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 Intraperitoneal Onlay Mesh in Ventral Hernia Repair – Experience in A Tertiary Care Hospital in Bangladesh

2017 ◽  
Vol 7 (2) ◽  
pp. 106-109
Author(s):  
Md Ezharul Haque Ratan ◽  
Hasina Alam
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Intraperitoneal Onlay Mesh ◽  
Diabetes Status ◽  
Onlay Mesh

Background: Ventral hernias are common problem in surgical practice. Repair of hernia by a prosthetic mesh is a well recognized procedure. But whether the procedure is to be done by open or laparoscopic technique is still a topic of discussion. Laparoscopic intraperitoneal onlay mesh (IPOM) hernioplasty is a newer technique in managing ventral hernia in our country. We are evaluating the usefulness of this procedure as routine operation for ventral hernias.Methods: All patients attending at Bangladesh Institute of Research & Rehabilitation of Diabetes, Endocrine and Metabolic disorders (BIRDEM) outpatient department (OPD) with ventral hernia were approached and counseled for laparoscopic IPOM, but only those who agreed were included in this study. Fifty consecutive patients underwent IPOM by a single surgeon. Preoperative evaluation was done rationally and surgery performed by standard laparoscopic method. Age, sex, diabetes status and additional procedures done were evaluated. Post- operative follow up period was from 3 months to 75 months and any complication or recurrence were noted.Results: We are reporting 50 cases of laparoscopic IPOM, over a time period of 78 months (April 2010- September 2016). Eleven cases were male, 39 female (M: F=1:3.5). 35 (70%) cases were diabetic, 15 (30%) were non-diabetic. Mean age of the patients were 47.7yrs (male 47.7+9.5 yrs, female 47.7- 2.6 yrs, diabetic patients 47.7+ 2.5yrs, non-diabetic patients 47.7-5.9yrs). Indication for IPOM was paraumbilical hernia 29 cases (58%), incisional hernia 14 cases(28%), multiple incisional hernia 2 cases ( 2 large defect in one case, 5 defects of varying size in another patient), umbilical port hernia 2 cases, paraumbilical along with incisional hernia 1 case, epigastric hernia 1 case, lumber hernia 1 case. In 48 cases (96%) polypropylene mesh and only in 2 cases (4%) dual mesh were used. In addition to IPOM procedure, in same sitting laparoscopic cholecystectomy was done in 8 cases, Dilatation & Curettage in 1 case and adhesiolysis in 7 cases. None of the case required conversion to open, neither was there any intra-operative complication. In one case there was recurrence . In another case there was false recurrence due to development of ascites. Four patients developed seroma which were managed conservatively.Conclusion: Laparoscopic intraperitoneal onlay mesh (IPOM) hernioplasty has proved to be an effective surgical procedure for ventral hernia repair. It provides much benefits with low complications and conversion in experienced hands.Birdem Med J 2017; 7(2): 106-109

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.

scholarly journals P008 SYNCHRONOUS SURGICAL TREATMENT OF MORBID OBESITY AND COMPLEX VENTRAL HERNIA AFTER PROGRESSIVE PNEUMOPERITONEUM AND BOTULINUM TOXIN A INJECTION

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Camillo Leonardo Bertoglio ◽  
Lorenzo Morini ◽  
Gisella Barone ◽  
Marianna Maspero ◽  
Bruno Alampi ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Botulinum Toxin ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Botulinum Toxin A ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Toxin A

Abstract Aim the worldwide increase in morbidly obese patients with complex hernia raises controversies in the choice of the appropriate treatment timing: synchronous bariatric and abdominal wall surgery versus delayed abdominal wall surgery. We report an innovative tailored surgical treatment carried out at our Institution. Material and Methods the approach provided the injection, six weeks before surgery, of 500 international units of botulinum toxin A on either side of the large abdominal wall muscles. Four weeks before surgery pneumoperitoneum was inducted and out-patient daily sessions of progressive insufflation with ambient air were then carried out. Surgery was scheduled 48 days after botulinum injection. Sleeve gastrectomy and simultaneous posterior component separation with transversus abdominis release were performed. Two prosthetic meshes were placed sublay. Results Postoperative superficial surgical site infection was successfully treated with negative pressure wound therapy. At one year follow up no hernia recurrence was recorded while total body weight loss was 31%. Conclusions a delay in ventral hernia repair could worsen quality of life of morbidly obese patients. In such high risk patients, the choice of the best surgical strategy remains controversial. There is great concern in performing bariatric surgery simultaneously to hernia repair, although there is lack of evidence on which is the ideal treatment modality. Synchronous bariatric surgery and complex ventral hernia repair should be approached in high volume centres where a consolidated experience of multidisciplinary team-work is available. Combined botulinum toxin A and preoperative progressive pneumoperitoneum administration allow for a safe resolution of loss of domain.

scholarly journals Postoperative Pain After Robot-Assisted Laparoscopic Ventral Hernia Repair

2021 ◽  
Vol 8 ◽  
Author(s):  
Per Lindström ◽  
Göran Rietz ◽  
Åsa Hallqvist Everhov ◽  
Gabriel Sandblom
Keyword(s):  
Postoperative Pain ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Robot Assisted ◽  
Potential Benefits ◽  
Onlay Mesh ◽  
Da Vinci Si

Background: Robot-assisted ventral hernia repair, when performed correctly, may reduce the risk for pain and discomfort in the postoperative period thus enabling shorter hospital stay. The aim of the present study was to evaluate postoperative pain following robot-assisted laparoscopic repair. The approach was selected after an intraoperative decision to complete the repair as: (1). Transabdominal Preperitoneal Repair (TAPP); (2). Trans-Abdominal RetroMuscular (TARM) repair; or (3). Intraperitoneal Onlay Mesh (IPOM) repair depending on anatomical conditions.Methods: Twenty ventral hernia repairs, 8 primary and 12 incisional, were included between 18th Dec 2017 and 11th Nov 2019. There were 8 women, mean age was 60.3 years, and mean diameter of the defect was 3.8 cm. The repairs were performed at Södersjukhuset (Southern General Hospital, Stockholm) using the Da Vinci Si Surgical System®. Sixteen repairs were completed with the TAPP technique, 2 with the TARM technique, and 2 as IPOM repair.Results: Mean hospital stay was 1.05 days. No postoperative infection was seen, and no recurrence was seen at 1 year. At the 30-day follow-up, fifteen patients (75%) rated their pain as zero or pain that was easily ignored, according to the Ventral Hernia Pain Questionnaire. After 1 year no one had pain that was not easily ignored.Conclusion: The present study shows that robot-assisted laparoscopic ventral hernia is feasible and safe. More randomized controlled trials are needed to show that the potential benefits in terms of shorter operation times, earlier discharge, and less postoperative pain motivate the extra costs associated with the robot technique.

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 The Effect of Bariatric Surgery Volume on General Surgery Outcomes for Morbidly Obese Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Katheryn Hope Wilkinson ◽  
Ruizhe Wu ◽  
Aniko Szabo ◽  
Rana Higgins ◽  
Jon Gould ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
General Surgery ◽  
Ventral Hernia Repair ◽  
High Volume ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Procedure Volume

Introduction. Bariatric surgery performed at high volume centers decreases length of stay, cost, and morbidity and mortality. The effect of a high volume of bariatric surgery procedures on outcomes may extend not just to bariatric surgery but to any general surgical procedure in morbidly obese patients. We hypothesized that patients with morbid obesity (body mass index >40 kg/m2) undergoing common, nonbariatric general surgery would have decreased morbidity and mortality at centers performing high volumes of bariatric surgery. Methods. The 2016 National Inpatient Sample (NIS) was used to identify the number of laparoscopic gastric bypass and sleeve gastrectomy performed at each hospital. Hospitals were classified as high volume bariatric hospitals (HVBH) ≥10 reported cases (50 actual)/year or low volume bariatric hospitals (LVBH) <10 reported cases (50 actual)/year, as NIS reports a 20% sample of actual cases. Patients with morbid obesity undergoing laparoscopic or open appendectomy, cholecystectomy, or ventral hernia repair were included for analysis. Propensity scores were developed based on available demographics, comorbidities, and hospital procedure volume. Postoperative complications during the index hospital admission, determined by ICD-10 code, were compared using inverse propensity weights. Differences were considered significant with a p value of <0.05. Results. The total number of general surgery patient cases analyzed was 14,028 from 2,482 hospitals, representing 70,140 admissions. The cohort of patients undergoing operations treated at HVBH were younger ( p = 0.03 ) with higher rates of COPD ( p = 0.04 ). Patients at LVBH had higher rates of nicotine dependence ( p = 0.0001 ) and obstructive sleep apnea ( p < 0.001 ). On propensity-weighted analysis adjusting for preoperative comorbidities and hospital procedure volume, there were significantly higher rates of multiple postprocedure complications at LVBH, specifically, postprocedure respiratory failure for patients undergoing elective laparoscopic cholecystectomy, elective ventral hernia repair with mesh and appendectomy. Conclusion. Patients with morbid obesity may have an advantage in having general surgery procedures at HVBH. HVBH may have a volume-outcomes relationship where the hospital and staff familiarity with the management principles required to minimize the postoperative risk associated with morbid obesity and improve patient outcomes.

scholarly journals A COMPARITIVE STUDY ON INTRA PERITONEAL ONLAY MESH REPAIR(IPOM) VS OPEN ONLAY MESH REPAIR FOR VENTRAL HERNIA

2020 ◽  
pp. 68-74
Author(s):  
Siddharth Kumar Sinha ◽  
Sanjay Singhal ◽  
Rudhee Sehgal ◽  
Dhaval Desai
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Laparoscopic Repair ◽  
Mesh Repair ◽  
Ventral Hernia Repair ◽  
Open Repair ◽  
Onlay Mesh ◽  
Ventral Hernias

Hernia is defined as abnormal protrusion of viscus through a normal or abnormal weakness in the wall of its containing cavity. Ventral Hernias are second most common type of hernias accounting for 21 to 35% of all verities of hernias. The main danger of all forms of hernia is strangulation and hence need surgical intervention. Repair of ventral hernias can be technically challenging and a myriad of methods have been described. The most important distinctions in describing surgical management of ventral hernias are primary vs mesh repair and open vs laparoscopic repair. Mesh repair became the gold standard in elective management of most ventral hernias. In the recent era of Minimal invasive surgeries, laparoscopic ventral hernia repair is being favoured by patients as well as the surgeons when compared to open repair. There is need to evaluate and compare quality of life and pain scoring postoperatively between open repair and laparoscopic repair of ventral hernias. AIMS & OBJECTIVES- TO COMPARE SURGICAL OUTCOMES OF INTRA PERITONEAL ONLAY MESH REPAIR(IPOM) VS OPEN ONLAY MESH REPAIR FOR VENTRAL HERNIA ON VARIOUS PARAMETERS MATERIAL & METHODS-This study was conducted on 60 pts which were divided in 2 groups (30 Intra peritoneal onlay mesh repair- 30 open onlay mesh repair) CONCLUSION-Laparoscopic ventral hernia repair provides lesser post-operative pain, lesser complications, shorter hospital stay and lesser economic impact as they returned to returned to work early. Thus patients have less morbidity and improved quality of life. LVHR may be considered a primary approach for most ventral and incisional hernias unless contraindicated for laparoscopy

scholarly journals Analysis of Factors Relevant to Revenue Improvement in Ventral Hernia Repair, Their Influence on Surgical Training, and Development of Predictive Models: An Economic Evaluation

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1226
Author(s):  
Anas Taha ◽  
Bassey Enodien ◽  
Vincent Ochs ◽  
Marta Bachmann ◽  
Maike Gripp ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Surgical Training ◽  
Significant Influence ◽  
Ventral Hernia Repair ◽  
Public Hospitals ◽  
Incisional Hernias ◽  
Revenue Enhancement ◽  
Ventral Hernias

Background: Ventral hernia repairs (VHR) are frequent but loss- making. This study aims to identify epidemiological and procedure related factors in VHR and their influence on surgical training. Methods: Data from 86 consecutive patients who underwent VHR in 2019 was collected. Moreover, 66 primary ventral hernias and 20 incisional hernias were repaired in open procedures. Linear regression models were made. Results: Primary VHR procedures showed a mean deficit of −378.17 CHF per case. Incisional hernia repair procedures resulted in a deficit of −1442.50 CHF per case. The two hernia groups were heterogeneous. For the primary VHR procedures, the surgery time (β = 0.564, p < 0.001) had the greatest influence, followed by the costs of the mesh (β = −0.215, p < 0.001). The epidemiological factors gender (β = 0.143, p < 0.01) and body mass index (BMI) (β = −0.087, p = 0.074) were also influential. For incisional hernia procedures a surgeon’s experience had the most significant influence (β = 0.942, p < 0.001), and the second largest influence was the price of the mesh (β = -.500, p < 0.001). The epidemiological factor BMI (β = −0.590, p < 0.001), gender (β = −0.113, p = 0.055) and age (β = −0.026, p < 0.050) also had a significant influence. Conclusion: Our analysis shows a way of improving financial results in the field of ventral hernia repair. Costs can be visualized and reduced to optimize revenue enhancement in surgical departments. In our analysis primary ventral hernias are an appropriate training operation, in which the experience of the surgeon has no significant impact on costs. In primary VHR procedures, revenue enhancement is limited when using an expensive mesh. However, the treatment of incisional hernias is recommended by specialists. The financial burden is significantly higher with less experience. Therefore, these operations are not suitable for surgical training. The re-operation rate decreases with increasing experience of the surgeon. This directly affects the Patient Related Outcome (PROM) and quality of treatment. Therefore, high-quality training must be enforced. Since financial pressure on hospitals is increasing further, it is crucial to investigate cost influencing factors. The majority of Swiss public hospitals will no longer be able to operate ventral hernias profitably without new concepts. In addition to purchasing management, new construction projects, and mergers, improving the results of individual departments is a key factor in maintaining the profitability of hospitals in the future regarding hernia repair without losing the scope of teaching procedures.

Laparoscopic Incisional and Ventral Hernia Repair with Absorbable Tacks in a Long Term Follow-up: A Retrospective Control Study

2019 ◽  
Vol 14 (2) ◽  
pp. 141-146
Author(s):  
Simone Zanella ◽  
Enrico Lauro ◽  
Francesco Franceschi ◽  
Francesco Buccelletti ◽  
Annalisa Potenza ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
The Elderly ◽  
Long Term Follow Up ◽  
Group A ◽  
Group B ◽  
Absorbable Tacks

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.

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

Hernia ◽  
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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