Hernia : the journal of hernias and abdominal wall surgery
-
Multicenter Study Comparative Study Controlled Clinical Trial
Evaluation of surgical outcomes of retro-rectus versus intraperitoneal reinforcement with bio-prosthetic mesh in the repair of contaminated ventral hernias.
Hernia repairs in contaminated fields are often reinforced with a bioprosthetic mesh. When choosing which of the multiple musculofascial abdominal wall planes provides the most durable repair, there is little guidance. We hypothesized that the retro-rectus plane would reduce recurrence rates versus intraperitoneal placement due to greater surface area contact of mesh with well-vascularized tissue. ⋯ In this retrospective analysis of a prospective multicenter study of large, contaminated ventral hernias, despite a larger hernia defect in the retro-rectus group, placement of the mesh in the retro-rectus compartment resulted in a similar recurrence rate to intraperitoneal mesh placement. Ongoing evaluation is important to establish longer-term outcomes and the validity of these findings.
-
Randomized Controlled Trial Multicenter Study Comparative Study
PerFix™ plug versus 4DDOME(®) implants for inguinal hernia repair: prospective multicentric randomised controlled trial.
Anterior mesh placement is the standard of care for hernia repair. The use of partially absorbable meshes may limit post-operative pain without altering the durability of the repair. We designed a prospective randomised study, which aims to compare the PerFix™ plug to the 4DDOME(®), a partially absorbable mesh. ⋯ This clinical study demonstrated similar short-term results. The 4DDOME(®) was associated with less pain and discomfort after 3 and 6 months. The combination of the dome shape and the double component mesh including an absorbable part meet the conflicting demands of early strength with a long-term low-weight material to minimise shrinkage and fibrosis. This design represents a potential advance in anterior tension-free hernia repair with mesh.
-
Randomized Controlled Trial Multicenter Study Comparative Study
Randomized controlled multicenter international clinical trial of self-gripping Parietex™ ProGrip™ polyester mesh versus lightweight polypropylene mesh in open inguinal hernia repair: interim results at 3 months.
To compare clinical outcomes following sutureless Parietex™ ProGrip™ mesh repair to traditional Lichtenstein repair with lightweight polypropylene mesh secured with sutures. ⋯ Surgery duration, early postoperative, pain and infection rates were significantly reduced with self-gripping polyester mesh compared to Lichtenstein repair with polypropylene mesh. The use of fixation increased postoperative pain in the P group. The absence of early recurrence highlights the gripping efficiency effect.
-
Multicenter Study Clinical Trial
A self-adhering mesh for inguinal hernia repair: preliminary results of a prospective, multicenter study.
Prosthetic reinforcement is the gold standard treatment for inguinal hernia and reduces the risk of recurrence. Yet up to one-third of patients complain of post-surgical pain due to irritation and inflammation caused by the mesh and the fixation materials. Of these patients, 3-4% will experience severe and disabling chronic pain. We performed a prospective multicenter clinical study of a self-adhering prosthesis, consisting of a lightweight polypropylene mesh (40 g/m²) coated on each side with synthetic glue, to evaluate early postoperative complications and patient outcomes. ⋯ Adhesix( ® ) self-adhering mesh for prosthetic reinforcement following inguinal hernia repair is atraumatic and associated with infrequent post-surgical complications or pain, a rapid recovery rate, and a high patient-reported QoL. A longer follow-up is underway to assess the frequency of post-surgical recurrence.
-
Multicenter Study
Multicentric observational study of pain after the use of a self-gripping lightweight mesh.
Investigation in the field of inguinal hernia surgery is now focused on postoperative pain. The extended use of lightweight meshes and alternative methods of fixation may play a relevant role in the reduction of pain. In this study, a new self-gripping lightweight polypropylene mesh is tested. ⋯ This self-gripping mesh can be used safely in type 1 and 2 primary, uncomplicated inguinal hernia with minimal morbidity and most patients under ambulatory setting. The registered incidence of chronic pain is lower than 3%.