Open and laparoscopic approach in incisional hernia repair with ePTFE prosthesis.
BACKGROUND
The aim of this retrospective study was to analyze the results of incisional hernia laparoscopic and open surgery, focusing on the morbidity and postoperative implications.


METHODS
A group of 106 (42 men, 64 women) patients suffering from incisional hernias were treated with either a laparoscopic (30) or an open (76) placement of a prosthetic mesh between January 1997 and December 2004. The age and gender of the patients, the size and type of the mesh, operation note, the length of postoperative hospital stay, and morbidity were recorded.


RESULTS
An expanded polytetrafluoroethylene (ePTFE) mesh was used in 103 patients, whereas a polypropylene mesh was used in 3 patients. In the open technique, 3 patients with the ePTFE prosthetic material developed a mesh infection and required a mesh removal, which was easily performed under local anesthesia. Moreover, 2 patients from the same group developed a hernia recurrence. As for the laparoscopic approach, the only complication observed was one hernia recurrence. Finally, it should be mentioned that 1 patient with a polypropylene mesh developed a colocutaneous fistula.


CONCLUSIONS
The benefits of the laparoscopic mesh technique, compared to the open technique, include a shorter hospital stay, less postoperative pain, and possibly, a reduction in wound and mesh complications. Regarding the recurrence rate, the two techniques show similar results.
Zografos
George N
GN
3rd Department of Surgery, Athens General Hospital, Athens, Greece. gnzografos@yahoo.com
Mitropapas
George
G
Vasiliadis
George
G
Farfaras
Athanasios
A
Ageli
Chrisanthi
C
Margaris
Elias
E
Tsipras
Iraklis
I
Koliopanos
Alekos
A
Pateras
John
J
Papastratis
George
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D003108:Colonic Diseases / Q000209:etiology; D017577:Cutaneous Fistula / Q000209:etiology; D020878:Device Removal; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011126:Polypropylenes; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications; D016459:Prosthesis-Related Infections / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D013997:Time Factors
D001672:Biocompatible Materials; D011126:Polypropylenes; D011138:Polytetrafluoroethylene