures during the period of January 2009 to December 2016, with at least 1 year of follow-up within 5 geographically diverse statewide inpatient/ambulatory databases (Florida, Iowa, Nebraska, New York, Utah). History of an abdominal operation was ascertained within the 3-year period preceding the index operation. Patients admitted to the hospital with a history of an abdominal operation (ie, bariatric, cholecystectomy, small- or large-bowel resection, prostatectomy, gynecologic) were identified using the International Classification of Diseases, Ninth Revision and Tenth Revision, Clinical Modification procedure codes. Patients with prior IHRWM were propensity score matched (1:1) to controls both with and without a history of an abdominal surgical procedure based on clinical and operative characteristics. Data analysis was conducted from March 1 to November 27, 2021.Main Outcomes and MeasuresThe primary outcome was a composite of adverse postoperative outcomes (surgical and nonsurgical). Secondary outcomes included health care utilization determined by length of hospital stay, hospital charges, and 1-year readmissions. Logistic and Cox regression determined the association of prior IHRWM with the outcomes of interest. Additional subanalyses matched and compared patients with prior IHR without mesh (IHRWOM) to those with a history of an abdominal operation.ResultsOf the 914 105 patients undergoing common abdominal surgical procedures (81 123 bariatric [8.9%], 284 450 small- or large-bowel resection [31.1%], 223 768 cholecystectomy [24.5%], 33 183 prostatectomy [3.6%], and 291 581 gynecologic [31.9%]), all 3517 patients (age group: 46-55 years, 1547 [44.0%]; 2396 majority sex [68.1%]) with prior IHRWM were matched to patients without a history of abdominal surgical procedures. After matching, prior IHRWM was associated with increased overall complications (odds ratio [OR], 1.43; 95% CI, 1.27-1.60), surgical complications (OR, 1.51; 95% CI, 1.34-1.70), length of hospital stay (mean increase of 1.03 days; 95% CI, 0.56-1.49 days; P &lt; .001), index admission charges (predicted mean difference of $11 896.10; 95% CI, $6096.80-$17 695.40; P &lt; .001), and 1-year unplanned readmissions (hazard ratio, 1.14; 95% CI, 1.05-1.25; P = .002). This trend persisted even when comparing matched patients with prior IHRWM to patients with a history of abdominal surgical procedures, and the treatment outcome disappeared when comparing patients with prior IHRWOM to those without a previous abdominal operation.Conclusions and RelevanceReoperation through a previously prosthetic-reinforced abdominal wall was associated with increased surgical complications and health care utilization. This risk appeared to be independent of a history of abdominal surgical procedures and was magnified by the presence of a prosthetic-mesh footprint in the abdominal wall.

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“…On the other hand, the main goal of posterior component separation or transversus abdominis release (TAR) is to access the posterior rectus sheath by developing the retromuscular space from the medial rectus into the space between the transversus abdominis and internal oblique [ 15 , 16 ]. This technique allows for the placement of the mesh sublay above the posterior fascial layer and the internal oblique muscle [ 16 , 17 ]. The TAR technique is the best option for large hernias due to the preservation of the neurovascular bundles innervating the medial abdominal wall and its versatility and durability in abdominal wall reconstruction [ 8 , 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Component Separation: A Case Report of Hybrid and Synthetic Absorbable Mesh Use for Complex Large Ventral Hernia Reparation

Bafitis¹,

Arboleda²,

Bernal³

2023

Cureus

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Ventral abdominal hernias are a common abdominal wall defect in the United States. We present a 50-yearold Caucasian male with a large (>18 cm) abdominal wall defect. An extensive complex abdominal wall reconstruction with advanced bilateral fascial flaps/component separation and repair of the abdominal wall defect was planned to restore the appropriate abdominal wall anatomic contour. The use of double mesh in large abdominal wall defects is still a relatively new documented technique. Only two case series detail the same technique used on this patient, with no articles on using a hybrid mesh with a synthetic absorbable mesh. This case uses an underlay and onlay mesh technique, with a hybrid mesh, Tela Biologics (Malvern, PA, USA), under the muscle, in this case, intraperitoneal bridging the gap. The anterior rectus sheath was reinforced with intercepted 0-Ethibond sutures (Ethicon/J&J, Bridgewater, NJ, USA) and then reinforced with a synthetic absorbable mesh (Phasix TM , Becton Dickinson, Franklin Lakes, NJ). The outcome with this patient shows more research should be conducted on considering long-term results with the types of mesh and the question of whether there are additional benefits when using two different types of mesh and their placement in the sandwich technique.

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Early Clinical and Patient-Reported Outcomes of a New Hybrid Mesh for Incisional Hernia Repair

Cited by 9 publications

References 28 publications

Comparison of Hybrid Versus Synthetic Mesh in Robotic Rives-Stoppa Ventral Hernia Repair

Comparison of Hybrid Versus Synthetic Mesh in Robotic Rives-Stoppa Ventral Hernia Repair

Reoperation Through a Prosthetic-Reinforced Abdominal Wall and Its Association With Postoperative Outcomes and Longitudinal Health Care Utilization

Component Separation: A Case Report of Hybrid and Synthetic Absorbable Mesh Use for Complex Large Ventral Hernia Reparation

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