Prospective, multicenter study of laparoscopic ventral hernioplasty

Toy, Frederick K.; Bailey, Robert W.; Carey, S.; Chappuis, C; Gautier, Michel; Josephs, Leon G.; Mangiante, Eugene C.; Park, A. E.; Pomp, Alfons; Smoot, Roy T.; Uddo, Joseph; Voeller, Guy

doi:10.1007/s004649900755

Cited by 209 publications

(107 citation statements)

References 16 publications

(18 reference statements)

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“…A lower incidence of postoperative seromas, hematomas, infections and other related complications is observed after laparoscopic paraumbilical hernia repair as compared with open repair surgery. The recurrence rate accounts for 8-10% in this patient group 12,13 . However, not all paraumbilical hernias need laparoscopic repair.…”

Section: Discussionmentioning

confidence: 74%

Factors Indicative of Recurrence Paraumbilical Hernia: Experience at a Tertiary Care Hospital in Dhaka City

Khalil¹,

Saha²,

Islam³

et al. 2018

J Curr Adv Med Res

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Background: Paraumbilical hernia has gained little attention from surgeons in comparison with other types of abdominal wall hernias (inguinal, postoperative); however, the primary suture for paraumbilical hernia is associated with a recurrence rate of 19.0 to 54.0%. Objective: The aim of this study was to analyze the results of the paraumbilical hernia repair and to assess the independent risk factors influencing paraumbilical hernia recurrence. Methodology: A retrospective analysis of patients who underwent surgery for paraumbilical hernia in the department of surgery, Dhaka Medical College Hospital from 2012 to 2015 was performed. Age, sex, hospital stay, hernia size, patient's body mass index, and postoperative complications were analyzed. Postoperative evaluation included pain and discomfort in the abdomen and hernia recurrence rate. Hernia recurrence was diagnosed during the patients' visit to a surgeon. Two surgical methods were used to repair paraumbilical hernia: open suture repair technique (keel technique) and open mesh repair technique (onlay technique). Every operation was chosen individually by the surgeon. Results: Ninety-seven patients (31 males and 66 females) with paraumbilical hernia were examined. The rate of postoperative complications was 5.2%. The complete patient's recovery time after surgery was 2.4±3.4 months. Fourteen patients (20.9%) complained of pain or discomfort in the abdomen, and 7(10.4%) patients had ligature fistula after the surgery. Forty-five patients (67.2%) did not have any complaints after surgery. The recurrence rate after paraumbilical hernia repair was 8.9%. The recurrence rate was higher when hernia size was >2cm (9% for <2 cm vs 10.5% for >2 cm) and patient's BMI was >30 kg/m 2 (8.6% for <30 vs 10.7% for >30). Conclusion: In conclusion significant independent risk factors are found for paraumbilical hernia recurrence.

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Section: Discussionmentioning

confidence: 74%

Factors Indicative of Recurrence Paraumbilical Hernia: Experience at a Tertiary Care Hospital in Dhaka City

Khalil¹,

Saha²,

Islam³

et al. 2018

J Curr Adv Med Res

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“…Postoperative hematoma was reported in 3, 2 and 1 patient in studies of Heniford et al with 407 patients [4], Toy et al with 144 patients [20] and Carbajo et al with 30 patients [16]. Taker and suture passer need to be applied with great care during mesh fixation after determining vessel traces particularly to avoid epigastric vessel injury.…”

Section: Discussionmentioning

confidence: 99%

Incisional Hernia Repair: Laparoscopic or Open? A Randomized Clinical Trial

Erturk

2013

J Curr Surg

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“…This mesh is composed of 2 layers of ePTFE with different surface characteristics; one layer has a "smooth," nonporous surface to be placed against the viscera to limit adhesions and the other has a "rough" surface with large interstices in the material (22 µm) to encourage tissue ingrowth. DualMesh has so far been used in more than 1000 laparoscopic ventral and incisional hernia repairs, 11,26,27,31,32 with good results with respect to recurrences and complications. The current study of 65 reoperations supports the assumption that no or minimal adhesions result from the use of DualMesh in such procedures.…”

Section: Discussionmentioning

confidence: 99%

Minimal adhesions to ePTFE mesh after laparoscopic ventral incisional hernia repair: reoperative findings in 65 cases

et al. 2003

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Objectives: Laparoscopic ventral incisional hernia repair involves intraabdominal placement of a synthetic mesh, and the possibility of formation of severe visceral adhesions to the prosthesis is a principal concern. Little clinical information based on reoperative findings is available about adhesions to biomaterials placed intraabdominally. We conducted a multiinstitutional study of adhesions to implanted expanded polytetrafluoroethylene (ePTFE) mesh at reoperation in patients who had previously undergone laparoscopic incisional hernia repair done with the same mesh implantation technique. Methods:Nine surgeons retrospectively assessed the severity of adhesions to ePTFE mesh at reoperation in 65 patients. For each case, adhesions were assigned a score of 0 to 3, with 0 indicating no adhesions and 3 severe adhesions. Results:The mean time from mesh implantation to reoperation was 420 days (range, 2 to 1739 days). No adhesions were observed in 15 cases. Forty-four cases received an adhesion score of 1, and 6 cases a score of 2; no scores of 3 were assigned. Thus, 59 patients (91%) had either no or filmy, avascular adhesions. No enterotomies occurred during adhesiolysis. Conclusions:In this large series of reoperations after laparoscopic incisional hernia repair, no or minimal formation of adhesions to implanted ePTFE mesh was observed in 91% of cases, and no severe cohesive adhesions were found. Comparative analyses of newer mate- INTRODUCTIONThe need for reinforcement of the abdominal wall by implantation of synthetic materials during repair of abdominal incisional hernias is well established. [1][2][3][4] Moreover, because early use of various biomaterials in ventral incisional hernia repair resulted in some serious complications, including fistulization due to adhesions, 5-7 it is clear that avoiding contact between the mesh and viscera is desirable. 2,3,8,9 In laparoscopic incisional herniorrhaphy, however, first described by LeBlanc and Booth in 1993, 10 placement of the mesh in the intraabdominal position is necessary. Thus, this procedure requires a biomaterial that provides both adequate strength and a minimal risk of severe adhesion formation that could result in bowel obstruction or fistula development.Numerous studies of the formation of adhesions to biomaterials placed intraabdominally have been conducted in animals, but few investigations of this issue have been based on information obtained at reoperation in patients. Moreover, no large study has examined reoperative observations pertaining to adhesions to a biomaterial after laparoscopic incisional hernia repair specifically. Therefore, we conducted a retrospective review of findings at reoperation in patients who had undergone such a repair and in whom a 1-mm-thick expanded polytetrafluoroethylene (ePTFE) dual-surface mesh (DualMesh, W.L. Gore & Associates, Flagstaff, AZ) had been implanted during the repair. METHODS Records

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Prospective, multicenter study of laparoscopic ventral hernioplasty

Cited by 209 publications

References 16 publications

Factors Indicative of Recurrence Paraumbilical Hernia: Experience at a Tertiary Care Hospital in Dhaka City

Factors Indicative of Recurrence Paraumbilical Hernia: Experience at a Tertiary Care Hospital in Dhaka City

Incisional Hernia Repair: Laparoscopic or Open? A Randomized Clinical Trial

Minimal adhesions to ePTFE mesh after laparoscopic ventral incisional hernia repair: reoperative findings in 65 cases

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