Results of laparoscopic repair of abdominal wall hernias using an ePTFE-polypropylene composite mesh

Background: The standard technique for laparoscopic ventral hernioplasty (peritoneal onlay) reduces the recurrence rate and the rate of other complications, in particular the risk of infections. However, the procedure requires a special mesh to mitigate the risk of visceral adhesions. For this purpose an ePTFE mesh is generally used. There are limited reported clinical data regarding the long-term results and benefits of other biomaterials. Study design: Bard Composix mesh was used for laparoscopic ventral hernia repair. This biomaterial combines two different clinically proven materials - polypropylene with a thin layer of ePTFE - to maximize ingrowth of surrounding tissue, while mitigating the risk of visceral adhesions. Demographic, operative and postoperative data were collected and analyzed. Follow-up clinical evaluations were conducted 6-10 days, 4 weeks, and every 6th month after surgery in all patients. Results: Fifteen patients were involved in the study. The mean operating time was 101.2 min (64-190 min). There were no intraoperative complications or conversion to open procedure. Postoperative complications were 1 seroma, 4 cases of prolonged ileus, one tacks-site pain requiring second-look laparoscopy. Hospital discharge occurred on average 6 days (3-10 days) after surgery. The mean follow-up was 12.4 months (range 5-29 months). No late complications or hernia recurrence were observed. Conclusions: Laparoscopic prosthetic ventral hernioplasty using the composite polypropylen/ePTFE mesh offers short hospital stay and acceptable complications for primary and recurrent ventral hernias. Disadvantage of the composite mesh is the difficulty to roll this product into a sufficiently small size to permit its easy introduction into the abdominal cavity.