Laparoscopic Intraperitoneal Onlay Repair of Abdominal Incisional and Ventral Hernias wth Polyvinylidene Fluoride-Coated Polypropylene Mesh; A Retrospective Study with Short to Medium Term Results
Science Journal of Clinical Medicine
Volume 1, Issue 1, December 2012, Pages: 10-14
Received: Nov. 13, 2012; Published: Dec. 30, 2012
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Authors
D. G. Roberts, Department of Surgery. Calderdale and Huddersfield NHS Trust
S. Anwar., Department of Surgery Huddersfield Royal infirmary, Lindley, Huddersfield, HD3 3EA
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Abstract
Laparoscopic repair of incisional and ventral hernias has increased in popularity due to reduced pain, shorter length of stay and earlier return to work. Dynamesh Intraperitoneal onlay mesh (IPOM), a composite of polyvinylidene fluoride (PVDF) coated polypropylene (PP) was designed to utilize the properties of both materials. This retrospective study reports a single surgeon experience with laparoscopic IPOM using Dynamesh , to ascertain any short to medium term complications. Forty consecutive patients underwent intraperitoneal onlay mesh repair with Dynamesh in a District General hospital (DGH) over a 33 month period. Data was collected retrospectively from medical notes, clinical assessment and telephone interviews. Short term complications include development of seromas post operatively in three patients which were successfully drained. One patient was readmitted with small bowel obstruction that was successfully managed conservatively. Medium term results showed two further seromas. Our recurrence rate is 13% after a mean follow up of 15 months. On submission of this manuscript, none of the patients have had to undergo surgical re-intervention for Dynamesh related complications. We have not noticed any significant short to medium term complications with Dynamesh in our experience. The debate about the best composite mesh continues; only a randomised control trial between the different meshes, with long term follow up can determine the true incidence of complications.
Keywords
Laparoscopic, Dynamesh, Incisional Hernia, Ventral Hernia
To cite this article
D. G. Roberts, S. Anwar., Laparoscopic Intraperitoneal Onlay Repair of Abdominal Incisional and Ventral Hernias wth Polyvinylidene Fluoride-Coated Polypropylene Mesh; A Retrospective Study with Short to Medium Term Results, Science Journal of Clinical Medicine. Vol. 1, No. 1, 2012, pp. 10-14. doi: 10.11648/j.sjcm.20120101.13
References
[1]
Forbes S, Eskicioglu C. Meta-analysis of randomized con-trolled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh. Br J Surg 2009; 96: 851 – 858.
[2]
LeBlanc KA, Booth WV. Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluroethylene: preliminary findings. Surg Laparoscopic Endosc 1993; 3: 39 – 41.
[3]
Den Hartog D, Dur AH, Tuinebreijer WE, Kreis RW. Open surgical repair for incisional hernia. Cochrane Data base Syst Rev 2008:CD006438.
[4]
Klinge U, Klosterhalfen B. PVDF as a new polymer for the construction of surgical meshes. Biomaterials 2002; V22: 16: 3487 – 3493.
[5]
Berger D, Bientzle M. Polyvinylidene fluoride: a suitable mesh material for laparoscopic incisional and parastomal hernia repair! A prospective observational study with 344 patients. Hernia 2009; 13: 167 – 172.
[6]
Fortelny R H, Petter-Puchner A H. Adverse effects of poly-vinylidene fluoride-coated polypropylene mesh used for la-paroscopic intraperitoneal onlay repair of incisional hernia. Br J Surg 2010; 97: 167 – 172.
[7]
Harrell AG, Novitsky YW, Peindl RD, Cobb WS, Austin CE, Cristiano JA, Norton JH, Kercher KW, Heniford BT. Pros-pective evaluation of adhesion formation and shrinkage of intraabdominal prosthetics in a rabbit model. Am Surg 2006;72:808-813.
[8]
Topart P, Ferrand L, Vandenbroucke F, Lozac’h P. Laparos-copic ventral hernia repair with the goretax Dual mesh; long term results and review of the literature. Hernia 2005;9:348-352.
[9]
Bellon JM, Rodrigues M, Garcia-Honduvilla N, Gomez-Gil V, pascual G, Bujan J. Post implant behaviour of lightweight polypropylene meshes in an experimental model of abdominal hernia. J Invest Surg 2008;21:280-7.
[10]
Emans PJ, Schreinemacher MH, Gijbels MJ, Beets GL, Greve JW, Koole LH, Bouvy ND. Polypropylene meshes to prevent abdominal herniation, Can stable coating prevent adhesions in the longterm? Ann Biomed Eng 2009;37:410-418.
[11]
Junge K, Binnebosel M, Rosch R, Jansen M, Kammer D, Otto J, Schumpelick V, Klinge U. Adhesion formation of a polyvinylflouride/polypropylene mesh for intra-abdominal placement in a rodent animal model. Surg endosc 2009;23:327-333.
[12]
Pierce RA, Spitler JA, Frisella MM, Matthews BD, Brunt LM. Pooled data analysis of laparoscopic vs. open ventral hernia repair:14 years of patient data accrual. Surg Endosc 2007;21:378-386.
[13]
Tagaya N, Mikami H, Aoki H, Kubota K. Longterm com-plications of laparoscopic ventral and incisional hernia repair. Sur laparosc Endosc Percutan Tech 2004;14:5-8.
[14]
Sajid MS, Bokhari SA, Mallick AS, Cheek E, Baig MK. Laparoscopic versus open repair of incisional/ventral hernia: a meta-analysis. Am J Surg. 2009 197(1):64-72.
[15]
BurgerJW, luijendijk RW, HopWC, Halm JA, Verdaasdonk EG, Jeekel J. Long term follow up of a randomised con-trolled trail of suture versus mesh repair of incisional hernia. AnnSurg 2004; 240:578-858.
[16]
Stokes JB, Friel C. Laparoscopic Ventral hernia repair: Mesh options and outcomes. Semin colon rectal Surg 20;118-124.
[17]
Berger D, Bientzle M, Muller A. Prospective complications after laparoscopic incisional hernia repair. Incidence and treatment. Surg Endosc 2002;16:1720-1723.
[18]
Tsimoyiannis EC, Siakas P, Glantzounis G, Koulas S, Ma-vridou P, Gossios KI. Seroma in laparoscopic ventral her-nioplasty. Surg Laparosc Endosc Percutan Tech 2001;11:317-321.
[19]
The ventral hernia working group : Breuing K, Butler CE, Ferzoco S, Franz M, Hultman CS, Kilbridge JF, Rosen M, Silverman RP, Vargo D. Incisional ventral hernia: review of the literature and recommendations regarding the grading and technique of repair. Surgery 2010;148;544-58.
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