Parietex™ Composite mesh versus DynaMesh^®-IPOM for laparoscopic incisional and ventral hernia repair: a retrospective cohort study

Abstract

INTRODUCTION Laparoscopic incisional and ventral hernia repair (LIVHR) is widely accepted and safe but the type of mesh used is still debated. We retrospectively compared postoperative outcomes with two different meshes commonly used in LIVHR. METHODS This is a retrospective study of patients who underwent incisional hernia repair between January 2008 and December 2010. Two meshes were used: Parietex™ Composite (Covidien, New Haven, CT, USA) and the DynaMesh®-IPOM (FEG Textiltechnik mbH, Aachen, Germany). The two groups were compared with respect to recurrence rates, incidence of seroma and intestinal obstruction. RESULTS Among the 88 patients who underwent LIVHR, 75 patients (85.2%) presented with primary incisional hernia, 10 (11.4%) presented with a first recurrence and 3 (3.4%) presented with a second recurrence. Median follow-up was 53.6 months (range 40–61 months). 12.9% of patients had recurrence in the Parietex™ Composite mesh group (n=62) in comparison to 3.8% in the DynaMesh®-IPOM mesh group (n=26; P=0.20). DynaMesh®-IPOM was associated with a significantly higher incidence of intestinal obstruction secondary to adhesions (11.5% vs. 0%, P=0.006) and lower incidence of seroma and haematoma formation compared to Parietex™ composite mesh group (0% vs. 6.4% of patients; P=0.185). CONCLUSIONS LIVHR is a safe and feasible technique. Dynamesh®-IPOM is associated with a significantly higher incidence of adhesion related bowel obstruction, albeit with a lower incidence of recurrence, seroma and haematoma formation compared with Parietex™ Composite mesh. However, there is a need for further well-designed, multicentre randomised controlled studies to investigate the use of these meshes.

Prospective cohort study on mesh shrinkage measured with MRI after laparoscopic ventral hernia repair with an intraperitoneal iron oxide-loaded PVDF mesh

“…A more recent prospective study by Sommer et al demonstrated a 6% reoperation rate after a median follow-up of 36 months, and although some reoperations were because of adhesions, the majority were reoperations for a symptomatic recurrence [ 26 ]. In a retrospective study on 88 patients undergoing laparoscopic ventral hernia repair, Tandon et al compared 62 Parietex™ Composite meshes and 26 DynaMesh® IPOM meshes [ 27 ]. With a median follow-up of 53.6 months, they found a recurrence rate of 12.9 and 3.8%, respectively, for Parietex™ Composite and DynaMesh® IPOM.…”

Two cases about mesh adhesion to intra-abdominal cavity tissue after using mesh to repair an incisional hernia

“…LVHR is now widely accepted for the repair of ventral hernia defects. 17 It has the advantages of a shorter hospital stay, lower incidence of infection, less pain and less risk of adhesion. 17 , 18 There are some common complications following LVHR, including seroma formation, ileus, pain and wound infection.…”

“… 17 It has the advantages of a shorter hospital stay, lower incidence of infection, less pain and less risk of adhesion. 17 , 18 There are some common complications following LVHR, including seroma formation, ileus, pain and wound infection. 19 More serious complications include bowel injury, which is higher in LVHR than OVHR.…”

Regulatory science for hernia mesh: Current status and future perspectives

“… Type of material Chemical name of material Ref. 1 A: Non-absorbable synthetic materials Polypropylene (PP) [ 22 ] 2 Polytetrafluoroethylene (PTFE) [ 23 ] 3 Expanded polytetrafluoroethylene (ePTFE) [ 24 ] 4 Polyvinylidene fluoride (PVDF) [ 24 ] 5 Polyethylene terephthalate (PET) [ 23 ] 6 nylon 6 [ 25 ] 7 Polycarbonate polyurethane urea [ 26 ] 8 Cross-linked acrylic polymer [ 27 ] 9 Polycaprolactone (PCL) based poly (urethane urea) (PUU) [ 28 ] 10 expanded polytetrafluoroethylene (ePTFE) reinforced with fluorinated ethylene propylene (FEP) [ 29 ] 11 Co-knitted using PP and PVDF [ 30 ] 12 Co-knitted using PP and Polyurethane (PU) [ 31 ] 13 Co-knitted using PP and Polycarbonate polyurethane urea [ 32 ] 14 PP with titanium coa...…”

“… Type of material Chemical name of material Ref. 1 Non-absorbable synthetic materials ePTFE [ 65 ] 2 PVDF [ 30 ] 3 Cross-linked acrylic polymer with polyamide [ 27 ] 4 Polyurethane [ 31 ] 5 silicone [ 66 ] 6 Absorbable synthetic materials P (LA-CL) [ 32 , 67 ] 7 P (GA-CL) [ 31 ] 8 P (GA-TMC) [ 40 ] 9 P (GA-CL-TMC-LA) [ 68 ] 10 Oxidized regenerated cellulose (ORC) [ 56 , 69 ] 11 Natural materials Bioabsorbable Oil Fatty Acid (O3FA): fatty acids, lipids and glycerides [ 31 ] 12 Cross-linked resorbable collagen film of porcine origin [ 53 ] 13 Composite materials Porcine collagen, polyethylene glycol (PEG)and glycerol …”