Laparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prosthetic patch repair of ventral hernia. Prospective comparison to open prefascial polypropylene mesh repair.
BACKGROUND
The purpose of this study was to determine whether laparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prosthetic patch (LIPP) repair of a ventral hernia is superior to open prefascial polypropylene mesh (OPPM) repair in a tertiary care university hospital in an urban environment.


METHODS
Data on 39 consecutive patients undergoing either LIPP repair (n = 21) or OPPM repair (n = 18) were compared.


RESULTS
Findings showed that LIPP repair is characterized by less painful recovery and shorter hospital stay, with 90% of patients treated successfully as outpatients as compared with 7% in the OPPM group. The total facility costs for the LIPP repair ($8,273+/-$2,950) was significantly lower than for the OPPM repair ($12,461+/-$5,987) (p<0.05). Two serious delayed complications in the LIPP group were treated by reoperation (colocutaneous fistula, mesh infection), but the higher readmission costs in this group did not negate the overall cost advantage for LIPP repair. In the follow-up evaluation, 1 hernia recurrence was found in the LIPP repair group, and none in the OPPM group.


CONCLUSIONS
Initial experience suggests that LIPP repair has advantages over OPPM repair in terms of decreased hospitalization, postoperative pain, and disability. Refinements in the technique to reduce complications may make LIPP repair the procedure of choice for repair of ventral hernias.
DeMaria
E J
EJ
Department of Surgery, Section of General and Endoscopic Surgery, MCV Station Box 980519, Medical College of Virginia of Virginia Commonwealth University, Richmond, VA 23298, USA.
Moss
J M
JM
Sugerman
H J
HJ
D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D005260:Female; D006555:Hernia, Ventral / Q000191:economics / Q000601:surgery*; D017721:Hospital Costs; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000601:surgery*; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications; D011446:Prospective Studies; D019919:Prosthesis Implantation; D012008:Recurrence; D012086:Reoperation; D013526:Surgical Mesh; D016896:Treatment Outcome
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene