Eva Lourdes, Sujith Wijerathne, Siau Wei Tang, Jesse Hu, Wee Boon Tan, Davide Lomanto, Prof. Minimally Invasive Surgery Centre, Department of Surgery, National University Health System, Singapore
Introduction: Laparoscopic ventral hernia mesh repairs are increasingly performed as it has been associated with less post-operative pain, decreased wound morbidities, shorter hospital stay and faster return to activity. Traditionally, this is performed using a dual layer composite mesh which has an absorbable collagen barrier on the visceral surface to allow tissue ingrowth yet minimising bowel adhesions. The 3 most common prosthetic mesh scaffolds are polypropylene (PP), polyester, and expanded polytetrafluoroethylene (ePTFE). The Omyra® mesh is a monolayer condensed polytetrafluoroethylene (cPTFE) mesh which allows for better tissue integration with the parietal tissue, yet have reduced adhesions with the visceral organs. The aim of this study is to assess the safety and efficacy of Omyra® mesh in laparoscopic ventral hernia repair in a single institution.
Method: From January 1, 2011 to March 31, 2015, we retrospectively collected data from patients who underwent laparoscopic ventral hernia repair using the Omyra® mesh. Patient demography, type of hernia, operative details and postoperative recovery and complications were collected and analysed.
Results: There were 26 patients who had laparoscopic ventral hernia repair with the Omyra® mesh with a mean age of 58 (range: 31-85 years) and mean BMI of 27.95 (range: 18.6-37.3). Of these 26 patients, 17 were female and 9 were male. Patients were symptomatic with a mean range of 24 months (range: 3 days – 48 months). Characteristics of the ventral hernia included 9 primary hernias and 17 incisional hernias. Of the 17 incisional hernias, 10 were midline hernias 7 were lateral. The mean size of the defect was 8.5 cm (range: 2-15cm), with mean operative time of 146 mins (range: 43-249 mins). Twenty patients had an incarcerated hernia containing omentum and/ or small intestine. There was no early postoperative mortality. The mean length of stay was 6 days (range: 1-10). Early postoperative complications (<30 days) were seroma (n=4), superficial wound infection (n=2) and ileus (n=2) which were treated conservatively. Late complications (>30 days) were superficial wound infection (n=1) and 2 patient developed recurrence. The recurrence occurred at 6 and 16 months after the procedure. Mean follow up 35 weeks (range: 1-68 weeks).
Conclusion: Laparoscopic ventral hernia mesh repair is feasible and safe with an Omyra® mesh. Early complications included seroma, superficial wound infection and ileus with 2 patients having a recurrence at 6 and 16 months.