LAPAROSCOPIC TREATMENT OF VENTRAL HERNIAS WITH NEW TYPE OF MESHES

Introduction. Incisional hernias are a major health problem; the recurrence rate ranges from 3–20%. They also pose a difficult technical problem that affects any surgeon trying to solve it. Incisional hernias occur in up to 11% of surgical abdominal wounds and in up to 20% of patients that develop a postoperative wound infection. There is no description of a standard technique of mesh fixation. Common methods of mesh fixation are metallic tacks with or without transfascial sutures and transfascial sutures alone. Thus fixation of the mesh seems to play a key role in this procedure.

The aim of the study was to compare new type of mesh for laparoscopic ventral hernia repair with standard composite mesh.

Materials and methods. Patients with incisional hernia who met eligibility criteria for surgical procedures were enrolled in this study between January 2009 and December 2011. Patients were randomized in two groups: one group underwent laparoscopic incisional hernia repair with the use of MMDI meshes (new generation of mesh, made from lightweight PTFEe mesh strain on the nitinol framework) (Group I, n=39); the other underwent laparoscopic incisional hernia repair with the PTFEe meshes Gore-Tex (Group II, n=33).

Results. Mean operative time and mean hospitalization were significantly shorter (p<0.05) in group I than in group II. The pain score was significantly less at 24 and 48 hrs in the patients of group I (mean visual analog scale score, 2.74 vs. 3.82, p<0.01). The mean mesh fixation time was significantly higher in the group II (22 min vs. 67 min, p<0.01).

Conclusion. Meshes of new generation with nitinol framework can significantly improve laparoscopic ventral hernia repair. Absences of taсks allows avoiding of postoperative pain. We consider that these new meshes can significantly improve laparoscopic ventral hernia repair.