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Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
Intraperitoneal polypropylene mesh hernia repair complicates subsequent abdominal surgery
J A Halm1, L L de Wall, E W Steyerberg
1Department of Surgery, 10M, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015, GD, Rotterdam, The Netherlands.
World Journal of Surgery
|December 21, 2006
Summary
Subsequent surgery after prosthetic incisional hernia repair (PIHR) is more complicated with intraperitoneal mesh. Preperitoneal mesh placement is associated with fewer complications during re-laparotomy following PIHR.
Area of Science:
- Surgical innovation and patient outcomes
- Hernia repair techniques
- Biomaterials in surgery
Background:
- Prosthetic incisional hernia repair (PIHR) offers superior recurrence prevention compared to primary closure.
- However, prosthetic materials are linked to serious complications.
- The impact of mesh position on complications during re-operation after PIHR is not well-defined.
Purpose of the Study:
- To evaluate complications of subsequent surgical interventions after PIHR.
- To determine if the anatomical position of the prosthetic mesh influences complication rates.
Main Methods:
- A retrospective review of patients undergoing laparotomy/laparoscopy after PIHR between 1992 and 2005.
- Analysis of complication rates based on whether the mesh was placed intraperitoneally or preperitoneally.
Main Results:
- Re-laparotomy after PIHR was performed in 66 of 335 patients.
- Intraperitoneal mesh placement was associated with significantly higher complication rates (76%) compared to preperitoneal placement (29%).
- Small bowel resections and surgical site infections were more frequent with intraperitoneal mesh.
Conclusions:
- Re-operation following PIHR with polypropylene mesh is linked to increased complications when the mesh is placed intraperitoneally.
- Avoidance of intraperitoneal positioning for polypropylene mesh in incisional hernia repair is recommended.
