Does expanded polytetrafluoroethylene mesh really shrink after laparoscopic ventral hernia repair?

Carter, P. R.; LeBlanc, Karl A.; Hausmann, Mark G.; Whitaker, J. M.; Rhynes, V. K.; Kleinpeter, Kenneth P; Allain, Brent W.

doi:10.1007/s10029-011-0898-6

Cited by 30 publications

(12 citation statements)

References 17 publications

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“…Schoenmaeckers et al [21] reported that shrinkage of ePTFE in 656 patients who underwent laparoscopic hernia repair was only 7.5 % when measured by CT. This was recently confirmed by Carter et al [22] who reported a mean shrinkage rate of 6.7 %, confirming that ePTFE has minimal contraction in the human clinical situation.…”

Section: Discussionsupporting

confidence: 70%

The laparoscopic modified Sugarbaker technique is safe and has a low recurrence rate: a multicenter cohort study

et al. 2012

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BackgroundParastomal hernia is a frequent complication of intestinal stomata. Mesh repair gives the best results, with the mesh inserted via laparotomy or laparoscopically. It was the aim of this retrospective multicenter study to determine the early and late results of the laparoscopically performed, modified Sugarbaker technique with ePTFE mesh.MethodsFrom 2005 to 2010, a total of 61 consecutive patients (mean age = 61 years), with a symptomatic parastomal hernia, underwent laparoscopic repair using the modified Sugarbaker technique with ePTFE mesh. Fifty-five patients had a colostomy, 4 patients an ileostomy, and 2 a urostomy according to Bricker. The records of the patients were reviewed with respect to patient characteristics, postoperative morbidity, and mortality. All patients underwent physical examination after a follow-up of at least 1 year to detect a recurrent hernia. Morbidity rate was 19 % and included wound infection (n = 1), ileus (n = 2), trocar site bleeding (n = 2), reintervention (n = 2), and pneumonia (n = 1). One patient died in the postoperative period due to metastasis of lung carcinoma that caused bowel obstruction. Concomitant incisional hernias were detected in 25 of 61 patients (41 %) and could be repaired at the same time in all cases. A recurrent hernia was found in three patients at physical examination, and in one patient an asymptomatic recurrence was found on a CT scan. The overall recurrence rate was 6.6 % after a mean follow-up of 26 months.ConclusionThe laparoscopic Sugarbaker technique is a safe procedure for repairing parastomal hernias. In our study, the overall morbidity was 19 % and the recurrence rate was 6.6 % after a mean follow-up of 26 months. Moreover, the laparoscopic approach revealed concomitant hernias in 41 % of the patients, which could be repaired successfully at the same time.

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Section: Discussionsupporting

confidence: 70%

The laparoscopic modified Sugarbaker technique is safe and has a low recurrence rate: a multicenter cohort study

et al. 2012

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“…Several authors have reported ePTFE mesh contraction rates of approximately 40% in experimental studies performed in animals . In contrast, postoperative CT findings in humans have shown minimal contraction of ePTFE mesh compared with animal models . In our LVHR cases, the contraction rate of ePTFE mesh was 10.6%, a little larger than the rates previously reported in human models.…”

Section: Discussioncontrasting

confidence: 71%

Retrospective comparison of open versus laparoscopic ventral and incisional hernia repair

Tsuruta

Hirai

Nakamura

2014

Asian J Endoscop Surgery

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“…Two retrospective studies reported 6.7 and 7 % shrinkage of ePTFE mesh measured by computed tomography [113,114]. These results were markedly lower than those determined in animal studies.…”

Section: Safetycontrasting

confidence: 43%

Laparoscopic ventral/incisional hernia repair: updated guidelines from the EAES and EHS endorsed Consensus Development Conference

et al. 2015

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The availability of recent level 1 evidence (a meta-analysis of 10 RCTs) allowed to recommend that not only laparoscopic repair is an acceptable alternative to the open repair, but also it is advantageous in terms of shorter hospital stay and wound infection rate. This conclusion appears to be extremely relevant in a clinical setting. Indications about specific conditions could also be issued: laparoscopy is recommended for the treatment of recurrent ventral hernias and obese patients, while it is a potential option for compensated cirrhotic and childbearing-age female patients. Many relevant and controversial topics were thoroughly examined by this consensus conference for the first time. Among them are the issue of safety of the intraperitoneal mesh placement, traditionally considered a major drawback of the laparoscopic technique, the role for the biologic meshes, and various aspects of the laparoscopic approach for particular locations of the defect such as the abdominal border or parastomal hernias.

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Does expanded polytetrafluoroethylene mesh really shrink after laparoscopic ventral hernia repair?

Abstract: Our results are markedly different from animal studies and show that ePTFE has minimal shrinkage after LIVH repair. The use of transfascial sutures in addition to tack fixation may have an implication on the mesh contraction rates.

Cited by 30 publications

References 17 publications

The laparoscopic modified Sugarbaker technique is safe and has a low recurrence rate: a multicenter cohort study

The laparoscopic modified Sugarbaker technique is safe and has a low recurrence rate: a multicenter cohort study

Retrospective comparison of open versus laparoscopic ventral and incisional hernia repair

Laparoscopic ventral/incisional hernia repair: updated guidelines from the EAES and EHS endorsed Consensus Development Conference

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