Proper mesh overlap is a key determinant in hernia recurrence following laparoscopic ventral and incisional hernia repair

Lately, incisional hernia repair (IHR) with onlay polypropylene mesh has been replaced by other surgical procedures. The aim of this study was to compare the complication and recurrence rate after onlay mesh repair and other surgical procedures for IHR. A retrospective cohort study of patients who underwent IHR in a single center was conducted. The data were obtained from electronic medical records. Patients who had been lost during follow-up were contacted for a visit in the clinic. Univariate and multivariate analysis was performed with Stata 13.0 to analyze the factors associated with postoperative complications and hernia recurrence. Between June 2004 and December 2015, 1078 patients underwent IHR in a single center. Onlay mesh repair was performed in 125 patients (11.6%). Other surgical procedures included Rives procedure (29.3%), sublay mesh repair (38.6%), intrabdominal mesh repair (17.1%), and primary closure (3.4%). After a mean follow-up of 2.8 years, 73 (7%) patients developed a recurrence. A higher percentage of complications were seen after onlay mesh repair than after other surgical procedures (22.4% vs 13.1%, P = 0.005). Nevertheless, recurrence was less frequent after onlay mesh repair (4.2% vs 7.1%, P = 0.241). Logistic regression discarded an association between onlay mesh repair and hernia recurrence or postoperative complications. Incisional hernia repair with onlay polypropylene mesh repair was not associated with a higher incidence of postoperative complications or recurrence rate. So, this procedure should not be discarded in selected patients presenting with incisional hernia.

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Two-year patient-related outcome measures (PROM) of primary ventral and incisional hernia repair using a novel three-dimensional composite polyester monofilament mesh: the SymCHro registry study

Hernia ◽

10.1007/s10029-019-01924-w ◽

2019 ◽

Vol 23 (4) ◽

pp. 767-781 ◽

Cited By ~ 1

Author(s):

J. F. Gillion ◽

◽

M. Lepere ◽

C. Barrat ◽

O. Cas ◽

...

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Outcome Measures ◽

Three Dimensional ◽

Incisional Hernia Repair ◽

Registry Study ◽

Patient Related Outcome ◽

Monofilament Mesh ◽

Ventral And Incisional Hernia ◽

Polyester Monofilament

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A new three-step hybrid approach is a safe procedure for incisional hernia: early experiences with a single centre retrospective cohort

Hernia ◽

10.1007/s10029-020-02300-9 ◽

2020 ◽

Author(s):

L. Matthijs van den Dop ◽

Gijs H. J. de Smet ◽

Michaël P. A. Bus ◽

Johan F. Lange ◽

Sascha M. P. Koch ◽

...

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Intraoperative Complications ◽

Operation Time ◽

Incisional Hernia Repair ◽

Hernia Recurrence ◽

Perioperative Outcomes ◽

Safe Procedure ◽

Intraoperative Complication ◽

Hybrid Repair

Abstract Purpose In this study, a three-step novel surgical technique was developed for incisional hernia, in which a laparoscopic procedure with a mini-laparotomy is combined: so-called ‘three-step incisional hybrid repair’. The aim of this study was to reduce the risk of intestinal lacerations during adhesiolysis and recurrence rate by better symmetrical overlap placement of the mesh. Objectives To evaluate first perioperative outcomes with this technique. Methods From 2016 to 2020, 70 patients (65.7% females) with an incisional hernia of > 2 and ≤ 10 cm underwent a elective three-step incisional hybrid repair in two non-academic hospitals performed by two surgeons specialised in abdominal wall surgery. Intra- and postoperative complications, operation time, hospitalisation time and hernia recurrence were assessed. Results Mean operation time was 100 min. Mean hernia size was 4.8 cm; 45 patients (64.3%) had a hernia of 1–5 cm, 25 patients (35.7%) of 6–10 cm. Eight patients had a grade 1 complication (11.4%), five patients a grade 2 (7.1%), two patients (2.8%) a grade 4 complication and one patient (1.4%) a grade 5 complication. Five patients had an intraoperative complication (7.0%), two enterotomies, one serosa injury, one omentum bleeding and one laceration of an epigastric vessel. Mean length of stay was 3.3 days. Four patients (5.6%) developed a hernia recurrence during a mean follow-up of 19.5 weeks. Conclusion A three-step hybrid incisional hernia repair is a safe alternative for incisional hernia repair. Intraoperative complications rate was low.

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