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Laparoscopic repair of incisional and ventral hernias with the new type of meshes: randomized control trial
INTRODUCTION: Laparoscopic incisional and ventral hernia repair (LIVHR) was first reported by Le Blanc and Booth in 1993. Many studies are available in the literature that have shown that laparoscopic repair of incisional and ventral hernia is preferred over open repair because of lower recurrence r...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Termedia Publishing House
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4105668/ https://www.ncbi.nlm.nih.gov/pubmed/25097679 http://dx.doi.org/10.5114/wiitm.2014.41623 |
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author | Grubnik, Vladimir V. Grubnik, Aleksandra V. Vorotyntseva, Kseniya O. |
author_facet | Grubnik, Vladimir V. Grubnik, Aleksandra V. Vorotyntseva, Kseniya O. |
author_sort | Grubnik, Vladimir V. |
collection | PubMed |
description | INTRODUCTION: Laparoscopic incisional and ventral hernia repair (LIVHR) was first reported by Le Blanc and Booth in 1993. Many studies are available in the literature that have shown that laparoscopic repair of incisional and ventral hernia is preferred over open repair because of lower recurrence rates (less than 10%), less wound morbidity, less pain, and early return to work. AIM: To identify the long-term outcomes between the different types of meshes and two techniques of mesh fixation, i.e., tacks (method Double crown) and transfascial polypropylene sutures. MATERIAL AND METHODS: A total of 92 patients underwent LIVHR at our department between January 2009 and August 2012. The hernias were umbilical in 26 patients, paraumbilical in 15 patients and incisional in 51 patients. All patients admitted for LIVHR were randomized to either group I (tacker fixation of ePTFE meshes) or group II (suture fixation of meshes with nitinol frame) using computer-generated random numbers with block randomization and sealed envelopes for concealed allocation. RESULTS: The mean mesh fixation time was significantly higher in the tacker fixation group (117 ±15 min vs. 72 ±6 min, p < 0.01). There were no conversions in either group. The median postoperative hospital stay was 3.5 ±1.5 days. All patients were followed up at 1, 3, 6, 12 and every 6 months thereafter postoperatively. There were 5 recurrences in the study population. In group I there were 4 patients with recurrence, and only 1 patient in the group with meshes with a nitinol frame. CONCLUSIONS: Meshes of the new generation with a 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. Absence of tackers allows postoperative pain to be minimized. We consider that these new meshes can significantly improve laparoscopic ventral hernia repair. |
format | Online Article Text |
id | pubmed-4105668 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-41056682014-08-05 Laparoscopic repair of incisional and ventral hernias with the new type of meshes: randomized control trial Grubnik, Vladimir V. Grubnik, Aleksandra V. Vorotyntseva, Kseniya O. Wideochir Inne Tech Maloinwazyjne Original Paper INTRODUCTION: Laparoscopic incisional and ventral hernia repair (LIVHR) was first reported by Le Blanc and Booth in 1993. Many studies are available in the literature that have shown that laparoscopic repair of incisional and ventral hernia is preferred over open repair because of lower recurrence rates (less than 10%), less wound morbidity, less pain, and early return to work. AIM: To identify the long-term outcomes between the different types of meshes and two techniques of mesh fixation, i.e., tacks (method Double crown) and transfascial polypropylene sutures. MATERIAL AND METHODS: A total of 92 patients underwent LIVHR at our department between January 2009 and August 2012. The hernias were umbilical in 26 patients, paraumbilical in 15 patients and incisional in 51 patients. All patients admitted for LIVHR were randomized to either group I (tacker fixation of ePTFE meshes) or group II (suture fixation of meshes with nitinol frame) using computer-generated random numbers with block randomization and sealed envelopes for concealed allocation. RESULTS: The mean mesh fixation time was significantly higher in the tacker fixation group (117 ±15 min vs. 72 ±6 min, p < 0.01). There were no conversions in either group. The median postoperative hospital stay was 3.5 ±1.5 days. All patients were followed up at 1, 3, 6, 12 and every 6 months thereafter postoperatively. There were 5 recurrences in the study population. In group I there were 4 patients with recurrence, and only 1 patient in the group with meshes with a nitinol frame. CONCLUSIONS: Meshes of the new generation with a 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. Absence of tackers allows postoperative pain to be minimized. We consider that these new meshes can significantly improve laparoscopic ventral hernia repair. Termedia Publishing House 2014-04-01 2014-06 /pmc/articles/PMC4105668/ /pubmed/25097679 http://dx.doi.org/10.5114/wiitm.2014.41623 Text en Copyright © 2014 Sekcja Wideochirurgii TChP http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Paper Grubnik, Vladimir V. Grubnik, Aleksandra V. Vorotyntseva, Kseniya O. Laparoscopic repair of incisional and ventral hernias with the new type of meshes: randomized control trial |
title | Laparoscopic repair of incisional and ventral hernias with the new type of meshes: randomized control trial |
title_full | Laparoscopic repair of incisional and ventral hernias with the new type of meshes: randomized control trial |
title_fullStr | Laparoscopic repair of incisional and ventral hernias with the new type of meshes: randomized control trial |
title_full_unstemmed | Laparoscopic repair of incisional and ventral hernias with the new type of meshes: randomized control trial |
title_short | Laparoscopic repair of incisional and ventral hernias with the new type of meshes: randomized control trial |
title_sort | laparoscopic repair of incisional and ventral hernias with the new type of meshes: randomized control trial |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4105668/ https://www.ncbi.nlm.nih.gov/pubmed/25097679 http://dx.doi.org/10.5114/wiitm.2014.41623 |
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