title: Initial Experience with a New Macroporous Partially Absorbable Mesh: Introducing Ultrapro® Advanced™.
abstract: BACKGROUND
  The Ultrapro® Advanced™ mesh (Ethicon, Sommerville, NJ) is a new mesh design, using the best characteristics from the previous platform, while adding new, advanced features. Our centre, Imelda Hospital, Bonheiden, Belgium, was chosen as one of the first clinical testing sites. The aim of this study was to present our preliminary data on complication rate and patient satisfaction.
  
  
  METHODS
  From October 1, 2015 until January 31, 2016, we treated 57 patients, implementing 67 Ultrapro® Advanced™ meshes. One patient was excluded due to postoperative cerebral haemorrhage with aphasia. Only patients with more than one-month follow-up were included for further analysis, resulting in a population of 41 patients with 51 meshes. Of them, 35 were male and only 6 were female, with an average age of 61.4 years and an average BMI of 25.9. The indications were uni- and bilateral laparoscopic inguinal hernia repair (n = 23 and 10 respectively), open inguinal hernia repair (n = 3), and open incisional hernia repair (n = 5). Quality of life was measured preoperatively and at four weeks postoperatively, using the hernia specific Carolina Comfort Scale (CCS) questionnaire.
  
  
  RESULTS
  The primary endpoint was complication rate. Only two patients (4.8%) mentioned a mild scrotal hematoma and two patients (4.8%) demonstrated a seroma. There were no superficial wound infections nor early recurrent hernias. Our secondary endpoint was quality of life, measured by the CCS questionnaire, which differentiates between a symptomatic and an asymptomatic group. A total of 13 patients were asymptomatic, whilst 28 patients reported some sort of discomfort, ranging from mild (n = 25) to moderate and/or daily symptoms (n = 3). No patients were disabled by their symptoms.
  
  
  CONCLUSIONS
  The Ultrapro® Advanced™ is a sequel of the classic Ultrapro® mesh with similar characteristics: it is a "lightweight", macroporous, partially absorbable mesh built out of thin filaments, while maintaining sufficient strength. Its improvement is due to incorporation of evidence-based characteristics such as an increased mesh elasticity. Furthermore, the surgical manipulation is improved thanks to the increased mesh memory. Our prospective cohort study shows good initial and short-term results after implementation of the Ultrapro® Advanced™. However, further prospective research is mandatory on the long-term outcomes.
authors.affiliation: Department of Abdominal Surgery, Imelda Hospital, Bonheiden, Belgium.
authors.forename: Karen
authors.initials: K
authors.lastname: Handojo
authors.affiliation: Department of Abdominal Surgery, Imelda Hospital, Bonheiden, Belgium.
authors.forename: Diederik
authors.initials: D
authors.lastname: Meylemans
authors.affiliation: Department of Abdominal Surgery, Imelda Hospital, Bonheiden, Belgium.
authors.forename: Kurt
authors.initials: K
authors.lastname: Devroe
authors.affiliation: Department of Abdominal Surgery, Imelda Hospital, Bonheiden, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Vermeiren
authors.affiliation: Department of Abdominal Surgery, Imelda Hospital, Bonheiden, Belgium.
authors.forename: Chris
authors.initials: C
authors.lastname: Aelvoet
authors.affiliation: Department of Abdominal Surgery, Imelda Hospital, Bonheiden, Belgium.
authors.forename: Tim
authors.initials: T
authors.lastname: Tollens
mesh_terms: D020341:Absorbable Implants / Q000706:statistics & numerical data; D001530:Belgium / Q000453:epidemiology; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006547:Hernia / Q000175:diagnosis / Q000453:epidemiology*; D059685:Herniorrhaphy / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010865:Pilot Projects; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D013526:Surgical Mesh / Q000706:statistics & numerical data*; D016896:Treatment Outcome