Are mesh anchoring sutures necessary in ventral hernioplasty? Multicenter study.
BACKGROUND
Avoiding mesh fixation to the surrounding tissue in ventral hernioplasty would simplify the operation, decrease the time of the procedure, and decrease the risk of suture-related complications.


METHODS
Four hospitals included 111 patients according to the common protocol for prospective clinical evaluation of sutureless ventral hernioplasty. Surgical technique involves placement of the polypropylene mesh with flat-shape memory in either the retromuscular or preperitoneal space without suture anchoring.


RESULTS
Local complication rate was low (12.6%, 14 patients), postoperative pain measured according to the visual analogue scale was minimal (mean 4, range 1-8). Three recurrences (3%) were recorded. Mild scar discomfort, which did not require treatment nor limit physical activity, was recorded in 28 (25%), 18 (17%), and 11 (14%) patients at 6-month, 1- and 2-year follow-up, respectively.


CONCLUSIONS
Results of the study suggest that the sutureless sublay technique is safe and effective in the treatment of ventral abdominal hernia, especially in small and medium defects.
Department of Surgery, Columbia University, New York, NY, USA. pw2004@columbia.edu
P
P
Witkowski
F
F
Abbonante
I
I
Fedorov
Z
Z
Sledziński
V
V
Pejcic
L
L
Slavin
W
W
Adamonis
S
S
Jovanovic
M
M
Smietański
D
D
Slavin
E E
EE
Trabucco
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods*; D013526:Surgical Mesh; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D016896:Treatment Outcome