Ventralex mesh in umbilical/epigastric hernia repairs: clinical outcomes and complications.
BACKGROUND
Umbilical and epigastric hernias have historically been repaired without mesh resulting in recurrence rates in some series of up to 40%. Recent data suggests mesh repair of these hernias may decrease recurrent hernia rates. Ideal placement of the mesh is behind the defect, which is difficult to do without a large incision in these hernias unless done laparoscopically. The Ventralex hernia patch is a composite PTFE/polypropylene patch allowing intraperitoneal placement behind the hernia defect through a small incision, and without the cost of laparoscopy. To date, only one study exists evaluating this new prosthesis.


METHODS
This study is a retrospective chart review of all umbilical and epigastric hernias repaired with the Ventralex hernia patch by a single surgeon. Patient characteristics and operative and post-operative data were collected. Hernia recurrence is the primary outcome. Secondary outcomes include complication rates.


RESULTS
Eighty-eight patients from 2003-2006 were evaluated. The population included patients aged 25-86 (mean 52) with nineteen females (22%). The average BMI was 32 (range 18-68). Eighteen patients were smokers, five patients were diabetic, and two patients were chronic steroid users. The size of patches used were small (72%), medium (27%), and unknown (1%). Average operating room time was 52 min (range 19-194). The different types of hernias repaired were umbilical (68%), epigastric (30%), and incisional (2%). Follow-up visits ranged from 8 days to 3.1 years in all but five patients (6%). No hernia recurrences were found in follow-up. Complications included two patients (2.2%) with mesh infection requiring removal of the patch, one patient with post-operative urinary retention, and seroma formation in another patient.


CONCLUSIONS
The composite PTFE/polypropylene hernia patch is effective in preventing hernia recurrence in umbilical, epigastric, and small ventral hernia repairs and can be accomplished with a low rate of complications.
Martin
D F
DF
Department of Surgery, University of Tennessee Health Science Center, Memphis, TN 38120, USA.
Williams
R F
RF
Mulrooney
T
T
Voeller
G R
GR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006554:Hernia, Umbilical / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000295:instrumentation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013526:Surgical Mesh; D016896:Treatment Outcome
D011138:Polytetrafluoroethylene