• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Sutureless Fixation of Onlay Ventral Hernia Repair: Review of 97 Patients

Charles P Shahan, MD, Nathaniel Stoikes, MD, David Webb, MD, Guy Voeller, MD. University of Tennessee Health Science Center

Background

Repair of large ventral hernias are a challenging problem. Often the disease process is accompanied by many associated comorbidities that can affect outcomes. Outside of recurrence, other factors such as wound complications and mesh infection create significant morbidity. Chevrel first described onlay ventral hernia repair in 1979. In 1989 he described a modification using fibrin glue in addition to absorbable sutures. The aim of this study is to review the largest case series of sutureless onlay ventral hernia repair whereby mesh is fixated with fibrin glue alone for complex ventral hernias.

Methods

All patients who underwent abdominal wall hernia repair with onlay of large-pore, lightweight, polypropylene mesh with fibrin glue fixation from July 2011 through April 2014 performed by the investigating surgeons were identified. Records were then queried for patient demographics, operative details, complications, and follow up. The data was then analyzed and descriptive statistics, Chi-squared, Exact tests, and regression analysis were performed where appropriate.

Results

97 patients underwent hernia repair during the study period. 54.6% were female, with a mean age of 57.3 years. Mean BMI was 32.2. Diabetes was present in 23(23.7%) patients. None of the patients were actively smoking at the time of repair. 90 (92.8%) of the operations were for incisional hernias, 3 (3.1%) primary ventral hernias, 2(2.1%) flank hernias, and 2(2%) were for complex abdominal wall reconstruction. 88(90.7%) of the cases were performed on an elective basis. 85 (85.9%) had bilateral myofascial advancement flaps, while 8 (8.2%) had right-sided only, 3 (3.1%) had left-sided only, and 2 (2.1%) had no advancement flap. 77 (77.3%) cases were classified as clean, 21 (21.6%) clean-contaminated, and 1 (1.0%) contaminated. The mean defect size was 149.5cm2 (median=120cm2). 5 (5.1%) had concurrent underlay. Mean follow up was 119.2 days (median= 76). There were 21 (21.6%) seromas, 4 (4.1%) wound infections, 7 (7.4%) had skin necrosis, and 9 (9.3%) required re-operation due to a complication. Age, gender, diabetes, defect size, contamination, and emergent status were not associated with any of the complications. Increasing BMI was associated with infection and re-operation, but not seroma or skin complications. There were no known hernia recurrences at the time of analysis spanning 3 years.

Discussion

The complex abdominal wall, especially large, recurrent incisional hernias, is a challenging problem faced by general surgeons. The sutureless onlay ventral hernia repair technique with fibrin glue fixation has proven effective in repairing complex hernias, including a small number of flank hernias. There was a relatively high rate of seroma formation as has been previously reported with the onlay technique. However, there are two notable findings; none of the patients requiring re-operation have required explantation of mesh, and contamination was not associated with any of the observed complications despite the use of permanent synthetic mesh. There have been no recurrences in the cohort. Further study of the biomechanics of onlay ventral hernia repair with fibrin glue fixation as well as long term follow-up are needed.

144

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2015 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons