title: Open ventral hernia repair using ProGrip self-gripping mesh.
abstract: OBJECTIVE
  Secure mesh fixation in incisional hernia repair is mandatory to prevent mesh dislocation and possible recurrence. Traditional fixation methods have been implicated as a source of chronic postoperative pain. We report 2-year outcomes with a self-gripping mesh for open tension-free repair of large incisional hernia.
  
  
  METHODS
  This prospective case series enrolled 20 patients with large primary incisional hernia (mean defect size: 84 cm(2)). Patients were electively treated by a single surgeon using a macroporous polyester mesh with resorbable polylactic acid microgrips (ProGrip, Covidien, Mansfield, MA, USA) using open onlay technique. Main outcomes included pain severity, Carolinas Comfort Scale (CCS), complications, and hernia recurrence. Patients returned for follow-up at 1, 3, 6, 12, and 24 months.
  
  
  RESULTS
  Median mesh fixation time was 2 min. Mean operative time was 38 min and blood loss was minimal (50 cc). Most patients (75%) were discharged same day. The only perioperative complication was a minor seroma in one patient. Patient follow-up compliance through 2 years was 100%. Mean pain score was 1.8 at discharge, 0.9 at 1 month, 0.7 at 1 year, and 0 at 2 years. At 2-years, all patients were "very satisfied" with treatment and hernia-specific quality of life was excellent (mean CCS score = 0). No infection, mesh removal, or hernia recurrence occurred during follow-up.
  
  
  CONCLUSIONS
  Open repair using a self-gripping mesh is a viable treatment option in patients with large incisional hernia. Immediate mesh fixation facilitates a safe and durable tension-free repair.
authors.affiliation: Bon Secours TPMG Hernia Center, 860 Omni Boulevard, Suite 204, Newport News, VA 23606, USA. Electronic address: stevenhopson@cox.net.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Hopson
authors.affiliation: Miller Scientific Consulting, Inc., 1854 Hendersonville Road, #231, Asheville, NC 28803, USA.
authors.forename: Larry E
authors.initials: LE
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D000069290:Incisional Hernia / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D049291:Seroma / Q000209:etiology; D013526:Surgical Mesh / Q000009:adverse effects; D013997:Time Factors
keywords: Incisional hernia; Mesh; ProGrip; Recurrence