Top

Surgical Endoscopy

Published in:

01-01-2017

Outcomes of bridging versus mesh augmentation in laparoscopic repair of small and medium midline ventral hernias

Authors: Kryspin Mitura, Marzena Skolimowska-Rzewuska, Karolina Garnysz

Published in: Surgical Endoscopy | Issue 1/2017

Abstract

Background

Bridging of the hernia defect in laparoscopic repair (sIPOM) technique does not fully restore the abdominal wall function. Closure of hernia defect in IPOM-plus technique leads to the restoration of abdominal wall function and improved long-term treatment outcomes. Against the expectations, the studies confirm the formation of intraabdominal adhesions to the mesh. Regardless of the above, the search of the proper technique for mesh implantation and fixation is still ongoing. There have also been attempts to identify groups of patients who may still benefit from IPOM procedure.

Materials and methods

Patients with midline abdominal wall hernias up to 10 cm wide were enrolled in the study except for subxiphoid and suprapubic hernias. Between 2011 and 2014 we performed 82 hernia repairs using the laparoscopic technique with Physiomesh. Patients were divided into sIPOM and IPOM-plus groups. The study included 44M and 38F patients aged 27–84 years. After 12-months and again in August 2015 a survey was posted to all patients with questions regarding potential recurrence.

Results

After 12 months, eight patients (20 %) in sIPOM group reported subjectively perceived recurrence and none in IPOM-plus group (p = 0.002). Six patients (14.3 %) in sIPOM group reported suspected recurrence, as compared to three patients (7.1 %) in IPOM-plus group (p = 0.13). These patients were invited for a follow-up physical examination and sonography. Eventually, four cases of hernia recurrence were confirmed in sIPOM group (10 %) and none in IPOM-plus group (p = 0.018). Other patients presented with mesh bulging.

Conclusions

Laparoscopic ventral hernia repair is generally safe and is associated with the low recurrence rate. Closure of fascial defects before mesh insertion offers better treatment outcomes. Non-closure of fascial defects with only bridging of the hernia defect (sIPOM) causes more frequent recurrence and bulging. As a result, patient satisfaction with treatment is lower, and they are concerned about hernia recurrence.

Schreinemacher MH, Emans PJ, Gijbels MJ, Greve JW, Beets GL, Bouvy ND (2009) Degradation of mesh coatings and intraperitoneal adhesion formation in an experimental model. Br J Surg 96(3):305–313CrossRefPubMed

Litarski A, Pawełczyk J, Majcherek J, Janczak D, Pawłowski L, Rucińska Z, Janczak D (2014) Laparoscopic treatment of abdominal hernia—5 years of experience. Polski Przegląd Chirurgiczny 86(8):353–358PubMed

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 reexploration after prior ventral hernia repair. Surg Endosc 24:3002–3007CrossRefPubMed

Ellis H (2005) Intraabdominal and postoperative peritoneal adhesions. J Am Coll Surg 200:641–644CrossRefPubMed

Muysoms FE, Bontinck J, Pletinckx P (2011) Complications of mesh devices for intraperitoneal umbilical hernia repair: a word of caution. Hernia 15:463–468CrossRefPubMed

ten Broek RPG, Schreinemacher MHF, Jilesen APJ, Bouvy N, Bleichrodt RP, van Goor H (2012) Enterotomy risk in abdominal wall repair: a prospective study. Ann Surg 256:280–287CrossRefPubMed

Schreinemacher MHF, ten Broek RP, Bakkum EA, van Goor H, Bouvy ND (2010) Adhesion awareness: a national survey of surgeons. World J Surg 34:2805–2812CrossRefPubMedPubMedCentral

Rickert A, Kienle P, Kuthe A, Baumann P, Engemann R, Kuhlgatz J, von Frankenberg M, Knaebel HP, Büchler MW (2012) A randomised, multi-centre, prospective, observer and patient blind study to evaluate a non-absorbable polypropylene mesh vs. a partly absorbable mesh in incisional hernia repair. Langenbecks Arch Surg 397(8):1225–1234CrossRefPubMedPubMedCentral

Schoenmaeckers EJP, Wassenaar EB, Raymakers JTFJ, Rakic S (2010) Bulging of the mesh after laparoscopic repair of ventral and incisional hernias. JSLS 14:541–546CrossRefPubMedPubMedCentral

10.

Carter SA, Hicks SC, Brahmbhatt R, Liang MK (2014) Recurrence and pseudorecurrence after laparoscopic ventral hernia repair: predictors and patient-focused outcomes. Am Surg 80(2):138–148PubMed

11.

Suwa K, Okamoto T, Yanaga K (2015) Closure versus non-closure of fascial defects in laparoscopic ventral and incisional hernia repairs: a review of the literature. Surg Today. doi:10.1007/s00595-015-1219-y

12.

Pawlak M, Bury K, Śmietański M (2015) The management of abdominal wall hernias—in search of consensus. Videosurg Miniinvasive 10(1):49–56CrossRef

13.

Bellón JM (2009) Degradation of mesh coatings and intraperitoneal adhesion formation in an experimental model. Br J Surg 96(6):693CrossRefPubMed

14.

Gierej P, Kotulski M, Piotrowicz M (2010) Adhesive complications in a patient after ventral hernia IPOM repair—a case report for Videoforum. Videosurg Miniinvasive Tech 5(4):166–170CrossRef

15.

Pawlak M, Hilgers RD, Bury K, Lehmann A, Owczuk R, Śmietański M (2015) Comparison of two different concepts of mesh and fixation technique in laparoscopic ventral hernia repair: a randomized controlled trial. Surg Endosc 30(3):1188–1197CrossRefPubMed

16.

Chelala E, Debardemaeker Y, Elias B, Charara F, Dessily M, Allé J-L (2010) Eighty-five redo surgeries after 733 laparoscopic treatments for ventral and incisional hernia: adhesion and recurrence analysis. Hernia 14:123–129CrossRefPubMed

17.

Muysoms FE, Miserez M, Berrevoet F, Campanelli G, Champault GG, Chelala E, Dietz UA, Eker HH, El Nakadi I, Hauters P, Pascual MH, Hoeferlin A, Klinge U, Montgomery A, Simmermacher RK, Simons MP, Smietański M, Sommeling C, Tollens T, Vierendeels T, Kingsnorth A (2009) Classification of primary and incisional abdominal wall hernias. Hernia 13(4):407–414CrossRefPubMedPubMedCentral

18.

Mueller MD, Tschudi J, Herrmann U, Klaiber C (1995) An evaluation of laparoscopic adhesiolysis in patients with chronic abdominal pain. Surg Endosc 9:802–804CrossRefPubMed

19.

Deeken CR, Matthews BD (2013) Ventralight ST and SorbaFix versus Physiomesh and Securestrap in a porcine model. JSLS 17(4):549–559CrossRefPubMedPubMedCentral

20.

Vogels RR, van Barneveld KW, Bosmans JW, Beets G, Gijbels MJ, Schreinemacher MH, Bouvy ND (2015) Long-term evaluation of adhesion formation and foreign body response to three new meshes. Surg Endosc 29(8):2251–2259CrossRefPubMed

21.

Pascual G, Sotomayor S, Rodríguez M, Bayon Y, Bellón JM (2015) Tissue integration and inflammatory reaction in full-thickness abdominal wall repair using an innovative composite mesh. Hernia. doi:10.1007/s10029-015-1383-4

22.

Deeken CR, Thompson DM Jr, Castile RM, Lake SP (2014) Biaxial analysis of synthetic scaffolds for hernia repair demonstrates variability in mechanical anisotropy, non-linearity and hysteresis. J Mech Behav Biomed Mater 38:6–16CrossRefPubMed

23.

Bittner R, Bingener-Casey J, Dietz U, Fabian M, Ferzli GS, Fortelny RH, Köckerling F, Kukleta J, LeBlanc K, Lomanto D, Misra MC, Morales-Conde S, Ramshaw B, Reinpold W, Rim S, Rohr M, Schrittwieser R, Simon Th, Smietanski M, Stechemesser B, Timoney M, Chowbey P (2014) Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society [IEHS])—Part 2. Surg Endosc 28:353–379CrossRefPubMed

24.

Takács I, Horváth S, Molnár Á, Gáspár S, Hajós R, Meczker Á, Kóbor P, Lantos J, Jávor S, Balatonyi B, Szekeres G, Röth E, Wéber G (2011) Comparative immunohistochemical study of tissue integration of macroporous and laminar surgical meshes. Histol Histopathol 26(7):821–830PubMed

25.

Mitura K (2016) Different approach to laparoscopic IPOM ventral hernia surgery—what has the last decade taught us? Pol Przegl Chir. 88(1):54–61PubMed

26.

Bradley JF III, Williams KB, Wormer BA, Tsirline VB, Walters AL, Sing RF, Belyansky I, Heniford BT (2012) Preliminary results of surgical and quality of life outcomes of Physiomesh in an international, prospective study. Surg Technol Int 22:113–119PubMed

27.

Chelala E, Thoma M, Tatete B, Lemye AC, Dessily M, Alle JL (2007) The suturing concept for laparoscopic mesh fixation in ventral and incisional hernia repair: mid-term analysis of 400 cases. Surg Endosc 21:391–395CrossRefPubMed

28.

Chelala E, Baraké H, Estievenart J, Dessily M, Charara F, Allé JL (2015) Long-term outcomes of 1326 laparoscopic incisional and ventral hernia repair with the routine suturing concept: a single institution experience. Hernia. 21 June 2015. [Epub ahead of print]

29.

Agarwal BB, Agarwal S, Gupta MK, Mishra A, Mahajan KC (2008) Laparoscopic ventral hernia meshplasty with “double-breasted” fascial closure of hernia defect: a new technique. J Laparoendosc Adv Surg Tech 18:222–229CrossRef

30.

Orenstein SB, Dumeer JL, Monteagudo J, Poi MJ, Novitsky YW (2011) Outcomes of laparoscopic ventral hernia repair with routine defect closure using “shoelacing” technique. Surg Endosc 25:1452–1457CrossRefPubMed

31.

Muysoms FE, Antoniou SA, Bury K, Campanelli G, Conze J, Cuccurullo D, de Beaux AC, Deerenberg EB, East B, Fortelny RH, Gillion JF, Henriksen NA, Israelsson L, Jairam A, Jänes A, Jeekel J, López-Cano M, Miserez M, Morales-Conde S, Sanders DL, Simons MP, Śmietański M, Venclauskas L, Berrevoet F, European Hernia Society (2015) European Hernia Society guidelines on the closure of abdominal wall incisions. Hernia 19(1):1–24CrossRefPubMed

32.

Millbourn D, Cengiz Y, Israelsson LA (2009) Effect of stitch length on wound complications after closure of midline incisions: a randomized controlled trial. Arch Surg 144(11):1056–1059CrossRefPubMed

33.

Palanivelu C, Jani KV, Senthilnathan P et al (2007) Laparoscopic sutured closure with mesh reinforcement of incisional hernias. Hernia 11:223–228CrossRefPubMed

34.

Strey CW (2014) Triple-step laparoscopic incisional hernia repair: midline suture closure supported by dorsal component separation and intraperitoneal onlay mesh reinforcement. World J Surg 38(12):3276–3279CrossRefPubMedPubMedCentral

35.

Zuvela M, Galun D, Djurić-Stefanović A, Palibrk I, Petrović M, Milićević M (2014) Central rupture and bulging of low-weight polypropylene mesh following recurrent incisional sublay hernioplasty. Hernia 18(1):135–140CrossRefPubMed

Title: Outcomes of bridging versus mesh augmentation in laparoscopic repair of small and medium midline ventral hernias
Authors: Kryspin Mitura
Marzena Skolimowska-Rzewuska
Karolina Garnysz
Publication date: 01-01-2017
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 1/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-016-4984-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Outcomes of bridging versus mesh augmentation in laparoscopic repair of small and medium midline ventral hernias

Abstract

Background

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2017

Current training on the basics of robotic surgery in the Netherlands: Time for a multidisciplinary approach?

Small bowel obstruction and incisional hernia after laparoscopic and open colorectal surgery: a meta-analysis of comparative trials

GERD and acid reduction medication use following gastric bypass and sleeve gastrectomy

Weight loss and improvement of lipid profiles in morbidly obese patients after laparoscopic one-anastomosis gastric bypass: 2-year follow-up

Total mesorectal excision using a soft and flexible robotic arm: a feasibility study in cadaver models

Intracorporeal versus extracorporeal anastomosis in right hemicolectomy: a systematic review and meta-analysis