Treatment of incisional hernias adopting an intra-abdominal approach with a new low-density composite prosthetic material: proceed: our preliminary experience on 50 cases.
BACKGROUND
The management of incisional hernias remains a challenge for the general surgeon. Repairing by using prosthetic materials has reduced the relapse rate, but intra-abdominal mesh placement continues to be a source of controversy.


OBJECTIVE
An evaluation is made of the results of treating incisional hernias with a new intra-abdominal low-density composite mesh through both the open and the laparoscopic approach.


METHODS
A prospective analysis was made on the first 50 patients operated upon for incisional hernia through the open (n=20) or laparoscopic route (n=30), with intra-abdominal repair using the Proceed composite mesh, composed of low-density polypropylene and a hydrophilic antiadherent membrane of oxidized regenerated cellulose.


RESULTS
There were no patient deaths. Reintervention proved necessary in one case due to hemoperitoneum caused by a trocar. The mean duration of stay was 3 days, and all patients recovered bowel transit within 24 hours. During follow-up there were no intra-abdominal complications associated with the use of the mesh (intestinal occlusion or subocclusion, prolonged ileus, infections, rejection, fistulas, or relapses).


CONCLUSIONS
Incision hernia repair using the intra-abdominal low-density composite mesh is safe and well tolerated. Proceed mesh facilitates laparoscopic hernioplasty maneuvering.
Moreno-Egea
Alfredo
A
Department of Surgery, Abdominal Wall Unit, University Hospital Morales Meseguer, Murcia, Spain. moreno-egea@ono.com
Aguayo-Albasini
José Luis
JL
Ballester
Monica Mengual
MM
Cases Baldó
Maria José
MJ
D020341:Absorbable Implants / Q000145:classification* / Q000639:trends; D000368:Aged; D002483:Cellulose, Oxidized / Q000737:chemistry; D005260:Female; D046449:Hernia, Abdominal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011126:Polypropylenes / Q000737:chemistry; D011446:Prospective Studies; D013526:Surgical Mesh / Q000145:classification* / Q000639:trends; D017211:Treatment Failure
D002483:Cellulose, Oxidized; D011126:Polypropylenes