V.v. Grubnik, Prof, N.d. Parphentyeva, K.o. Vorotyntseva. Odessa national medical university
Introduction. Laparoscopic operations are being used increasingly in the repair of ventral hernias. Results and rate of complications after laparoscopic hernia repair depend on type of mesh and methods of mesh fixation. The aim of the study was to compare new type of mesh for laparoscopic ventral hernia repair with standard composite mesh.
Materials and methods. Prospective randomized study was conducted from January 2009 to September 2011. Study group consisted of 72 patients (men – 31, women – 41) with a mean age 56.4±11.5 years (range, 28-79 years). Umbilical hernias were in 19 patients, paraumbilical hernias were in 12 patients and ventral postoperative hernias were in 41 patients. 33 patients (group I) were operated laparoscopically with the use of PTFEe mesh Gore – Tex, which was fixed to the abdominal wall with double row of spiral tackers. 39 patients (group II) were operated laparoscopically with MMDI mesh (new generation of mesh, made from lightweight PTFEe mesh strain on the nitinol framework). These meshes were adequately fixed to the abdominal wall using only 3-4 transfascial sutures.
Results. The patients in the two groups were comparable at baseline in terms of sex, size of hernia defects, presenting complains and comorbidity conditions. The mean surgery duration was 117 min for the patients of the group I and 72 min for the patients of the group II (p<0.05). The pain score was significantly less at 24 and 48 hours in the patients of group II (mean visual analog scale score, 2.74 vs. 3.82, p<0.01). There were fewer complications among the patients of group II (7.5% vs. 37%, p<0.01). Mean follow-up time was 23 months. Recurrence of hernia was detected in 2 patients of the group I, and no recurrence among the patients of the group II.
Conclusion. Meshes of new generation with nitinol framework can significantly improve laparoscopic ventral hernia repair. The fixation of these meshes is very simple using 3-4 transfascial sutures. The absence of shrinkage of these meshes makes the probability of recurrence minimal. Absences of takers allow avoiding the postoperative pain. We consider that these new meshes can significantly improve laparoscopic ventral hernia repair.
Session Number: Poster – Poster Presentations
Program Number: P301