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Erschienen in: Hernia 5/2013

01.10.2013 | Original Article

DynaMesh® in the repair of laparoscopic ventral hernia: a prospective trial

verfasst von: T. Sommer, H. Friis-Andersen

Erschienen in: Hernia | Ausgabe 5/2013

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Abstract

Purpose

To investigate mesh-related complications in patients undergoing laparoscopic ventral hernia repair using DynaMesh®.

Methods

In the period 1 January 2005 through 31 December 2010, 181 consecutive patients undergoing laparoscopic ventral hernia repair in our day surgery unit using DynaMesh® were entered prospectively in the National Danish Hernia Database. Data concerning abdominal reoperations after hernia repair were later collected on all 181 patients from the National Danish Health Registry. Postoperative telephone interviews were conducted estimating postoperative pain and patient satisfaction.

Results

Six % (11 patients) were reoperated because of mesh-related complications. Three had small bowel obstruction and one had a colonic fistula with mesh infection, all causing bowel resection and mesh removal. Mesh-related cutaneous fistula was seen in one patient. Six patients had a symptomatic recurrence requiring reoperation. Abdominal wall hematomas were seen in two cases, while two other patients had symptomatic large seromas, of which one was drained surgically. After a median follow-up of 34 months (range 12–63) in 140 patients, 66 % were pain free (0 on the Numeric Rating Scale (NRS)). Of 26 patients with moderate to severe pain (NRS > 3) at follow-up, only 4 regretted the operation. Sixteen patients thought they had a recurrence, of these only 3 regretted the operation.

Conclusion

The use of DynaMesh® in laparoscopic ventral hernia repair was associated with a 6 % risk of mesh-related reoperation in a high volume setting. Despite chronic pain in 19 %, after 34 months follow-up patient satisfaction was high.
Literatur
1.
Zurück zum Zitat LeBlanc KA, Booth WV (1993) Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endosc 3:39–41PubMed LeBlanc KA, Booth WV (1993) Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endosc 3:39–41PubMed
2.
Zurück zum Zitat Sauerland S, Walgenbach M, Habermalz B, Seiler CM, Miserez M (2011) Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst Rev 16: CD007781 Sauerland S, Walgenbach M, Habermalz B, Seiler CM, Miserez M (2011) Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst Rev 16: CD007781
3.
Zurück zum Zitat Forbes SS, Eskicioglu C, McLeod RS, Okrainec A (2009) Meta-analysis of randomized controlled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh. Br J Surg 96:851–858PubMedCrossRef Forbes SS, Eskicioglu C, McLeod RS, Okrainec A (2009) Meta-analysis of randomized controlled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh. Br J Surg 96:851–858PubMedCrossRef
4.
Zurück zum Zitat Itani KM, Hur K, Kim LT, Anthony T, Berger DH, Reda D, Neumayer L (2010) Comparison of laparoscopic and open repair with mesh for the treatment of ventral incisional hernia: a randomized trial. Arch Surg 145:322–328PubMedCrossRef Itani KM, Hur K, Kim LT, Anthony T, Berger DH, Reda D, Neumayer L (2010) Comparison of laparoscopic and open repair with mesh for the treatment of ventral incisional hernia: a randomized trial. Arch Surg 145:322–328PubMedCrossRef
5.
Zurück zum Zitat Helgstrand F, Rosenberg J, Kehlet H, Bisgaard T (2011) Nationwide analysis of prolonged hospital stay and readmission after elective ventral hernia repair. Dan Med Bull 58:A4322PubMed Helgstrand F, Rosenberg J, Kehlet H, Bisgaard T (2011) Nationwide analysis of prolonged hospital stay and readmission after elective ventral hernia repair. Dan Med Bull 58:A4322PubMed
6.
Zurück zum Zitat Deeken CR, Faucher KM, Matthews BD (2012) A review of the composition, characteristics, and effectiveness of barrier mesh prostheses utilized for laparoscopic ventral hernia repair. Surg Endosc 26:566–575PubMedCrossRef Deeken CR, Faucher KM, Matthews BD (2012) A review of the composition, characteristics, and effectiveness of barrier mesh prostheses utilized for laparoscopic ventral hernia repair. Surg Endosc 26:566–575PubMedCrossRef
7.
Zurück zum Zitat Klinge U, Klosterhalfen B, Ottinger AP, Junge K, Schumpelick V (2002) PVDF as a new polymer for the construction of surgical meshes. Biomaterials 23:3487–3493PubMedCrossRef Klinge U, Klosterhalfen B, Ottinger AP, Junge K, Schumpelick V (2002) PVDF as a new polymer for the construction of surgical meshes. Biomaterials 23:3487–3493PubMedCrossRef
8.
Zurück zum Zitat Berger D, Bientzle M (2009) Polyvinylidene fluoride: a suitable mesh material for laparoscopic incisional and parastomal hernia repair! A prospective, observational study with 344 patients. Hernia 13:167–172PubMedCrossRef Berger D, Bientzle M (2009) Polyvinylidene fluoride: a suitable mesh material for laparoscopic incisional and parastomal hernia repair! A prospective, observational study with 344 patients. Hernia 13:167–172PubMedCrossRef
9.
Zurück zum Zitat Fortelny RH, Petter-Puchner AH, Glaser KS, Offner F, Benesch T, Rohr M (2010) Adverse effects of polyvinylidene fluoride-coated polypropylene mesh used for laparoscopic intraperitoneal onlay repair of incisional hernia. Br J Surg 97:1140–1145PubMedCrossRef Fortelny RH, Petter-Puchner AH, Glaser KS, Offner F, Benesch T, Rohr M (2010) Adverse effects of polyvinylidene fluoride-coated polypropylene mesh used for laparoscopic intraperitoneal onlay repair of incisional hernia. Br J Surg 97:1140–1145PubMedCrossRef
10.
Zurück zum Zitat Morales-Conde S, Cadet H, Cano A, Bustos M, Martín J, Morales-Mendez S (2005) Laparoscopic ventral hernia repair without sutures–double crown technique: our experience after 140 cases with a mean follow-up of 40 months. Int Surg 90:S56–S62PubMed Morales-Conde S, Cadet H, Cano A, Bustos M, Martín J, Morales-Mendez S (2005) Laparoscopic ventral hernia repair without sutures–double crown technique: our experience after 140 cases with a mean follow-up of 40 months. Int Surg 90:S56–S62PubMed
11.
Zurück zum Zitat Helgstrand F, Rosenberg J, Bay-Nielsen M, Friis-Andersen H, Wara P, Jorgensen LN, Kehlet H, Bisgaard T (2010) Establishment and initial experiences from the Danish Ventral Hernia Database. Hernia 14:131–135PubMedCrossRef Helgstrand F, Rosenberg J, Bay-Nielsen M, Friis-Andersen H, Wara P, Jorgensen LN, Kehlet H, Bisgaard T (2010) Establishment and initial experiences from the Danish Ventral Hernia Database. Hernia 14:131–135PubMedCrossRef
12.
Zurück zum Zitat Jonas J (2009) The problem of mesh shrinkage in laparoscopic incisional hernia repair. Zentralbl Chir 134:209–213PubMedCrossRef Jonas J (2009) The problem of mesh shrinkage in laparoscopic incisional hernia repair. Zentralbl Chir 134:209–213PubMedCrossRef
13.
Zurück zum Zitat Zinther NB, Wara P, Friis-Andersen H (2010) Shrinkage of intraperitoneal onlay mesh in sheep: coated polyester mesh versus covered polypropylene mesh. Hernia 14:611–615PubMedCrossRef Zinther NB, Wara P, Friis-Andersen H (2010) Shrinkage of intraperitoneal onlay mesh in sheep: coated polyester mesh versus covered polypropylene mesh. Hernia 14:611–615PubMedCrossRef
14.
Zurück zum Zitat Junge K, Binnebösel M, Rosch R, Jansen M, Kämmer D, Otto J, Schumpelick V, Klinge U (2009) Adhesion formation of a polyvinylidenfluoride/polypropylene mesh for intra-abdominal placement in a rodent animal model. Surg Endosc 23:327–333PubMedCrossRef Junge K, Binnebösel M, Rosch R, Jansen M, Kämmer D, Otto J, Schumpelick V, Klinge U (2009) Adhesion formation of a polyvinylidenfluoride/polypropylene mesh for intra-abdominal placement in a rodent animal model. Surg Endosc 23:327–333PubMedCrossRef
15.
Zurück zum Zitat Beldi G, Wagner M, Bruegger LE, Kurmann A, Candinas D (2011) Mesh shrinkage and pain in laparoscopic ventral hernia repair: a randomized clinical trial comparing suture versus tack mesh fixation. Surg Endosc 25:749–755PubMedCrossRef Beldi G, Wagner M, Bruegger LE, Kurmann A, Candinas D (2011) Mesh shrinkage and pain in laparoscopic ventral hernia repair: a randomized clinical trial comparing suture versus tack mesh fixation. Surg Endosc 25:749–755PubMedCrossRef
16.
Zurück zum Zitat Brill JB, Turner PL (2011) Long-term outcomes with transfascial sutures versus tacks in laparoscopic ventral hernia repair: a review. Am Surg 77:458–465PubMed Brill JB, Turner PL (2011) Long-term outcomes with transfascial sutures versus tacks in laparoscopic ventral hernia repair: a review. Am Surg 77:458–465PubMed
17.
Zurück zum Zitat Bansal VK, Misra MC, Kumar S, Rao YK, Singhal P, Goswami A, Guleria S, Arora MK, Chabra A (2011) A prospective randomized study comparing suture mesh fixation versus tacker mesh fixation for laparoscopic repair of incisional and ventral hernias. Surg Endosc 25:1431–1438PubMedCrossRef Bansal VK, Misra MC, Kumar S, Rao YK, Singhal P, Goswami A, Guleria S, Arora MK, Chabra A (2011) A prospective randomized study comparing suture mesh fixation versus tacker mesh fixation for laparoscopic repair of incisional and ventral hernias. Surg Endosc 25:1431–1438PubMedCrossRef
18.
Zurück zum Zitat Nguyen SQ, Divino CM, Buch KE, Schnur J, Weber KJ, Katz LB, Reiner MA, Aldoroty RA, Herron DM (2008) Postoperative pain after laparoscopic ventral hernia repair: a prospective comparison of sutures versus tacks. JSLS 12:113–116PubMed Nguyen SQ, Divino CM, Buch KE, Schnur J, Weber KJ, Katz LB, Reiner MA, Aldoroty RA, Herron DM (2008) Postoperative pain after laparoscopic ventral hernia repair: a prospective comparison of sutures versus tacks. JSLS 12:113–116PubMed
19.
Zurück zum Zitat Chelala E, Debardemaeker Y, Elias B, Charara F, Dessily M, Allé J (2010) Eighty-five redo surgeries after 733 laparoscopic treatments for ventral and incisional hernia: adhesion and recurrence analysis. Hernia 14:123–129PubMedCrossRef Chelala E, Debardemaeker Y, Elias B, Charara F, Dessily M, Allé J (2010) Eighty-five redo surgeries after 733 laparoscopic treatments for ventral and incisional hernia: adhesion and recurrence analysis. Hernia 14:123–129PubMedCrossRef
20.
Zurück zum Zitat Koehler RH, Begos D, Berger D, Carey S, LeBlanc K, Park A, Ramshaw B, Smoot R, Voeller G (2003) Minimal adhesions to ePTFE mesh after laparoscopic ventral incisional hernia repair: reoperative findings in 65 cases. JSLS 7:335–340PubMed Koehler RH, Begos D, Berger D, Carey S, LeBlanc K, Park A, Ramshaw B, Smoot R, Voeller G (2003) Minimal adhesions to ePTFE mesh after laparoscopic ventral incisional hernia repair: reoperative findings in 65 cases. JSLS 7:335–340PubMed
21.
Zurück zum Zitat Jenkins ED, Yom V, Melman L, Brunt LM, Eagon JC, Frisella MM, Matthews BD (2010) Prospective evaluation of adhesion characteristics to intraperitoneal mesh and adhesiolysis-related complications during laparoscopic re-exploration after prior ventral hernia repair. Surg Endosc 24:3002–3007PubMedCrossRef Jenkins ED, Yom V, Melman L, Brunt LM, Eagon JC, Frisella MM, Matthews BD (2010) Prospective evaluation of adhesion characteristics to intraperitoneal mesh and adhesiolysis-related complications during laparoscopic re-exploration after prior ventral hernia repair. Surg Endosc 24:3002–3007PubMedCrossRef
22.
Zurück zum Zitat Helgstrand F, Rosenberg J, Kehlet H, Strandfelt P, Bisgaard T (2012) Reoperation vs. clinical recurrence rate after ventral hernia repair. Ann Surg [Epub ahead of print] Helgstrand F, Rosenberg J, Kehlet H, Strandfelt P, Bisgaard T (2012) Reoperation vs. clinical recurrence rate after ventral hernia repair. Ann Surg [Epub ahead of print]
23.
Zurück zum Zitat Moreno-Egea A, Torralba JA, Girela E, Corral M, Bento M, Cartagena J, Vicente JP, Aguayo JL, Canteras M (2004) Immediate, early, and late morbidity with laparoscopic ventral hernia repair and tolerance to composite mesh. Surg Laparosc Endosc Percutan Tech 14:130–135PubMedCrossRef Moreno-Egea A, Torralba JA, Girela E, Corral M, Bento M, Cartagena J, Vicente JP, Aguayo JL, Canteras M (2004) Immediate, early, and late morbidity with laparoscopic ventral hernia repair and tolerance to composite mesh. Surg Laparosc Endosc Percutan Tech 14:130–135PubMedCrossRef
24.
Zurück zum Zitat LeBlanc KA, Elieson MJ, Corder JM (2007) Enterotomy and mortality rates of laparoscopic incisional and ventral hernia repair: a review of the literature. JSLS 11:408–414PubMed LeBlanc KA, Elieson MJ, Corder JM (2007) Enterotomy and mortality rates of laparoscopic incisional and ventral hernia repair: a review of the literature. JSLS 11:408–414PubMed
25.
Zurück zum Zitat Bencini L, Sánchez LJ (2004) Learning curve for laparoscopic ventral hernia repair. Am J Surg 187:378–382PubMedCrossRef Bencini L, Sánchez LJ (2004) Learning curve for laparoscopic ventral hernia repair. Am J Surg 187:378–382PubMedCrossRef
26.
Zurück zum Zitat Morales-Conde S (2012) A new classification for seroma after laparoscopic ventral hernia repair. Hernia 16:261–267PubMedCrossRef Morales-Conde S (2012) A new classification for seroma after laparoscopic ventral hernia repair. Hernia 16:261–267PubMedCrossRef
27.
Zurück zum Zitat Cuccurullo D, Piccoli M, Agresta F, Magnone S, Corcione F, Stancanelli V, Melotti G (2013) Laparoscopic ventral incisional hernia repair: evidence-based guidelines of the first Italian Consensus Conference. Hernia [Epub ahead of print] Cuccurullo D, Piccoli M, Agresta F, Magnone S, Corcione F, Stancanelli V, Melotti G (2013) Laparoscopic ventral incisional hernia repair: evidence-based guidelines of the first Italian Consensus Conference. Hernia [Epub ahead of print]
Metadaten
Titel
DynaMesh® in the repair of laparoscopic ventral hernia: a prospective trial
verfasst von
T. Sommer
H. Friis-Andersen
Publikationsdatum
01.10.2013
Verlag
Springer Paris
Erschienen in
Hernia / Ausgabe 5/2013
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-013-1090-y

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