Skip to main content
Erschienen in: Hernia 5/2011

01.10.2011 | Original Article

Retrospective analysis of umbilical, epigastric, and small incisional hernia repair using the Ventralex™ hernia patch

verfasst von: T. Tollens, M. Den Hondt, K. Devroe, C. Terry, S. Speybroeck, C. Aelvoet, J.-P. Vanrykel

Erschienen in: Hernia | Ausgabe 5/2011

Einloggen, um Zugang zu erhalten

Abstract

Objective

The aim of this retrospective study was to determine the long-term recurrence and complication rates following small abdominal wall hernia repair with the Ventralex hernia patch. The study also aimed to identify risk factors for hernia recurrence in patients undergoing such repair and to examine the relationship between quality of life and hernia recurrence.

Background

Hernia repair using prosthetic mesh materials has become the preferred method of repair, as the recurrence rates are much lower than with conventional repair techniques. The prevention of long-term complications and improvements in the quality of life should also be considered as important features of successful repair. The Ventralex patch is a bilayer prosthesis, designed for retromuscular or intraperitoneal placement. Currently, seven studies have evaluated the device for small ventral hernia repair, and all have shown low short- and long-term recurrence rates.

Materials and methods

The medical records of 176 patients who underwent abdominal wall hernia repair using the Ventralex patch between May 2004 and February 2009 were reviewed. All patients were followed up after 1 month and later in 2010. The rate of recurrence, immediate postoperative and long-term complications, and quality of life were evaluated.

Results

Long-term follow-up data were available for 135 patients. The mean follow-up was 49 months (range 13–70 months). There were 12 hernia recurrences (8.9%) during this time. Postoperative (1-month) complications included seroma (4%), superficial surgical site infections (3%), and an abscess (1.5%). At the mean long-term follow-up, complications included infection (1.5%) and subobstruction (1.5%). The only risk factor for hernia recurrence was female gender (unadjusted odds ratio 0.19, 95% confidence interval [CI] 0.05–0.72, P = 0.02). Patients with hernia recurrence reported significantly lower quality of life scores than patients without recurrence.

Conclusions

The Ventralex hernia patch offers a simple and quick means of repairing small abdominal wall hernias. A relatively high recurrence rate was observed in this study. Reviewing the available literature, a critical appraisal is needed, attention should be paid to follow the correct implantation technique, proper deployment technology should be used, and a lightweight version would be welcome.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Cilley RE, Shereef S (2004) Umbilical hernia repair. Oper Tech Gen Surg 6(4):244–252CrossRef Cilley RE, Shereef S (2004) Umbilical hernia repair. Oper Tech Gen Surg 6(4):244–252CrossRef
2.
Zurück zum Zitat Tollens T, Struyve D, Aelvoet C, Vanrijkel JP (2010) Introducing the proceed ventral patch as a new device in surgical management of umbilical and small ventral hernias: preliminary results. Surg Technol Int 19:99–103PubMed Tollens T, Struyve D, Aelvoet C, Vanrijkel JP (2010) Introducing the proceed ventral patch as a new device in surgical management of umbilical and small ventral hernias: preliminary results. Surg Technol Int 19:99–103PubMed
3.
Zurück zum Zitat Rodriguez JA, Hinder RA (2004) Surgical management of umbilical hernia. Oper Tech Gen Surg 6(3):156–164CrossRef Rodriguez JA, Hinder RA (2004) Surgical management of umbilical hernia. Oper Tech Gen Surg 6(3):156–164CrossRef
4.
Zurück zum Zitat Arroyo A, García P, Pérez F, Andreu J, Candela F, Calpena R (2001) Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adults. Br J Surg 88:1321–1323PubMedCrossRef Arroyo A, García P, Pérez F, Andreu J, Candela F, Calpena R (2001) Randomized clinical trial comparing suture and mesh repair of umbilical hernia in adults. Br J Surg 88:1321–1323PubMedCrossRef
5.
Zurück zum Zitat Schumacher OP, Peiper C, Lörken M, Schumpelick V (2003) Long-term results after Spitzy’s umbilical hernia repair. Chirurg 74:50–54PubMedCrossRef Schumacher OP, Peiper C, Lörken M, Schumpelick V (2003) Long-term results after Spitzy’s umbilical hernia repair. Chirurg 74:50–54PubMedCrossRef
6.
Zurück zum Zitat Halm JA, Heisterkamp J, Veen HF, Weidema WF (2005) Long-term follow-up after umbilical hernia repair: are there risk factors for recurrence after simple and mesh repair? Hernia 9:334–337PubMedCrossRef Halm JA, Heisterkamp J, Veen HF, Weidema WF (2005) Long-term follow-up after umbilical hernia repair: are there risk factors for recurrence after simple and mesh repair? Hernia 9:334–337PubMedCrossRef
7.
Zurück zum Zitat Venclauskas L, Šilanskaitė J, Kiudelis M (2008) Umbilical hernia: factors indicative of recurrence. Medicina (Kaunas) 44(11):855–859 Venclauskas L, Šilanskaitė J, Kiudelis M (2008) Umbilical hernia: factors indicative of recurrence. Medicina (Kaunas) 44(11):855–859
8.
Zurück zum Zitat Witherspoon P, O’Dwyer PJ (2005) Surgeon perspectives on options for ventral abdominal wall hernia repair: results of a postal questionnaire. Hernia 9:259–262PubMedCrossRef Witherspoon P, O’Dwyer PJ (2005) Surgeon perspectives on options for ventral abdominal wall hernia repair: results of a postal questionnaire. Hernia 9:259–262PubMedCrossRef
9.
Zurück zum Zitat Sanjay P, Reid TD, Davies EL, Arumugam PJ, Woodward A (2005) Retrospective comparison of mesh and sutured repair for adult umbilical hernias. Hernia 9:248–251PubMedCrossRef Sanjay P, Reid TD, Davies EL, Arumugam PJ, Woodward A (2005) Retrospective comparison of mesh and sutured repair for adult umbilical hernias. Hernia 9:248–251PubMedCrossRef
10.
Zurück zum Zitat Arroyo Sebastián A, Pérez F, Serrano P, Costa D, Oliver I, Ferrer R, Lacueva J, Calpena R (2002) Is prosthetic umbilical hernia repair bound to replace primary herniorrhaphy in the adult patient? Hernia 6:175–177PubMedCrossRef Arroyo Sebastián A, Pérez F, Serrano P, Costa D, Oliver I, Ferrer R, Lacueva J, Calpena R (2002) Is prosthetic umbilical hernia repair bound to replace primary herniorrhaphy in the adult patient? Hernia 6:175–177PubMedCrossRef
12.
Zurück zum Zitat Stoppa RE (1989) The treatment of complicated groin and incisional hernias. World J Surg 13:545–554PubMedCrossRef Stoppa RE (1989) The treatment of complicated groin and incisional hernias. World J Surg 13:545–554PubMedCrossRef
13.
Zurück zum Zitat Hadi HI, Maw A, Sarmah S, Kumar P (2006) Intraperitoneal tension-free repair of small midline ventral abdominal wall hernias with a Ventralex hernia patch: initial experience in 51 patients. Hernia 10:409–413PubMedCrossRef Hadi HI, Maw A, Sarmah S, Kumar P (2006) Intraperitoneal tension-free repair of small midline ventral abdominal wall hernias with a Ventralex hernia patch: initial experience in 51 patients. Hernia 10:409–413PubMedCrossRef
14.
Zurück zum Zitat Vychnevskaia K, Mucci-Hennekinne S, Casa C, Brachet D, Meunier K, Briennon X, Hamy A, Arnaud JP (2010) Intraperitoneal mesh repair of small ventral abdominal wall hernias with a Ventralex hernia patch. Dig Surg 27:433–435PubMedCrossRef Vychnevskaia K, Mucci-Hennekinne S, Casa C, Brachet D, Meunier K, Briennon X, Hamy A, Arnaud JP (2010) Intraperitoneal mesh repair of small ventral abdominal wall hernias with a Ventralex hernia patch. Dig Surg 27:433–435PubMedCrossRef
15.
Zurück zum Zitat Iversen E, Lykke A, Hensler M, Jorgensen LN (2010) Abdominal wall hernia repair with a composite ePTFE/polypropylene mesh: clinical outcome and quality of life in 152 patients. Hernia 14(6):555–560PubMedCrossRef Iversen E, Lykke A, Hensler M, Jorgensen LN (2010) Abdominal wall hernia repair with a composite ePTFE/polypropylene mesh: clinical outcome and quality of life in 152 patients. Hernia 14(6):555–560PubMedCrossRef
16.
Zurück zum Zitat Berrevoet F, Van den Bossche B, de Baerdemaeker L, de Hemptinne B (2010) Laparoscopic evaluation shows deficiencies in memory ring deployment during small ventral hernia repair. World J Surg 34:1710–1715PubMedCrossRef Berrevoet F, Van den Bossche B, de Baerdemaeker L, de Hemptinne B (2010) Laparoscopic evaluation shows deficiencies in memory ring deployment during small ventral hernia repair. World J Surg 34:1710–1715PubMedCrossRef
17.
Zurück zum Zitat Berrevoet F, D’Hont F, Rogiers X, Troisi R, De Hemptinne B (2011) Open intraperitoneal versus retromuscular mesh repair for umbilical hernias less than 3 cm diameter. Am J Surg 201:85–90PubMedCrossRef Berrevoet F, D’Hont F, Rogiers X, Troisi R, De Hemptinne B (2011) Open intraperitoneal versus retromuscular mesh repair for umbilical hernias less than 3 cm diameter. Am J Surg 201:85–90PubMedCrossRef
18.
Zurück zum Zitat Martin DF, Williams RF, Mulrooney T, Voeller GR (2008) Ventralex mesh in umbilical/epigastric hernia repairs: clinical outcomes and complications. Hernia 12:379–383PubMedCrossRef Martin DF, Williams RF, Mulrooney T, Voeller GR (2008) Ventralex mesh in umbilical/epigastric hernia repairs: clinical outcomes and complications. Hernia 12:379–383PubMedCrossRef
19.
Zurück zum Zitat Tinelli A, Malvasi A, Manca C, Alemanno G, Bettocchi S, Benhidjeb T (2011) Post-laparoscopic mesh in post-menopausal umbilical hernia repair: a case series. Minim Invasive Ther Allied Technol. Jan 19 [Epub ahead of print] Tinelli A, Malvasi A, Manca C, Alemanno G, Bettocchi S, Benhidjeb T (2011) Post-laparoscopic mesh in post-menopausal umbilical hernia repair: a case series. Minim Invasive Ther Allied Technol. Jan 19 [Epub ahead of print]
20.
Zurück zum Zitat Ware JE, Snow KK, Kosinski M, Gandek B (1993) SF-36 Health survey—manual and interpretation guide. New England Medical Center, The Health Institute, Boston, MA Ware JE, Snow KK, Kosinski M, Gandek B (1993) SF-36 Health survey—manual and interpretation guide. New England Medical Center, The Health Institute, Boston, MA
21.
Zurück zum Zitat Farrow B, Awad S, Berger DH, Albo D, Lee L, Subramanian A, Bellows CF (2008) More than 150 consecutive open umbilical hernia repairs in a major Veterans Administration Medical Center. Am J Surg 196:647–651PubMedCrossRef Farrow B, Awad S, Berger DH, Albo D, Lee L, Subramanian A, Bellows CF (2008) More than 150 consecutive open umbilical hernia repairs in a major Veterans Administration Medical Center. Am J Surg 196:647–651PubMedCrossRef
22.
Zurück zum Zitat Mayo WJ (1901) VI. An operation for the radical cure of umbilical hernia. Ann Surg 34:276–280PubMedCrossRef Mayo WJ (1901) VI. An operation for the radical cure of umbilical hernia. Ann Surg 34:276–280PubMedCrossRef
23.
Zurück zum Zitat Wright BE, Beckerman J, Cohen M, Cumming JK, Rodriguez JL (2002) Is laparoscopic umbilical hernia repair with mesh a reasonable alternative to conventional repair? Am J Surg 184:505–509PubMedCrossRef Wright BE, Beckerman J, Cohen M, Cumming JK, Rodriguez JL (2002) Is laparoscopic umbilical hernia repair with mesh a reasonable alternative to conventional repair? Am J Surg 184:505–509PubMedCrossRef
24.
Zurück zum Zitat Usher FC, Ochsner J, Tuttle LLD Jr (1958) Use of Marlex mesh in the repair of incisional hernias. Am Surg 24(12):969–974PubMed Usher FC, Ochsner J, Tuttle LLD Jr (1958) Use of Marlex mesh in the repair of incisional hernias. Am Surg 24(12):969–974PubMed
25.
Zurück zum Zitat Lau H, Patil NG (2003) Umbilical hernia in adults. Laparoscopic vs open repair. Surg Endosc 17:2016–2020PubMedCrossRef Lau H, Patil NG (2003) Umbilical hernia in adults. Laparoscopic vs open repair. Surg Endosc 17:2016–2020PubMedCrossRef
26.
Zurück zum Zitat Gonzalez R, Mason E, Duncan T, Wilson R, Ramshaw BJ (2003) Laparoscopic versus open umbilical hernia repair. JSLS 7:323–328PubMed Gonzalez R, Mason E, Duncan T, Wilson R, Ramshaw BJ (2003) Laparoscopic versus open umbilical hernia repair. JSLS 7:323–328PubMed
27.
Zurück zum Zitat Klosterhalfen B, Junge K, Klinge U (2005) The lightweight and large porous mesh concept for hernia repair. Expert Rev Med Devices 2:103–117PubMedCrossRef Klosterhalfen B, Junge K, Klinge U (2005) The lightweight and large porous mesh concept for hernia repair. Expert Rev Med Devices 2:103–117PubMedCrossRef
28.
Zurück zum Zitat Bringman S, Conze J, Cuccurullo D, Deprest J, Junge K, Klosterhalfen B, Parra-Davila E, Ramshaw B, Schumpelick V (2010) Hernia repair: the search for ideal meshes. Hernia 14:81–87PubMedCrossRef Bringman S, Conze J, Cuccurullo D, Deprest J, Junge K, Klosterhalfen B, Parra-Davila E, Ramshaw B, Schumpelick V (2010) Hernia repair: the search for ideal meshes. Hernia 14:81–87PubMedCrossRef
Metadaten
Titel
Retrospective analysis of umbilical, epigastric, and small incisional hernia repair using the Ventralex™ hernia patch
verfasst von
T. Tollens
M. Den Hondt
K. Devroe
C. Terry
S. Speybroeck
C. Aelvoet
J.-P. Vanrykel
Publikationsdatum
01.10.2011
Verlag
Springer-Verlag
Erschienen in
Hernia / Ausgabe 5/2011
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-011-0816-y

Weitere Artikel der Ausgabe 5/2011

Hernia 5/2011 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.