Comparison of Hernia Recurrence and Seroma Formation in Cancer Patients Undergoing Incisional Hernia Repair with Transfascial Sutures vs. Fibrin Glue for Mesh Fixation

Abstract Background Patient-reported outcomes such as postoperative pain are critical for the evaluation of outcomes after incisional hernia repair. The aim of this study is to determine the long-term impact of mesh fixation on postoperative pain in patients operated by open and laparoscopic technique. Methods A multicenter prospective observational cohort study was conducted from September 2011 until March 2016 in nine hospitals across Switzerland. Patients undergoing elective incisional hernia repair were included in this study and stratified by either laparoscopic or open surgical technique. Propensity score matching was applied to balance the differences in baseline characteristics between the treatment groups. Clinical follow-up was conducted 3, 12 and 36 months postoperatively to detect hernia recurrence, postoperative pain and complications. Results Three-hundred-sixty-one patients were included into the study. No significant differences in hernia recurrence and pain at 3, 12 and 36 months postoperatively were observed when comparing the laparoscopic with the open treatment group. Mesh fixation by sutures to fascia versus other mesh fixation led to significantly more pain at 36 months postoperatively (32.8% vs 15.7%, p = 0.025). Conclusions At long-term follow-up, no difference in pain was identified between open and laparoscopic incisional hernia repair. Mesh fixation by sutures to fascia was identified to be associated with increased pain 36 months after surgery. Omitting mesh fixation by sutures to the fascia may reduce long-term postoperative pain after hernia repair.

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Re: JSLS(2010)14:240–245 Laparoscopic Incisional Hernia Repair With Fibrin Glue in Select Patients

JSLS Journal of the Society of Laparoendoscopic Surgeons ◽

10.4293/108680811x13125733357313 ◽

2011 ◽

Vol 15 (3) ◽

pp. 430-430

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Fibrin Glue ◽

Incisional Hernia Repair ◽

Laparoscopic Incisional Hernia Repair

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Mesh fixation techniques in primary ventral or incisional hernia repair

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd011563 ◽

2015 ◽

Cited By ~ 2

Author(s):

Maren Walgenbach ◽

Tim Mathes ◽

Robert Siegel ◽

Michaela Eikermann

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Mesh Fixation ◽

Incisional Hernia Repair ◽

Fixation Techniques

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Is Onlay Polypropylene Mesh Repair an Available Option for Incisional Hernia Repair? A Retrospective Cohort Study

The American Surgeon ◽

10.1177/000313481908500226 ◽

2019 ◽

Vol 85 (2) ◽

pp. 183-187 ◽

Cited By ~ 2

Author(s):

Oscar Cano-Valderrama ◽

JosÉ L. Porrero ◽

Esther Quirós ◽

Oscar Bonachia ◽

MarÍA J. Castillo ◽

...

Keyword(s):

Postoperative Complications ◽

Incisional Hernia ◽

Hernia Repair ◽

Surgical Procedures ◽

Polypropylene Mesh ◽

Mesh Repair ◽

Incisional Hernia Repair ◽

Hernia Recurrence ◽

Onlay Mesh

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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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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