Comparative Study on the Use of Polypropylene Mesh in the Surgical Treatment of Patients with Strangulated or Uncomplicated Incisional Hernias

Incisional hernias affects approximately 10-20% of patients with history of abdominal surgery. The purpose of this study was to examine the tissue integration of the polypropylene mesh in patients operated for strangulated incisional hernias to those operated for uncomplicated incisional hernias. For this purpose, we introduced 218 patients with surgical treatment of the incisional hernia with polypropylene mesh. The total number of patients studied was divided into 2 lots: group A consisting of 189 patients with uncomplicated incisional hernia and group B of 29 patients with strangulated incisional hernia. We studied separately the local postoperative complications in the two groups (hematomas, seromas, abdominal wall infections). Although the number of local postoperative complications was higher for group B, the differences were statistically significant only for the incidence of abdominal wall infections. Although the use of the polypropylene mesh in the surgical treatment of strangulated incisional hernias predisposes to a higher risk of local postoperative complications compared to its use in the surgical treatment of the uncomplicated incisional hernias, its use in the surgical treatment of the strangulated incisional hernias is beneficial.

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Comparative Study on the Efficiency of 2 Different Types of Meshes (Polypropylene and ProGripTM ) in the Surgical Treatment of Incisional Hernias

Materiale Plastice ◽

10.37358/mp.18.2.4984 ◽

2018 ◽

Vol 55 (2) ◽

pp. 152-155

Author(s):

Bogdan Andrei Suciu ◽

Ioana Halmaciu ◽

Decebal Fodor ◽

Cristian Trambitas ◽

Adrian Ivanescu ◽

...

Keyword(s):

Surgical Treatment ◽

Postoperative Complications ◽

Polypropylene Mesh ◽

Incisional Hernias ◽

Hospitalization Period ◽

Duration Of Surgery ◽

Different Types ◽

Group A ◽

Group B ◽

Clinical Records

Postoperative eventration is a quite common condition in patients with clinical records of abdominal surgery. The purpose of this study was to investigate the efficacy of use of 2 different types of meshes (Polypropylene mesh and ProGripTM mesh-self-gripping mesh) in the surgical treatment of incisional hernias. In this respect, we conducted a study in which we introduced 128 patients operated for incisional hernias. Patients were divided into 2 lots: group A (102 patients with polypropylene mesh) and group B (26 patients with ProGripTM mesh). From the analysis of the data studied, we noticed that the average duration of surgery and hospitalization for patients with ProGripTM mesh is lower compared to patients with polypropylene mesh. Also, the rate of local postoperative complications was lower when using the ProGripTM mesh (15.38%) than in the case of polypropylene mesh. In conclusion, we can state that the use of the ProGripTM heterologous mesh is beneficial in the surgical treatment of patients with incisional hernias. The major advantage of using this type of mesh is given by a shorter hospitalization period for these patients, as well as by a lower rate of local postoperative complications in these patients.

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Study on the Need for Postoperative Analgesic Medication in Patients where Polypropylene Mesh was Used in the Surgical Treatment of Incisional Hernias

Materiale Plastice ◽

10.37358/mp.18.4.5094 ◽

2018 ◽

Vol 55 (4) ◽

pp. 648-651

Author(s):

Ioana Halmaciu ◽

Bogdan Andrei Suciu ◽

Cristian Trambitas ◽

Vlad Vunvulea ◽

Alexandra Martin Stoica ◽

...

Keyword(s):

Statistical Analysis ◽

Surgical Treatment ◽

Postoperative Complications ◽

Polypropylene Mesh ◽

Incisional Hernias ◽

Surgical Meshes ◽

Analgesic Medication ◽

Group A ◽

Group B ◽

Surgical Clinic

One of the most common postoperative complications that may occur in patients treated for incisional hernias is pain. The occurrence of postoperative pain refractory to drug treatment may worsen the prognosis of these patients. We have carried out a retrospective observational study in which we have introduced 122 patients operated for incisional hernia at the Surgical Clinic No. 1 in the Tirgu Mures Emergency County Clinical Hospital. The patients included in the study were divided into two groups: group A consisting of 80 patients where the polypropylene mesh was used over the aponeurosis in the surgical treatment of the incisional hernias, and the group B consisting of 42 patients where no prosthetic materials were used in the surgical treatment of the incisional hernias. All patients were administrated 1 g of sodium metamizole monohydrate for the treatment of pain. The statistical analysis of the data revealed that, on the day of surgery, on the first, second and third postoperative day there were statistically significant differences in the need for analgesic medication between the two groups, the need for the analgesic medication being lower for group A. In contrast, on the 4th postoperative day there were no statistically significant differences in the need for analgesic medication between the two groups. In conclusion, our study showed that, when using the polypropylene mesh in the surgical treatment of incisional hernias, the need for analgesic medication is lower in the immediate postoperative period compared to cases where surgical meshes are not used in the surgical treatment of these patients.

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INCREASING SAFETY OF SURGICAL INTERVENTIONS IN PATIENTS WITH VENTRAL AND INCISIONAL HERNIA UNDER COMORBIDITY CONDITIONS WHEN PERFORMING DIFFERENT TYPES OF OPEN HERNIOPLASTY

Art of Medicine ◽

10.21802/artm.2020.3.15.135. ◽

2020 ◽

pp. 135-139

Author(s):

V. I. Piatnochka ◽

I. Ya. Dziubanovskyi ◽

A. M. Prodan

Keyword(s):

Surgical Treatment ◽

Postoperative Complications ◽

Abdominal Wall ◽

Ventral Hernia ◽

Polypropylene Mesh ◽

Immunosuppressive Agents ◽

Technical Improvement ◽

Surgical Interventions ◽

Duration Of Surgery ◽

Ventral Hernias

Abstract. In the period from 2001 to 2017, 1419 patients with ventral and postoperative ventral hernia were operated on. The unsatisfactory results of the surgical treatment of this pathology were due to a number of disadvantages: the choice of an inadequate method of hernioplasty in a specific clinical situation, an incomplete revision of the muscle-aponeurotic layer of the anterior abdominal wall, especially in patients with postoperative veterinary hernias, concomitant syndrome of undifferentiated connective tissue dysplasia and obesity, and weak points, the wrong choice of the type of mesh implant (“light” or “heavy” polypropylene mesh) and its size, the choice of an inappropriate type of suture material, as well as the high invasiveness of surgical intervention. Based on the given causes of complications in the operated patients with a high risk of their development, we have made a technical improvement of the existing methods of hernioplasty and development of new ones, which significantly reduced the number of postoperative complications and increased the safety of performing surgical interventions in patients with ventral and postoperative ventral hernia. Purpose. Based on the results of the analysis of surgical treatment of patients with comorbid conditions for primary and incisional ventral hernias to develop technical prerequisites for improving the safety of surgical interventions in this category of patients. Methods. Іn the period from 2001 to 2017, an in-depth comprehensive clinical-instrumental and laboratory examination of 1419 patients with primary ventral hernia (PVH) and postoperative ventral hernia (PVH) was conducted. The patients were divided into groups according to the periods of surgical treatment of patients. For this purpose, two periods were formed: from 2001 to 2009 and from 2010 to 2017. At the first period, 597 (42.07%) patients were examined and operated on. These patients formed a comparison group. The main group corresponding to patients who were treated in the period from 2010 to 2017 was 822 (57.93%) people. Results. Developed techniques for performing retromuscular allogernioplasty, which were based on controlled visualization of suturing when fixing polypropylene mesh to the posterior leaf of the vagina of the rectus muscle, allowed us to reliably and safely place and secure the implant in the retromuscular space, significantly reduce the trauma and duration of surgery. Kind of treatment using the mesh allograft with a liposomal complex with included antibacterial and immunosuppressive agents during the operation on the "onlay" method significantly reduced the number of local infectious complications. The location of the PRF membrane over the polypropylene mesh during retromuscular allogernioplasty improved neoangiogenesis at the mesh implantation site, increased fibroblast activity and the formation of collagen fibers around the mesh material, which provided maximum integration of the "light" abdominal wall with polypropylene tissue. Conclusion. These features of the dynamics of the used methods of surgical interventions and types of polypropylene nets with an individualized approach to each patient were reflected in a significant reduction in the number of both early local and general late postoperative complications, which improved the effectiveness of surgical treatment of patients with primary postoperative ventral hernias.

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Abdominal wall muscles function estimation after hernioplasty

Bulletin of Siberian Medicine ◽

10.20538/1682-0363-2007-3-62-64 ◽

2007 ◽

Vol 6 (3) ◽

pp. 62-64

Author(s):

A. D. Timoshin ◽

A. L. Shestakov ◽

O. I. Zagorulko ◽

A. G. Inakov

Keyword(s):

Surgical Treatment ◽

Abdominal Wall ◽

Polypropylene Mesh ◽

Function Estimation ◽

High Effectiveness ◽

Incisional Hernias ◽

Results Of Surgery

The results of surgery in the group of patients with incisional hernias are evaluated. Hernioplasty with polypropylene mesh was performed in 22 patients. Electromyography was performed for abdominal wall muscles function estimation. High effectiveness of surgical treatment was established.

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Outcomes of Surgical and Nonsurgical Treatment for Colorectal Cancer in Nonagenarian Patients

The American Surgeon ◽

10.1177/0003134821995060 ◽

2021 ◽

pp. 000313482199506

Author(s):

Youngbae Jeon ◽

Kyoung-Won Han ◽

Won-Suk Lee ◽

Jeong-Heum Baek

Keyword(s):

Colorectal Cancer ◽

Overall Survival ◽

Surgical Treatment ◽

Postoperative Complications ◽

Postoperative Mortality ◽

Nonsurgical Treatment ◽

Perioperative Outcomes ◽

Rank Test ◽

Kaplan Meier ◽

Number Of Patients

Purpose This study is aimed to evaluate the clinical outcomes of surgical treatment for nonagenarian patients with colorectal cancer. Methods This retrospective single-center study included patients diagnosed with colorectal cancer at the age of ≥90 years between 2004 and 2018. Patient demographics were compared between the operation and nonoperation groups (NOG). Perioperative outcomes, histopathological outcomes, and postoperative complications were evaluated. Overall survival was analyzed using Kaplan-Meier methods and log-rank test. Results A total of 31 patients were included (16 men and 15 women), and the median age was 91 (range: 90‐96) years. The number of patients who underwent surgery and who received nonoperative management was 20 and 11, respectively. No statistical differences in baseline demographics were observed between both groups. None of these patients were treated with perioperative chemotherapy or radiotherapy. Surgery comprised 18 (90.0%) colectomies and 2 (10.0%) transanal excisions. Short-term (≤30 days) and long-term (31‐90 days) postoperative complications occurred in 7 (35.0%) and 4 (20.0%) patients, respectively. No complications needed reoperation, such as anastomosis leakage or bleeding. No postoperative mortality occurred within 30 days: 90-day postoperative mortality occurred in two patients (10.0%), respectively. The median overall survival of the operation group was 31.6 (95% confidence interval: 26.7‐36.5) and that of NOG was 12.5 months (95% CI: 2.4‐22.6) ( P = 0.012). Conclusion Surgical treatment can be considered in carefully selected nonagenarian patients with colorectal cancer in terms of acceptable postoperative morbidity, with better overall survival than the nonsurgical treatment.

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Predictors of Incisional Hernia after Robotic Assisted Radical Prostatectomy

Advances in Urology ◽

10.1155/2015/457305 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 7

Author(s):

Avinash Chennamsetty ◽

Jason Hafron ◽

Luke Edwards ◽

Scott Pew ◽

Behdod Poushanchi ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Incisional Hernia ◽

Operative Time ◽

Patient Counseling ◽

Incisional Hernias ◽

Prostate Weight ◽

History Of ◽

Robotic Assisted Radical Prostatectomy

Introduction.To explore the long term incidence and predictors of incisional hernia in patients that had RARP.Methods.All patients who underwent RARP between 2003 and 2012 were mailed a survey reviewing hernia type, location, and repair.Results.Of 577 patients, 48 (8.3%) had a hernia at an incisional site (35 men had umbilical), diagnosed at (median) 1.2 years after RARP (mean follow-up of 5.05 years). No statistically significant differences were found in preoperative diabetes, smoking, pathological stage, age, intraoperative/postoperative complications, operative time, blood loss, BMI, and drain type between patients with and without incisional hernias. Incisional hernia patients had larger median prostate weight (45 versus 38 grams;P=0.001) and a higher proportion had prior laparoscopic cholecystectomy (12.5% (6/48) versus 4.6% (22/480);P=0.033). Overall, 4% (23/577) of patients underwent surgical repair of 24 incisional hernias, 22 umbilical and 2 other port site hernias.Conclusion.Incisional hernia is a known complication of RARP and may be associated with a larger prostate weight and history of prior laparoscopic cholecystectomy. There is concern about the underreporting of incisional hernia after RARP, as it is a complication often requiring surgical revision and is of significance for patient counseling before surgery.

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Managing a Colonoscopic Perforation in a Patient with No Abdominal Wall

Case Reports in Surgery ◽

10.1155/2018/7175381 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Jayan George ◽

Michael Peirson ◽

Samuel Birks ◽

Paul Skinner

Keyword(s):

Abdominal Pain ◽

Incisional Hernia ◽

Plastic Surgery ◽

Abdominal Wall ◽

Abdominal Wall Defect ◽

Colonic Perforation ◽

Conservative Approach ◽

Wall Defect ◽

Surgical History ◽

History Of

We describe the case of a 37-year-old gentleman with Crohn’s disease and a complex surgical history including a giant incisional hernia with no abdominal wall. He presented on a Sunday to the general surgical on-call with a four-day history of generalised abdominal pain, nausea, and decreased stoma output following colonoscopy. After CT imaging, he was diagnosed with a large colonic perforation. Initially, he was worked up for theatre but following early senior input, a conservative approach with antibiotics was adopted. The patient improved significantly and is currently awaiting plastic surgery input for the management of his abdominal wall defect.

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A randomized controlled study to compare the efficacy of hughes abdominal repair with conventional abdominal closure-to reduce the incidence of incisional hernias in Indian population

International Surgery Journal ◽

10.18203/2349-2902.isj20172783 ◽

2017 ◽

Vol 4 (7) ◽

pp. 2291

Author(s):

Rajasekaran C. ◽

Vijaykumar K. ◽

Arulkumaran M. ◽

Meera S. S.

Keyword(s):

Randomized Controlled Trial ◽

Incisional Hernia ◽

Abdominal Wall ◽

Controlled Trial ◽

Secondary Outcome ◽

Midline Laparotomy ◽

Incisional Hernias ◽

Abdominal Closure ◽

Randomized Controlled ◽

Abdominal Repair

Background: Incisional hernia forms the most common delayed morbidity following midline laparotomy surgeries- causing mental trauma to the patient impairing their quality of life and scars the name and fame of the surgeon. So, the need for possible attributes on surgeon’s aspect to prevent the incisional hernia is the need of the hour. We planned a randomized controlled trial to compare two different abdominal closure techniques to reduce the incidence of Incisional hernia following midline laparotomy incisions. We advocated Hughes abdominal repair which includes a series of two horizontal and two vertical mattresses within single suture whereby the tension load of suture is distributed both along and across the suture line.Methods: 1:1 Randomized controlled trial in which the patient is blinded and obviously operating surgeon is non-blinded. Evaluating examiner and radiologist are blinded.100 patients who underwent emergency and elective midline laparotomies were enrolled in the study and intra-operatively randomized into two groups in 1:1 pattern. Ethical clearance obtained from the Institutional ethical committee. The primary outcome measure is the incidence of burst abdomen at the end of 15 days by the evaluating surgeon (non-operated surgeon who is blinded). The secondary outcome is the incidence of incisional hernia at the end of one year-evaluated by detailed clinical examination with radiological proof using CT abdomen.Results: The incidence of incisional hernia is significantly low in Hughes abdominal repair than conventional abdominal closure.Conclusions: Hughes abdominal wall closure is superior to conventional closure in both emergency and elective laparotomy cases, in prevention of wound dehiscence and Incisional hernias later. Present study encourages us that Hughes abdominal wall repair is comparable to mesh repairs. This study needs to be continued further to a vast sample size to perfectly assess the statistical significance.

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Abdominal Wall Reconstruction with a Free Fibula Flap after Internal Extended Hemipelvectomy

Indian Journal of Plastic Surgery ◽

10.1055/s-0040-1709378 ◽

2020 ◽

Vol 53 (01) ◽

pp. 131-134

Author(s):

Pedro C. Cavadas ◽

Daniela Téllez-Palacios

Keyword(s):

Postoperative Complications ◽

Incisional Hernia ◽

Abdominal Wall ◽

Malignant Tumors ◽

Abdominal Wall Reconstruction ◽

Morbidity And Mortality ◽

Significant Morbidity ◽

Free Fibula Flap ◽

Fibula Flap ◽

Free Fibula

AbstractMajor pelvic resections for malignant tumors are infrequent and have significant morbidity and mortality, for instance, incisional hernias are postoperative complications uncommonly reported probably because most cases are overshadowed by more serious complications. Reconstruction depends on the extent of the resection and overall prognosis of the patient. A case of a late complex hypogastric and femoral incisional hernia after extended hemipelvectomy for recurrent osteosarcoma treated with distal abdominal wall fixation into a free fibula flap is reported.

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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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