Comparison of Follow-Up Methods for Long-Term Patient Reported Outcomes after Ventral Hernia Repair

Background: Laparoscopic Incisional and Ventral Hernia Repair (LIVHR) is a safe and worldwide accepted procedure performed using absorbable tacks. The aim of the study was to evaluate recurrence rate in a long term follow-up and whether the results of laparoscopic IVH repair in the elderly (≥65 years old) are different with respect to results obtained in younger patients. Methods: One hundred and twenty-nine consecutive patients (74 women and 55 men, median age 67 years, range = 30-87 years) with ventral (N = 42, 32.5%) or post incisional (N = 87, 67.5%) hernia were enrolled in the study. Patients were divided into two groups according to their age: group A (N = 55, 42.6%) aged <65 years and group B (N = 74, 57.4%) aged ≥65 years. Results: The mean operative time was not significantly different between groups (66.7 ± 37 vs. 74 ± 48.4 min, p = 0.4). To the end of 2016, seven recurrences had occurred (group A = 3, group B = 4, p = 1). Complications occurred in 8 (16%) patients in group A and 21 (28.3%) patients in group B. Conclusion: In conclusion, our results confirm that the use of absorbable tacks does not increase recurrence frequency and laparoscopic incisional and ventral repair is a safety procedure also in elderly patients.

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Long term outcome and elasticity of a polyester mesh used for laparoscopic ventral hernia repair

Hernia ◽

10.1007/s10029-021-02486-6 ◽

2021 ◽

Author(s):

P. J. O’Dwyer ◽

C. Chew ◽

H. Qandeel

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Laparoscopic Repair ◽

Ventral Hernia Repair ◽

Laparoscopic Ventral Hernia Repair ◽

Ct Scans ◽

Unique Problem ◽

Polyester Mesh

Abstract Background Repair of a ventral hernia is increasingly being performed by a laparoscopic approach despite lack of good long term follow up data on outcomes. The aim of this study was to examine the long term performance of a polyester mesh and to assess its elastic properties in patients undergoing laparoscopic ventral hernia repair. Methods All patients being assessed for a ventral hernia repair between August 2011 and November 2013 were placed on a prospective database. Those undergoing laparoscopic repair with a polyester mesh were seen at clinic at one month and one year, while their electronic records were assessed at 34 months (range 24–48 months) and 104 months (range 92–116 months). In addition, CT scans of the abdomen and pelvis performed for any reason on these patients during the follow up period were reviewed by a consultant gastrointestinal radiologist. Mechanical failure testing of the mesh was also performed. Results Thirty-two of the 100 patients assessed for ventral hernia repair had a laparoscopic repair with a polyester mesh. Nineteen (59%) had CT scans performed during the follow-up period. No recurrence was recorded at 34 months, while three (9.4%) had a recurrence at 104 months. Two had central breakdown of the mesh at 81 and 90 months, while 1 presented acutely at 116 months after operation. Mesh had stretched across the defect by an average of 21% (range 5.7–40%) in nine patients. Mechanical testing showed that this mesh lost its elasticity at low forces ranging between 1.8 and 3.2 N/cm. Conclusion This study shows that late recurrence is a problem following laparoscopic ventral hernia repair with polyester mesh. The mesh loses it elasticity at a low force. This combined with degradation of mesh seems the most likely cause of failure. This is unlikely to be a unique problem of polyester mesh and further long-term studies are required to better assess this operative approach to ventral hernia repair.

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Patient-Reported Outcomes Following Ventral Hernia Repair: Designing a Qualitative Assessment Tool

The Patient: Patient-Centered Outcomes Research ◽

10.1007/s40271-017-0275-3 ◽

2017 ◽

Vol 11 (2) ◽

pp. 225-234 ◽

Cited By ~ 2

Author(s):

Martin J. Carney ◽

Kate E. Golden ◽

Jason M. Weissler ◽

Michael A. Lanni ◽

Andrew R. Bauder ◽

...

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Patient Reported Outcomes ◽

Ventral Hernia Repair ◽

Assessment Tool ◽

Qualitative Assessment ◽

Patient Reported

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Long-Term Outcomes of Ventral Hernia Repair: An 11-Year Follow-Up

Cureus ◽

10.7759/cureus.9523 ◽

2020 ◽

Author(s):

Nikita Kadakia ◽

Ross Mudgway ◽

Jonathan Vo ◽

Vinson Vong ◽

Tiffany Seto ◽

...

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Long Term Outcomes

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Patient-Reported Outcomes of Robotic vs Laparoscopic Ventral Hernia Repair With Intraperitoneal Mesh

JAMA Surgery ◽

10.1001/jamasurg.2020.4569 ◽

2020 ◽

Cited By ~ 1

Author(s):

Clayton C. Petro ◽

Sam Zolin ◽

David Krpata ◽

Hemasat Alkhatib ◽

Chao Tu ◽

...

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Patient Reported Outcomes ◽

Ventral Hernia Repair ◽

Laparoscopic Ventral Hernia Repair ◽

Intraperitoneal Mesh ◽

Patient Reported

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A Prospective, Single Arm, Multi-Center Study Evaluating the Clinical Outcomes of Ventral Hernias Treated with OviTex® 1S Permanent Reinforced Tissue Matrix: The BRAVO Study 12-Month Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10214998 ◽

2021 ◽

Vol 10 (21) ◽

pp. 4998

Author(s):

George DeNoto ◽

Eugene P. Ceppa ◽

Salvatore J. Pacella ◽

Michael Sawyer ◽

Geoffrey Slayden ◽

...

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Hernia Recurrence ◽

Patient Reported ◽

Multi Center Study ◽

Tissue Matrix ◽

Ventral Hernias ◽

Center Study

Background: Conflicting results from previous studies have led to dissent over whether surgical mesh is safe and effective in ventral hernia repair. A newer class of mesh known as a reinforced tissue matrix, combining a biologic scaffold and minimal polymer reinforcement, offers promise in reducing inflammatory response and increasing abdominal wall support. This study sought to assess the clinical utility of a reinforced tissue matrix (OviTex) in ventral hernia repair 12 months after implantation. Methods: This is a prospective, single-arm, multi-center study to evaluate the clinical performance of OviTex® 1S Permanent (OviTex) in the repair of primary or recurrent ventral hernias (VH) in consecutive patients (ClinicalTrials.gov/NCT03074474). The rate of surgical site occurrences (SSOs) was evaluated 90 days post-surgery as the primary endpoint. Hernia recurrence and the incidence of postoperative events were evaluated between three and 12 months as secondary endpoints. The incidence of other complications and patient-reported outcomes were also recorded. Results: Ninety-two (92) patients were enrolled in the study, of whom seventy-six (76) reached the 12-month follow-up. All patients were at least 18 years of age with a BMI of <40 kg/m2. Hernia defects were <20 × 20 cm, classified as class I–III according to the CDC wound classification system. Of the 76 patients who reached 12-month follow-up, twenty-six (34%) had previous VH repairs and thirteen (17%) had previous surgical infection. Sixty (79%) had factors known to increase the risk of recurrence. Twenty patients (26%) experienced SSOs, with ten (13%) requiring procedural intervention. Two of the 75 patients (2.7%) experienced a recurrence. Conclusions: The low rate of hernia recurrence and SSOs requiring intervention illustrates the potential that reinforced tissue matrices, and OviTex 1S, in particular, have to improve outcomes in VH repairs. Follow-up to 24 months is ongoing.

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P089 THE IMPACT OF VENTRAL HERNIA REPAIR ON PATIENT-REPORTED QUALITY OF LIFE: IDENTIFYING FACTORS ASSOCIATED WITH IMPROVEMENT

British Journal of Surgery ◽

10.1093/bjs/znab395.083 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Martin Morris ◽

Viren Patel ◽

Adrienne Christopher ◽

Robyn Broach ◽

John Fischer

Keyword(s):

Quality Of Life ◽

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Abdominal Hernia ◽

Factors Associated ◽

Patient Reported ◽

The Impact

Abstract Aim Assessing pre- and postoperative quality of life (QoL) is essential to quantify the magnitude of improvement in disease burden after ventral hernia repair (VHR). Here, we identify patient and operative factors associated with QoL improvement after VHR. Material and Methods Patients that underwent VHR by a single surgeon were retrospectively identified and included if they had minimum 1 year of follow-up, and completed pre- and postoperative Abdominal Hernia-Q (AHQ) questionnaires. Patients were divided into quintiles based on absolute pre- to postoperative improvement in AHQ score. Chi-squared and fisher’s exact tests were used for categorical data, and Student’s t-test for continuous data, as appropriate. Results Compared to the lowest quintile (n = 27, follow-up 32.6 months, mean improvement 3.24 [SD 10.4]), patients in the highest quintile (n = 26, follow up 23.9 months, mean improvement 66.3 [SD 12.1]) were female (76.9% vs 37.0%, p = 0.005) with a greater number of previous hernia repairs (mean 2.12 vs. 0.78, p < 0.005) and previous abdominal surgeries (mean 4.0 vs 2.0, p < 0.001). Patients with greater improvement also had higher incidences of delayed healing (42.3% vs 7.41%), required more office visits (5.54 vs 3.89), and had higher inpatient costs ($30,084 USD vs. $16,886, all p < 0.05). No significant differences were seen in terms of race, ethnicity, body mass index, age, length of stay, Clavien-Dindo scores, hernia recurrence, or other postoperative complications. Conclusions Despite increased preoperative risk and healthcare burden, some of the most significant QoL improvement after VHR is demonstrated in patients with complex repairs and recoveries. This indicates the global utility of VHR regardless of patient demographics and complicating perioperative factors.

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Ventral Hernia Repair: Outcomes Change with Long-Term Follow-Up

JSLS Journal of the Society of Laparoendoscopic Surgeons ◽

10.4293/108680812x13427982377067 ◽

2012 ◽

Vol 16 (3) ◽

pp. 373-379 ◽

Cited By ~ 19

Author(s):

Vikas Singhal ◽

Patrick Szeto ◽

Thomas J. VanderMeer ◽

Burt Cagir

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Long Term Follow Up

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P090 LONG-TERM OUTCOMES FOLLOWING HYBRID BIOMATERIAL REPAIR OF VENTRAL HERNIAS: A MULTICENTER, RETROSPECTIVE STUDY

British Journal of Surgery ◽

10.1093/bjs/znab395.084 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Carl Doerhoff ◽

David Grantham ◽

Eric Mallico ◽

Raymond Washington ◽

John Linn

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Hybrid Composite ◽

Ventral Hernia Repair ◽

Mesh Fixation ◽

Composite Mesh ◽

Mesh Placement ◽

Patient Reported ◽

Ventral Hernias

Abstract Aim To analyze device safety and clinical outcomes of ventral hernia repair with a hybrid composite mesh Material and Methods This retrospective, multicenter, case review analyzed device/procedure endpoints and patient-reported outcomes in patients treated for hernia repair ≥ 1 year from study enrollment. Results There were 459 patients with 469 ventral hernias with a mean age of 58 ±15 years and 77% Ventral Hernia Working Group 2 (VHWG2). Mean hernia size was 18.9 cm2. Laparoscopic or robotic approach were utilized in 95% of patients, incisional hernias accounted for 57%. Mesh location was 75% intraperitoneal and bridging repair was performed in 57%. Procedure related adverse events within 30-days occurred in 5%, including: surgical site infection (SSI), surgical site occurrence (SSO), ileus, readmission, and re-operation. Procedure-related SSI or SSO events were 3.75% through 12-months. SSO events requiring procedural intervention (SSOPI) were 2.57% through 24-months. An estimated 7% of subjects had hernia recurrence through the study with a mean follow-up of 32-months (14-53 months) using a patient-reported outcome measure. Subgroup comparison of fixation type (permanent vs absorbable, p = 0.93) and repair (bridging vs reinforcement, p = 0.99) were conducted for recurrence and were not statistically significant. Conclusions In this analysis, ventral hernia repair with hybrid, composite mesh results in successful outcomes in the majority of patients. This study represents a heterogeneous patient population undergoing repair using various approaches, mesh fixation, and mesh placement locations. These data appear to confirm long-term acceptable safety and device performance with a low rate of recurrence in a predominantly VHWG2 population.

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