Mesh in Elective Hernia Repair: 10-Year Experience with over 6,000 Patients

Attaar, Mikhail; Forester, Beau; Chirayil, Sebastian; Su, Bailey; Wong, Harry J.; Kuchta, Kristine; Linn, John G.; Denham, Woody; Ujiki, Michael

doi:10.1016/j.jamcollsurg.2021.03.006

Cited by 6 publications

(3 citation statements)

References 41 publications

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“…На данный момент имеются данные и о возможности сокращения эндопротеза, которое может достигать 50 % от его изначального размера [14,15]. Такое изменение размера и миграция сетки могут вызвать рецидив даже в условиях эндопротезирования [16,17]. Противопоказанием к использованию аллотрансплантатов может быть индивидуальная непереносимость пациентом материала эндопротеза, а также указание на склонность к образованию рубцовой ткани [18].…”

Section: Introductionunclassified

Postoperative outcomes in patients after modified inguinal reconstruction: An observational cohort study

Lymar,

Stavtsev,

Supriyaga

et al. 2024

Kuban. nauсh. med. vestnik

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Background. Despite major progress in surgical care, the need remains to reduce the number of recurrences in the postoperative period in inguinal hernia patients and to improve their quality of life (QoL). To this end, the development of a technique for hernia repair, which would decrease dependence on the availability of consumables, appears promising. We present the surgical outcomes of inguinal hernia patients treated by the technique of tension-free hernioplasty using implants and auto-tissue flaps. Objective. To develop a technique for hernia repair with a reduced dependence on the availability of consumables, which could decrease the number of recurrences in the postoperative period in inguinal hernia patients and to improve their QoL indicators. Methods. An observational cohort study of 759 patients with inguinal hernias aged 18 years and older was conducted. The patients underwent treatment at the Ryazan City Clinical Hospital No. 11 and the Ryazan Region Clinical Hospital in the period from 2006 to 2022. The main group included 39 patients, who were operated by the Desarda technique modified by the authors. The modification consisted in the formation of a flap from the aponeurosis of the external oblique muscle, covering the seminal canal, with fixation of its free end to the inguinal ligament. The control group included 720 patients, 454 and 266 of whom were operated by the Bassini and Lichtenstein techniques, respectively. In order to evaluate the surgical outcomes, a comprehensive examination was performed, including collection of complaints, anamnesis, examination of the postoperative suture, and inguinal region. This included the size, shape, and hernia repairability, if any, dilation of the external inguinal ring, skin condition, painfulness and cough tremor at palpation, and ultrasound examination of the inguinal region. QoL was assessed using the SF-36 (Short Form) questionnaire. Statistical analysis was performed using the Statistica 13 software package (StatSoft, USA). Results. The patients of the main and control groups were divided into those who were admitted as planned and emergency patients. Long-term hernioplasty outcomes in the planned surgery patients were as follows: recurrences after the Desarda technique modified by the authors — 0 out of 24 (0.00%); recurrences after the Bassini technique — 44 out of 310 (14.20%); recurrences after the Lichtenstein technique — 7 out of 181 (3.87%). Long-term hernioplasty outcomes in the emergency patients were as follows: recurrences after the Desarda technique modified by the authors — 0 out of 15 (0,00%); recurrences after the Bassini technique — 31 out of 144 (21.53%); recurrences after the Lichtenstein technique — 4 out of 85 (4.70%). In the planned surgery patients of the main group, 5 QoL indicators were statistically significantly higher in relation to at least one method of hernioplasty of the control group. In the emergency patients, this number was 4 indicators. The absence of recurrences, both in planned and emergency patients, was associated with the non-invasiveness of auto-tissue, preserved non-tension, reduced dependence on the availability of consumables, and improved QoL of patients with inguinal hernias. These factors determine the advantages of the Desarda technique modification proposed by the authors. Conclusion. The application of the Desarda technique modified by the authors reduced the number of recurrences in the postoperative period in inguinal hernia in both planned surgery and emergency patients, improving their QoL. The suggested method of herniorrhaphy ensures reduced dependence on the availability of consumables.

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Section: Introductionunclassified

Postoperative outcomes in patients after modified inguinal reconstruction: An observational cohort study

Lymar,

Stavtsev,

Supriyaga

et al. 2024

Kuban. nauсh. med. vestnik

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“…[6][7][8] Meshes based on polypropylene, polyester, and other polymers offer notable benefits such as superior mechanical strength and resistance to deformation and are widely used in patients with uncontaminated abdominal wall defect. [9,10] However, ≈20% of patients diagnosed with abdominal wall defect experience complications related to local contamination, rendering them unable to utilize synthetic meshes due to severe foreign body reactions. [8,11] In recent decades, biological meshes have emerged as the preferred materials for repairing contaminated abdominal wall defect owing to their good tissue remodeling capabilities and ability The conventional approach involving the implantation of SIS mesh for addressing contaminated abdominal wall defect.…”

Section: Introductionmentioning

confidence: 99%

Double‐Layer Asymmetric Porous Mesh with Dynamic Mechanical Support Properties Enables Efficient Single‐Stage Repair of Contaminated Abdominal Wall Defect

Tang,

Miao,

Huang

et al. 2024

Advanced Materials

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Pollution tolerance and long‐term mechanical support are the two critical properties of meshes for contaminated abdominal wall defect repair. However, biological meshes with excellent pollution tolerance fail to provide bio‐adaptive long‐term mechanical support due to their rapid degradation. Here, a novel double‐layer asymmetric porous mesh (SIS/PVA‐EXO) is designed by simple and efficient in situ freeze‐thaw of sticky polyvinyl alcohol (PVA) solution on the loosely porous surface of small intestinal submucosal decellularized matrix (SIS), which can successfully repair the contaminated abdominal wall defect with bio‐adaptive dynamic mechanical support through only single‐stage surgery. The exosome‐loaded degradable loosely porous SIS layer accelerates the tissue healing, while the exosome‐loaded densely porous PVA layer can maintain long‐term mechanical support without any abdominal adhesion. In addition, the tensile strength and fracture strain of the SIS/PVA‐EXO mesh change gradually from 0.37 MPa and 210% to 0.10 MPa and 385% with the degradation of SIS layer. This unique performance can dynamically adapt to the variable mechanical demands during different periods of contaminated abdominal wall reconstruction. As a result, our SIS/PVA‐EXO mesh shows an attractive prospect in the treatment of contaminated abdominal wall defect without recurrence by integrating local immune regulation, tissue remodeling, and dynamic mechanical supporting.This article is protected by copyright. All rights reserved

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“…Estimated risk of developing IH throughout life is about 27% in men and 3% in women, with a frequency of 10–28 surgical procedures for every 100.000 patients 4 . Gold standard treatment for IH is surgical repair 5 .…”

Section: Introductionmentioning

confidence: 99%

Outcomes of 207 totally extraperitoneal hernia repairs using self-fixation mesh

Girón

Hernández

Linares

et al. 2021

Sci Rep

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Inguinal hernia (IH) repair is one of the most common procedures in general surgery around the world. Minimizing postoperative acute and chronic pain without increasing recurrence has been a critical point, giving place to different strategies like self-fixation mesh. The current study aimed to describe a group of patients who underwent IH repair by Totally Extraperitoneal (TEP) technique with self-gripping mesh at a fourth level hospital between 2012 and 2019. Retrospective review of a prospectively collected database including patients who underwent laparoscopic TEP approach with self-fixation mesh for IH repair. Follow up data was obtained at 12, 24, 36, 48, and 60 months post surgical intervention. 207 hernia repairs were performed in 142 patients, with a total of 66 patients with bilateral IH. 10.6% required hospitalization due to either concomitant procedure performed or cardiovascular comorbidities, with a mean hospital stay of 1.6 days. Median and late follow up was up to 5 years. 88.9% of patients complete a year, 86% two years, and 36.7% with a 5 year follow-up. IH repair using the TEP technique and self-fixation mesh showed to be an excellent approach, demonstrating satisfactory results in follow up and complications.

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Mesh in Elective Hernia Repair: 10-Year Experience with over 6,000 Patients

Cited by 6 publications

References 41 publications

Postoperative outcomes in patients after modified inguinal reconstruction: An observational cohort study

Postoperative outcomes in patients after modified inguinal reconstruction: An observational cohort study

Double‐Layer Asymmetric Porous Mesh with Dynamic Mechanical Support Properties Enables Efficient Single‐Stage Repair of Contaminated Abdominal Wall Defect

Outcomes of 207 totally extraperitoneal hernia repairs using self-fixation mesh

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