The results of clinical application of the mesh with anti-adhesive fluoropolymer coating in laparoscopic intraperitoneal repair of primary ventral hernia

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OBJECTIVE

The purpose of the study was to evaluate the results of using fluoropolymer-coated mesh during intraperitoneal onlay mesh hernia repair in patients with primary ventral hernias.

MATERIAL AND METHODS

The multicenter, non-randomized, controlled clinical study included 88 patients of both sexes who were operated on using a laparoscopic approach using the IPOM technique for a primary ventral hernia. The duration of observation ranged from 3 to 12 months. In the main group, 48 patients received fluoropolymer-coated meshes (Ftorex). A comparison was made with a retrospective group of 40 patients who were treated with anti-adhesive collagen-coated meshes (Parietene composite, Parietex Composite, Symbotex).

RESULTS

The number of early and late postoperative complications in the groups did not have significant differences, at the same time, their number was lower in the group of patients in whom fluoropolymer-coated meshes were used. Most of the complications corresponded to Clavien—Dindo class I and II and did not pose a significant threat to health. There were no recurrences of hernias observed in patients included in the study. There were slightly more adhesions in the fluoropolymer-coated mesh group (35.4% vs. 25.0% in the collagen-coated mesh group). The quality of life of patients in the study groups did not differ.

CONCLUSION

In laparoscopic IPOM hernia repair fluoropolymer-coated meshes are not inferior in effectiveness and safety to traditionally used collagen-coated meshes and can be recommended for use in patients with primary ventral hernias.

Keywords:

ventral hernia

laparoscopic intraperitoneal onlay mesh

IPOM

recurrence

complications

Authors:

Belousov A.M.

Loginov Moscow Clinical Scientific Center

ORCID: 0000-0002-2274-8170

Nepomnyashchaya S.L.

St. Petersburg State University Hospital

ORCID: 0000-0003-4897-6144

Danilin V.N.

St. Petersburg State University Hospital

ORCID: 0000-0003-2076-4983

Timofeeva K.O.

St. Petersburg State University Hospital

ORCID: 0000-0002-8585-2063

Armashov V.P.

Pirogov Russian National Research Medical University;
Loginov Moscow Clinical Scientific Center

ORCID: 0000-0001-5108-1400

Makarov S.A.

Center for Surgical Treatment of Obesity and Metabolic Disorders — St. George Hospital

ORCID: 0000-0002-8423-8002

Matveev N.L.

Pirogov Russian National Research Medical University;
Loginov Moscow Clinical Scientific Center

ORCID: 0000-0001-9113-9400

Received:

20.03.2024

Accepted:

10.04.2024

List of references:

Bittner R, Bain K, Bansal VK, Berrevoet F, Bingener-Casey J, Chen D, Chen J, Chowbey P, Dietz UA, de Beaux A, Ferzli G, Fortelny R, Hoffmann H, Iskander M, Ji Z, Jorgensen LN, Khullar R, Kirchhoff P, Köckerling F, Kukleta J, LeBlanc K, Li J, Lomanto D, Mayer F, Meytes V, Misra M, Morales-Conde S, Niebuhr H, Radvinsky D, Ramshaw B, Ranev D, Reinpold W, Sharma A, Schrittwieser R, Stechemesser B, Sutedja B, Tang J, Warren J, Weyhe D, Wiegering A, Woeste G, Yao Q. Update of Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS))-Part A. Surg. Endosc. 2019;33(10):3069-3139. https://doi.org/10.1007/s00464-019-06907-7
Howard R, Thompson M, Fan Z, Englesbe M, Dimick JB, Telem DA. Costs associated with modifiable risk factors in ventral and incisional hernia repair. JAMA Netw. Open. 2019;2(11):e1916330. https://doi.org/10.1001/jamanetworkopen.2019.16330
Egiev V.N. Tension-free hernioplasty/V.N. Egiev [and others]; under general ed. V.N. Egieva. M.: Medpraktika-M, 2002. 148
Earle D, Roth JS, Saber A, Haggerty S, Bradley JF 3rd, Fanelli R, Price R, Richardson WS, Stefanidis D; SAGES Guidelines Committee. SAGES guidelines for laparoscopic ventral hernia repair. Surg Endosc. 2016;30:3163-3183. https://doi.org/10.1007/s00464-016-5072-x
Silecchia G, Campanile FC, Sanchez L, Ceccarelli G, Antinori A, Ansaloni L, Olmi S, Ferrari GC, Cuccurullo D, Baccari P, Agresta F, Vettoretto N, Piccoli M. Laparoscopic ventral/incisional hernia repair: updated guidelines from the EAES and EHS endorsed Consensus Development Conference. Surg Endosc. 2015;29:2463-2584. https://doi.org/10.1007/s00464-015-4293-8
Liang MK, Holihan JL, Itani K, Alawadi ZM, Gonzalez JR, Askenasy EP, Ballecer C, Chong HS, Goldblatt MI, Greenberg JA, Harvin JA, Keith JN, Martindale RG, Orenstein S, Richmond B, Roth JS, Szotek P, Towfigh S, Tsuda S, Vaziri K, Berger DH. Ventral Hernia management — expert consensus guided by systematic review. Ann Surg. 2017;265:80-89. https://doi.org/10.1097/SLA.0000000000001701
Bittner R, Bain K, Bansal VK, Berrevoet F, Bingener-Casey J, Chen D, Chen J, Chowbey P, Dietz UA, de Beaux A, Ferzli G, Fortelny R, Hoffmann H, Iskander M, Ji Z, Jorgensen LN, Khullar R, Kirchhoff P, Köckerling F, Kukleta J, LeBlanc K, Li J, Lomanto D, Mayer F, Meytes V, Misra M, Morales-Conde S, Niebuhr H, Radvinsky D, Ramshaw B, Ranev D, Reinpold W, Sharma A, Schrittwieser R, Stechemesser B, Sutedja B, Tang J, Warren J, Weyhe D, Wiegering A, Woeste G, Yao Q. Update of Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS)) — part A. Surg Endosc. 2019;33:3069-3139. https://doi.org/10.1007/s00464-019-06907-7
Bittner R, Bain K, Bansal VK, Berrevoet F, Bingener-Casey J, Chen D, Chen J, Chowbey P, Dietz UA, de Beaux A, Ferzli G, Fortelny R, Hoffmann H, Iskander M, Ji Z, Jorgensen LN, Khullar R, Kirchhoff P, Köckerling F, Kukleta J, LeBlanc K, Li J, Lomanto D, Mayer F, Meytes V, Misra M, Morales-Conde S, Niebuhr H, Radvinsky D, Ramshaw B, Ranev D, Reinpold W, Sharma A, Schrittwieser R, Stechemesser B, Sutedja B, Tang J, Warren J, Weyhe D, Wiegering A, Woeste G, Yao Q. Update of Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS)) — part B. Surg Endosc. 2019;33:3511-3549. https://doi.org/10.1007/s00464-019-06908-6
Köckerling F, Schug-Paß C, Adolf D, Reinpold W, Stechemesser B. Is pooled data analysis of ventral and incisional hernia repair acceptable? Front Surg. 2015;2:15. https://doi.org/10.3389/fsurg.2015.00015
Stabilini C, Cavallaro G, Dolce P, Giovannini SC, Corcione F, Frascio M, Sodo M, Merola G, Bracale U. Pooled data analysis of primary ventral (PVH) and incisional hernia (IH) repair is no more acceptable: results of a systematic review and meta-analysis of current literature. Hernia. 2019;23:831-845. https://doi.org/10.1007/s10029-019-02033-4
Makarov SA, Armashov VP, Belousov AM, Kupriyanova AS, Matveev NL. The place of laparoscopic IPOM repair in the surgical treatment of midline ventral hernias — lessons learned from seven years of prospective experience. Perioperative and early postoperative results. Endoscopic Surgery. 2022;28(2):5-15. (In Russ.). https://doi.org/10.17116/endoskop2022280215
Hellinger A, Wotzlaw F, Fackeldey V, Pistorius G, Zdichavsky M, Jünemann R, Buia A. Development of an open prospective observational multicentre cohort study to determine the impact of standardization of laparoscopic intraperitoneal onlay mesh repair (IPOM) for incisional hernia on clinical outcome and quality of life (LIPOM-Trial). Contemp Clin Trials Commun. 2016;4:118-123. https://doi.org/10.1016/j.conctc.2016.08.001
Misiakos EP, Patapis P, Zavras N, Tzanetis P, Machairas A. Current trends in laparoscopic ventral hernia repair. JSLS. 2015;19(3):e2015.00048. https://doi.org/10.4293/JSLS.2015.00048
Sauerland S, Walgenbach M, Habermalz B, Seiler CM, Miserez M. Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst Rev. 2011;3:CD007781. https://doi.org/10.1002/14651858.CD007781.pub2
Bezsilla J. Hasfali sérvek laparoscopos műtéti technikája. Magy Seb. 2010;63(5):327-332. https://doi.org/10.1556/MaSeb.63.2010.5.6
Hawn MT, Snyder CW, Graham LA, Gray SH, Finan KR, Vick CC. Long-term follow-up of technical outcomes for incisional hernia repair. J Am Coll Surg. 2010;210(5):648-655. https://doi.org/10.1016/j.jamcollsurg.2009.12.038
Wassenaar EB, Schoenmaeckers EJ, Raymakers JT, Rakic S. Subsequent abdominal surgery after laparoscopic ventral and incisional hernia repair with an expanded polytetrafluoroethylene mesh: a single institution experience with 72 reoperations. Hernia. 2010;14(2):137-142. https://doi.org/10.1007/s10029-009-0568-0
Chelala E, Debardemaeker Y, Elias B, Charara F, Dessily M, Alle ́ J-L. Eighty-five redo surgeries after 733 laparoscopic treatments for ventral and incisional hernia: adhesion and recurrence analysis. Hernia. 2010;14:123-129. https://doi.org/10.1007/s10029-010-0637-4
Belousov AM, Armashov VP, Shkarupa DD, Anushchenko TYu, Filipenko TS, Zhukovskiy VA, Matveev NL. Safety of mesh with fluoropolymer coating during intra-abdominal placement in large animals: results of the pilot study. Khirurgiya. Zhurnal im. N.I. Pirogova. 2023;2:43-58. (In Russ.). https://doi.org/10.17116/hirurgia202302143
Belousov AM, Armashov VP, Shkarupa DD, Anushchenko TYu, Filipenko TS, Blum NM, Potapov PA, Timofeeva KO, Putulyan AA, Matveev NL. Histological changes in intraperitoneal onlay mesh (IPOM) with synthetic and biological meshes. Results of the chronic experiment. Pirogov Russian Journal of Surgery. 2023;7:37-50. (In Russ.). https://doi.org/10.17116/hirurgia202307137
LeBlanc KA, Booth WV. Lapraroscopic repair of incisional abdominal hernias using expanded polytetraflouroethylene: preliminary findings. Surg Laparosc Endosc. 1993;3:39-41.
Gómez-Menchero J, Balla A, García Moreno JL, Gila Bohorquez A, Bellido-Luque JA, Morales-Conde S. Laparoscopic intracorporeal rectus aponeuroplasty (LIRA) technique versus intraperitoneal onlay mesh (IPOM plus) for ventral hernia repair: a comparative analysis. Hernia. 2024;28(1):167-177. https://doi.org/10.1007/s10029-023-02858-0
Morales-Conde S, Suarez-Artacho G, Socas-Macias M, Barranco-Moreno A. Retroprosthetic seroma after laparoscopic ventral hernia repair: incidence, risk factors and clinical significance. Hernia. 2015;19(6):943-947. https://doi.org/10.1007/s10029-015-1352-y
Heniford BT, Park A, Ramshaw BJ, Voeller G. Laparoscopic repair of ventral hernias: nine years’ experience with 850 consecutive hernias. Ann Surg. 2003;238(3):391-399. https://doi.org/10.1097/01.sla.0000086662.49499.ab
Franklin ME Jr, Gonzalez JJ Jr, Glass JL, Manjarrez A. Laparoscopic ventral and incisional hernia repair: an 11-year experience. Hernia. 2004;8(1):23-27. https://doi.org/10.1007/s10029-003-0163-8
Frantzides CT, Carlson MA, Zografakis JG, Madan AK, Moore RE. Minimally invasive incisional herniorrhaphy: a review of 208 cases. Surg Endosc. 2004;18(10):1488-1491. https://doi.org/10.1007/s00464-004-8105-9
McGinty JJ, Hogle NJ, McCarthy H, Fowler DL. A comparative study of adhesion formation and abdominal wall ingrowth after laparoscopic ventral hernia repair in a porcine model using multiple types of mesh. Surg Endosc. 2005;19(6):786-790. https://doi.org/10.1007/s00464-004-8174-9

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