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Abstract:
Background: Laparoscopic approach is now generally accepted for the treatment of incisional hernia. The ideal mesh is still to be found. The aim of this study is to compare the well-known Gore® DUALMESH® Plus (WL Gore & Associates, Flagstaff, AZ) to a new prosthesis, the DynaMesh®-IPOM (FEG Textiltechnik GmbH, Aachen, Germany), to clinically verify its potential benefits in the laparoscopic treatment of incisional hernia.
Materials and Methods: Comparing the results of the laparoscopic treatment of two groups of patients affected by incisional hernia using Gore® DUALMESH® Plus and DynaMesh®-IPOM.
Results: There were 45 females and 31 males, with age variable from 21 to 84 years of age. The two groups were well matched for age (median age 60 years for group A and 57.6 years for group B—p=0.44) and sex (28F and 17M group A and 13 F and 18 M group B—p=0.008), while median BMI resulted slightly higher in group B (26.12 group A and 29.74 group B—p=0.001). The median size of the defect was similar in the two groups (87.5 mm group A and 83.4 mm for group B—p=0.83), while the median operating time was slightly longer in group A (77 min group A and 67 min group B—p=0.44). No difference in the length of hospital stay was evidenced between the two groups (3.19 days for group A and 3 days for group B—p=0.74). Time to return to physical activity was similar between the two groups (13.46 days for group A and 12.7 days for group B—p=0.32). Minor complications occurred in 15 cases (19.7%): seromas (7 cases), prolonged ileus (6 cases), and hemoperitoneum (2 cases), without significant difference in the incidence of such complications in the two groups. Five recurrences (6.5% of cases) occurred. No differences in the recurrence rate was noted between the two groups (3 cases/7% for group A and 2 cases/6% for group B—p=00.7).
Conclusions: DynaMesh®-IPOM proved to be a safe and effective mesh for the laparoscopic repair of incisional hernia even when compared to DUALMESH® Plus.
Authors:
Alessandro Verbo, MD, Assistant Professor, Paolo Pafundi, MD, Alberto Manno, MD, Department of Emergency Medicine, Rocco Bacccaro, MD, Assistant Professor, Augusto Veneziani, MD, Assistant Professor, Rosa Colli, MD, Assistant Professor, Claudio Coco, MD, Associate Professor, Department of Surgical Sciences, Università Cattolica del Sacro Cuore, Rome, Italy
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