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

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

International Surgery Journal ◽

10.18203/2349-2902.isj20211287 ◽

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.

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