• J Laparoendosc Adv Surg Tech A · Apr 2017

    Massive Incisional Hernia Repair with Parietex: Monocentric Analysis on 500 Cases Treated with a Laparoscopic Approach.

    • Francesco Caruso, Francesca Ciccarese, Giovanni Cesana, Matteo Uccelli, Giorgio Castello, and Stefano Olmi.
    • Department of General and Oncologic Surgery, Centre of Laparoscopic and Bariatric Surgery, Istituti Ospedalieri Bergamaschi-Policlinico San Marco , Zingonia, Italy .
    • J Laparoendosc Adv Surg Tech A. 2017 Apr 1; 27 (4): 388-392.

    PurposeThe aim of this retrospective study is to demonstrate the safety and feasibility of the laparoscopic technique for treatment of massive incisional hernias (MIHs) and to compare three different fixation devices.MethodsFrom January 1, 2001, to December 31, 2014, we collected retrospective data from patients with large incisional hernias (IHs). Laparoscopic IH repair is performed by applying a three-dimensional polyester knit structure mesh with a resorbable collagen barrier on peritoneal side (Parietex™ Composite Mesh; Covidien, New Haven, CT). Patients were divided into three groups according to the different fixation devices. The mean follow-up was 19 (12-156) months.ResultsThe mean defect size was 12.83 cm (10-26 cm) and the mean body mass index was 30.8 kg/m2 (26-39 kg/m2). The EMS stapler™ was used on 260 patients, the Protack® on 210 patients, and the AbsorbaTack™ on 30 patients. The mean operative time was 69.9 minutes (38-130 minutes). Intraoperative morbidity rate was 1.6% (8 cases). Early reoperation rate was 0.2% (1 case). The mean length of hospital stay was 2.3 days (range 2-7 days). Seromas were observed in 20 patients (4.0%) and neuralgia in 10 patients (2.0%). Recurrence was observed in 12 patients (2.4%) with the majority in the absorbable tack group (10%). There were no conversions (0%) to open technique.ConclusionsThe laparoscopic approach seems to be safe and appropriate for treatment of MIH. The Parietex composite mesh we used guarantees excellent intraabdominal laparoscopic repair of abdominal wall defects. Absorbatack system seems to give less postoperative neuralgia, but it is related to a high recurrence rate. Protack system seems to give more postoperative neuralgia than the Endopath EMS. In our experience, the best fixation system is the latter.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.