Adhesion formation after laparoscopic ventral incisional hernia repair with polypropylene mesh: a study using abdominal ultrasound.
OBJECTIVE
Laparoscopic repair of ventral incisional hernias is feasible and safe. Polypropylene mesh is often preferred because of its ease of handling and lower cost. Complications like adhesion and fistula formation can occur. The goal of this study was to determine whether bowel adhesions and their attendant complications could be prevented by interposition of omentum.


METHODS
Thirty patients underwent laparoscopic ventral incisional hernias repair with polypropylene mesh. Omentum was always positioned over the loops of bowel for protection. At a mean follow-up of 14 months, 20 patients underwent ultrasonic examination using the previously described visceral slide technique to detect adhesions.


RESULTS
The mean size of the hernias in the study was 50.3 cm2, and the mean size of the mesh applied was 275 cm2. Thirteen patents (65%) had no sonographically detectable adhesions. Five patients demonstrated adhesions between the mesh and omentum, 1 patient developed adhesions between the left lobe of the liver and the mesh, and only 1 case of bowel adhesion to the edge of the mesh was found.


CONCLUSIONS
Laparoscopic ventral incisional hernias repair with polypropylene mesh and omental interposition is not associated with visceral adhesions in the majority of patients. Polypropylene mesh can be used safely when adequate omental coverage is available.
Bingener
Juliane
J
Department of Surgery, University of Texas Health Science Center, San Antonio, Texas 78229-3900, USA.
Kazantsev
George B
GB
Chopra
Shailendra
S
Schwesinger
Wayne H
WH
D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000627:therapeutic use; D005260:Female; D006555:Hernia, Ventral / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007410:Intestinal Diseases / Q000209:etiology / Q000517:prevention & control*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000601:surgery*; D011126:Polypropylenes / Q000627:therapeutic use; D011446:Prospective Studies; D013526:Surgical Mesh; D000267:Tissue Adhesions / Q000209:etiology / Q000517:prevention & control*; D014463:Ultrasonography
D001672:Biocompatible Materials; D011126:Polypropylenes