scholarly journals EP.TH.652Use of the Proceed Ventral Patch (PVP) Mesh for Small to Medium sized defects in Ventral Hernia Repair over 10 years – Simple, Safe and Secure

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ashwin Krishnamoorthy ◽  
LamChin Tan
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Intraoperative Complications ◽  
Patient Characteristics ◽  
Lightweight Mesh ◽  
Complication Rates ◽  
Single Centre Experience ◽  
Ventral Hernias ◽  
Laparoscopic Reoperation

Abstract Aims The Proceed Ventral Patch (PVP) has been in use since the late 2000s and is a self-expanding lightweight mesh patch comprised of multiple layers of absorbable and non-absorbable materials including polypropylene and polydioxanone. It is intended for use in all ventral hernias. We report our single-centre experience of using the mesh with primary outcomes being recurrence and reoperation for recurrence, readmission within 21 days for post-operative complications and discharge as day-case. Methods Retrospective review of case notes from 54 patients who were operated between October 2010 and November 2020 was undertaken. Patient characteristics were of a 2.1: 1 Male:Female ratio with a median age of 56 years old. 3 epigastric hernias and 51 paraumbilical hernias were repaired using either a 4.3cm or 6.4cm Proceed Ventral Patch. The size of the hernia defect ranged from 0.5cm to 4cm with a median defect size of 2cm for the 54 patients. Results There were no intraoperative complications. Two patients (0.04%) underwent laparoscopic reoperation for recurrence. Only one (0.02%) patient was readmitted within 21 days for a wound abscess which was drained and treated with a VAC dressing with satisfactory healing. The operations were split between nine different surgeons of varying expertise from ST5 level to Consultant level. Conclusions Ventral hernia repair with PVP is intuitive to learn and has low recurrence/complication rates.

scholarly journals Evaluation of intra-abdominal adhesion formation after laparoscopic ventral hernia repair with composite mesh using abdominal ultrasound: a prospective observational study

2021 ◽  
Vol 8 (4) ◽  
pp. 1143
Author(s):  
Jainendra K. Arora ◽  
Manjunatha Sankal ◽  
Rohini Gupta Ghasi ◽  
Radhika Thakur
Keyword(s):  
Observational Study ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Prospective Observational Study ◽  
Adhesion Formation ◽  
Laparoscopic Ventral Hernia Repair ◽  
Composite Mesh ◽  
Ventral Hernias

Background: Laparoscopic ventral hernia repair has revolutionized treatment of ventral hernia by offering shorter recovery time, decreased pain, reduced wound complications and lower recurrence rates as compared to conventional open hernia repair. But intra-abdominal mesh placement is associated with a high risk of complications including adhesions, bowel obstruction and fistula formation. Many different types of meshes with adhesion barriers have been developed to overcome these problems. This prospective observational study evaluated the outcomes of laparoscopic repair of ventral hernias in terms of Intra-abdominal adhesion formation with composite mesh using ultrasound.Methods: The study was conducted from August 2017 to February 2019. All patients underwent standard laparoscopic ventral hernias repair using composite mesh secured with tackers. Omentum was interposed between the mesh and underlying bowel. At a mean follow-up of one year, all patients were subjected to ultrasound examination using visceral slide technique to detect Intra-abdominal adhesions.Results: Our study included 50 patients with a mean age of 43 years (range 26-59 years) and mean body mass index of 29.07±2.35 kg/m2 (range, 24-33 kg/m2). Mean fascial defect size of hernia was 13.4±3.77 cm2 (range12-16 cm2). There were no mesh-related complications and recurrence during the follow-up period of 1 year.Conclusions: Laparoscopic ventral hernia repair using composite mesh seems to be a promising technique for treating ventral hernias. However, longer follow-up periods are needed to confirm effectiveness and safety of the composite mesh.

Plasty of incisional ventral hernias using a mechanical suture

1982 ◽  
Vol 63 (3) ◽  
pp. 37-40
Author(s):  
B. L. Elyashevich ◽  
F. Sh. Sharafislamov ◽  
R. M. Ramazanov
Keyword(s):  
Hernia Repair ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Anterior Abdominal Wall ◽  
Long Term Results ◽  
Mechanical Suture ◽  
And Function ◽  
Ventral Hernias

Developed and applied in patients with hernias of the anterior abdominal wall a method of plasty with own tissues using a mechanical suture. 109 patients with postoperative and recurrent ventral hernias were operated on. This method of ventral hernia repair allows to restore the anatomy and function of the abdominal wall, standardizes and simplifies the technique of the operation, reducing the time of its implementation, and gives 95.4% positive long-term results.

scholarly journals 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

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.

scholarly journals Is it safe to combine ventral hernia repair with bariatric surgery?

2020 ◽  
Vol 7 (10) ◽  
pp. 3455
Author(s):  
Ashok Kumar Mathur ◽  
Praveen Kumar Mathur
Keyword(s):  
Bariatric Surgery ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Optimal Time ◽  
Morbidly Obese ◽  
Onlay Mesh ◽  
Ventral Hernias

Obesity is one of the important precipitating factors for primary and incisional ventral hernias. There is controversy regarding the optimal time and method of repair of abdominal wall hernias in patients undergoing bariatric surgery. We reviewed our series of 250 patients who underwent bariatric surgery over 6 years period. 7 morbidly obese patients undergoing bariatric surgery had simultaneous ventral hernia repair. Roux-en-Y gastric bypass (RYGB) in 2 patients and laparoscopic sleeve gastrectomy (LSG) were done in 5 patients. 6 patients had primary midline paraumbilical hernia and 1 patient had large recurrent incisional hernia. Open intraperitoneal onlay mesh (IPOM) repair was done in 5 cases with hernia defect <5 cm. Sutured repair was done in 1 patient, recurrence occurred after 3 months. IPOM repair was done 6 months later after significant weight loss. 1 patient of large incisional hernia (10 cm defect) with cholelithiasis underwent open mesh hernioplasty and panniculectomy. Postoperative seroma occurred in one patient, it subsided after repeated aspirations. After average follow up of over 2 years there has been no recurrence.

scholarly journals Outcomes and Complications of Open, Laparoscopic, and Hybrid Giant Ventral Hernia Repair

2020 ◽  
Author(s):  
Shuo Yang ◽  
Minggang Wang ◽  
Yusheng Nie ◽  
Xuefei Zhao ◽  
Jing Liu
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Hybrid Procedure ◽  
Hernia Recurrence ◽  
Fistula Formation ◽  
Intestinal Fistula ◽  
Hybrid Repair ◽  
Giant Ventral Hernia ◽  
Ventral Hernias

Abstract Background This study aimed to compare outcomes and complications between open, laparoscopic, and hybrid (laparoscopic and open combined) approaches in giant ventral hernia repair. Methods Records of patients with giant ventral hernias who received operations from 2006 to 2013 were retrospectively reviewed. Open, laparoscopic, or a hybrid procedure was performed in every case. The primary outcome was hernia recurrence rate, and secondary outcomes included intraoperative and postoperative complications. Results A total of 82 patients received open repair, 94 laparoscopic repair, and 132 hybrid repair. The median hernia diameter was 13.11 ± 3.4 cm. With a mean follow-up of 41 months, the incidence of hernia recurrence in the hybrid procedure group was 1.3%, which was significantly lower than that in the laparoscopic (20.5%) or open procedure group (8.5%) (P < 0.001). The incidence of intraoperative intestinal injury was 6.1% in open, 4.1% in laparoscopic, and only 1.5% in the hybrid procedure (hybrid vs. open and laparoscopic procedures; P < 0.05). Rates of postoperative intestinal fistula formation in the open, laparoscopic, and hybrid groups were 2.4%, 6.8%, and 3.3%, respectively (P > 0.05). Conclusions Compared with an open and a simple laparoscopic procedure, a hybrid procedure is more effective and safer in the repair of giant ventral hernias.

scholarly journals O34 AUTOLOGOUS FENESTRATED CUTIS GRAFTS FOR VENTRAL HERNIA REPAIR IN PATIENTS WITH OBESITY

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Charles Mansour ◽  
Claudia Leonardi ◽  
Patrick McLaren ◽  
Michael Cook ◽  
Ian Hodgdon ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Abdominal Wall Hernia ◽  
Synthetic Mesh ◽  
Complication Rates ◽  
Recurrence Rates ◽  
Significant Difference ◽  
The Impact

Abstract Aim Traditional approaches to ventral hernia repair involve implantation of synthetic mesh (SM), primary suture (PS) repair, and the use of biologic prostheses (BP). A body mass index (BMI) &gt; 30 increases recurrence rates and complications for such repairs. We have begun to use Autologous Fenestrated Cutis Grafts (CG) as an alternative hernia repair. We investigated the impact of obesity on the recurrence and complication rates of CG compared to traditional repairs. Material and Methods A five-surgeon, retrospective study included all ventral/incisional, epigastric and umbilical hernia repairs (SM, PS, and BP from 2015-2020; CG repairs from 2018-2020). Patients with a BMI ≥ 30 were stratified according to surgical approach. Outcomes included recurrence and complication rates. Descriptive statistics for demographics and outcomes were compared and logistic regression performed with p &lt; 0.05 considered significant. Results A total of 301 hernia repairs were performed (173 CGs, 54 SM, 59 PS, 15 BS). The groups had similar recurrence rates. A significant difference in complications rates did exist (37% CGs, 48.1% SMs, 15.3% PS, 66.7% BP, p &lt; 0.001). Logistic regression revealed PS had fewer total complications than all other repairs. Compared to SM, CG had fewer seromas. Compared to BP, CG had fewer wound infections, systemic infections, renal complications, and additional procedures. Conclusions CG for abdominal wall hernia repair in patients with BMI ≥ 30 is an acceptable hernia repair in obese patients with similar recurrence rates and an acceptable complication profile compared to traditional repairs.

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

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.

scholarly journals A Comparative Analysis between Laparoscopic and Open Ventral Hernia Repair at a Tertiary Care Center

2012 ◽  
Vol 78 (8) ◽  
pp. 888-892 ◽  
Author(s):  
Stephen W. Davies ◽  
Kristin C. Turza ◽  
Robert G. Sawyer ◽  
Bruce D. Schirmer ◽  
Peter T. Hallowell
Keyword(s):  
Postoperative Complications ◽  
Confidence Interval ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Odds Ratio ◽  
Ventral Hernia Repair ◽  
Open Repair ◽  
Patient Characteristics ◽  
Laparoscopic Ventral Hernia Repair ◽  
Increased Risk

Laparoscopic ventral hernia repair reportedly yields lower postoperative complications than open repair. We hypothesized that patients undergoing laparoscopic repair would have lower postoperative infectious outcomes. Also, certain preoperative patient characteristics and preoperative hernia characteristics are hypothesized to increase complication risk in both groups. All ventral hernia repairs performed at University of Virginia from January 2004 to January 2006 were reviewed. Primary outcomes included wound healing complications and hernia recurrence. Categorical data were analyzed with χ2 and Fisher's exact tests. Continuous variables were evaluated with independent t tests and Mann-Whitney U tests. Multivariable logistic regression was performed. A total of 268 repairs (110 open, 158 laparoscopic) were evaluated. Patient and hernia characteristics were similar between groups, though the percents of wound contamination (5.4% vs 0.6%; P = 0.02) and simultaneous surgery (7.2% vs 0%; P = 0.001) were greater in the open procedures. Univariate analysis also revealed that open cases had a greater incidence of postoperative superficial surgical site infection (SSI) (30.0% vs 10.7%; P < 0.0001). Multivariable analysis revealed that both diabetes and open repair were associated with an increased risk of superficial SSI ( P = 0.019; odds ratio = 3.512; 95% confidence interval = 1.229–10.037 and P = 0.001; odds ratio = 4.6; 95% confidence interval = 1.9–11.2, respectively). Laparoscopic ventral hernia repair yielded lower rates of postoperative superficial SSI than open surgery. Other pre-operative patient characteristics and preoperative hernia characteristics, with the exception of diabetes, were not found to be associated with an increased risk of postoperative complications.

Hospital and surgeon variation in 30-day complication rates after ventral hernia repair

2020 ◽  
Author(s):  
Ryan Howard ◽  
Emily Johnson ◽  
Nicholas L. Berlin ◽  
Zhaohui Fan ◽  
Michael Englesbe ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Complication Rates
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