[Umbilical hernias treatment by the "stamp mesh technique"]

Management of epigastric, umbilical, spigelian and small incisional hernia as a day case procedure: results of long-term follow-up after open preperitoneal flat mesh technique

PURPOSE

To investigate short and long-term outcome after the open preperitoneal flat mesh technique (OPFMT) for umbilical, epigastric, spigelian, small incisional and "port-site" hernia performed as a day case procedure.

METHODS

We retrospectively analyzed records of patients who underwent OPFMT for umbilical, epigastric, Spigelian, small incisional and "port-site" hernia in ambulatory settings between 2004 and 2020 at Clinical Center of Serbia. Demographic and clinical characteristics, operative data and postoperative complications were compared between the groups. Univariate and multivariate analyses were performed to identify predictive factors for mesh infection and recurrence.

RESULTS

Overall, 476 patients were divided according to the type of hernia. Early postoperative complications were similar in all study groups. Mesh infection, chronic pain and recurrence were different between groups (p = 0.013, p = 0.019 and p = 0.011, respectively). Overall recurrence rate after OPFMT was 2.5%. Hernia defect, hematoma and length of postoperative stay at the Day Surgery Unit were identified as potential predictors of mesh infection (Odds ratio 6.449, 22.143 and 1.546, respectively; p = 0.027, p = 0.011 and p = 0.038, respectively) while mesh infection was the only potential predictor of recurrence in univariate analysis. Hematoma was an independent predictor of recurrence (Odds ratio 27.068; 95% Confidence interval 2.355-311.073; p = 0.008).

CONCLUSION

The OPFMT performed under local anesthesia as a day case procedure is a safe technique associated with favorable long-term outcome. Hematoma is an independent predictor of mesh infection occurrence.

Multicentre prospective feasibility study on the repair of hernias and incisional ventral hernias with an innovative Tintrap mesh

BACKGROUND

The aim of this study is to assess an innovative prosthesis Tintrap Mesh and its inserter in the repair of hernias and incisional ventral hernias. The inserter helps the deployment of the mesh the same way an umbrella would open, which prevents the enlargement of the wound.

METHOD

Four centres took part in this study. A questionnaire was completed preoperatively, postoperatively and after 1 month of surgery. Data on pain and complications, patients' satisfaction, as well as the ease of installation and the quality of deployment of the mesh was gathered and assessed.

RESULTS

From January 2009 to December 2009, 80 patients were assessed. The prosthesis, ease of installation and the deployment quality were rated "very good" and "good". The average operating room time was 20.86 min (range: 10-50 min). Postoperative pain was rated level 0 and 3 on VAS score in 73 cases (91.25%). After 1 month, no occlusion or relapse were reported on 77 patients; 82.47% of patients had no pain. One seroma required the removal of the mesh.

CONCLUSION

The first set of results on 80 cases is encouraging judging by the simplicity of implantation, low postoperative pain and patient's satisfaction.