Routine use of bioprosthetic mesh is not necessary: A retrospective review of 100 consecutive cases of intra-abdominal midweight polypropylene mesh for ventral hernia repair

BACKGROUND A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. Hernias come in a variety of forms. The abdomen, specifically the groin, is most frequently involved. Incisional hernias and other ventral hernias are common surgical problems. A prosthetic mesh should always be used in ventral hernia repair (VHR). Now, the polypropylene mesh (PPM) has become the prosthetic mesh of choice in the repair of hernias, including inguinal hernia. Newer meshes are introduced, claiming lesser complication rate, but are invariably costlier than Polypropylene mesh (PPM) by 15 – 20 times. In this study we wanted to evaluate the outcomes of intraperitoneal monofilament and dual layer meshes in laparoscopic incisional and ventral hernia repair. METHODS This is a prospective observational study, with a minimum 30 cases for each type of mesh used. All those patients who had undergone ventral and incisional hernia laparoscopic repair at SRM General Hospital, Chennai between June 2018 and 2021 were included in the study. Data was entered in Microsoft excel for analysis, done by using SPSS software version 23. RESULTS Out of 86 hernias which were repaired laparoscopically, PPM was used in 34 (40 %) and composite meshes in 52 (60 %) cases. Out of 52 composite meshes, 11 cases (21.2 %) turned out with complications whereas out of 34 PPMs (11.8 %), 4 cases turned out with complications. CONCLUSIONS With the composite mesh, complications of intraperitoneal PPM (adhesions, inflammation, intestinal fistulisation, sinus formation, seroma and recurrence) may also occur. The difference between the meshes in the occurrence of these complications is not statistically important. KEY WORDS Hernia, Mesh, Surgery, Intraperitoneal Mesh, Laparoscopic Hernia Repair

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Self-gripping mesh versus polypropylene mesh in ventral hernia repair: an observational study

International Surgery Journal ◽

10.18203/2349-2902.isj20203790 ◽

2020 ◽

Vol 7 (9) ◽

pp. 3036

Author(s):

V. Om Kumar ◽

Venkatesh Subbiah

Keyword(s):

Observational Study ◽

Hernia Repair ◽

Ventral Hernia ◽

Polypropylene Mesh ◽

Ventral Hernia Repair ◽

Test Group ◽

Postoperative Phase ◽

Suture Fixation ◽

Preoperative Pain ◽

Duration Of Surgery

Background: To compare clinical outcomes following sutureless Parietex ProGrip™ mesh in ventral hernia repair to traditional lightweight polypropylene mesh secured with sutures.Methods: This was a study conducted at the Department of General Surgery in Velammal medical college from August 2019 to February 2020. This prospective observational study involved, 60 patients, 30 each undergoing ventral hernia repair with polypropylene mesh with suture fixation and Parietex ProGrip™ precut mesh (P group) without fixation. The primary outcome measure was postoperative pain using the visual analog scale were assessed prior to surgery and up to 3 months postoperatively (VAS, 0-150 mm); other outcomes (duration of surgery, wound infection and recurrence of hernia) were assessed up to 3 months postoperatively.Results: Compared to baseline (preoperative), pain score below four on the visual analogue scale was higher in the test group at discharge (76.7%) and 24 hours (96.7%), while the pain was more in the study group at discharge (43.3%) and seven days (70%). The difference between groups was significant at both time points. In the test group, patients without fixation suffered less pain compared to those with single-suture fixation (48 hours: 100% versus 86.6%, p=0.038; 3 months: 100% versus 100%, p≤0.001). Surgery duration was significantly shorter in the test group (<60 minutes) (66.7% versus 40%; p<0.038). No recurrence was observed at three months in both groups.Conclusions: A self-gripping mesh for ventral hernia repair may result in less pain in the early postoperative phase. Recurrence rates reduce as well as the patient’s quality of life improves.

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