Minimal adhesions to ePTFE mesh after laparoscopic ventral incisional hernia repair: reoperative findings in 65 cases
| Autor: | David H. Berger, Roy Smoot, Karl A. LeBlanc, Guy R. Voeller, Steve Carey, Dennis Begos, Richard H. Koehler, Bruce Ramshaw, Adrian Park |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Time Factors Adhesions medicine.medical_treatment Adhesion (medicine) Hernia Inguinal Tissue Adhesions Expanded polytetrafluoroethylene Severity of Illness Index Prosthesis Ventral incisional hernia Postoperative Complications Surveys and Questionnaires Clinical information Scientific Papers medicine Humans In patient Laparoscopy Polytetrafluoroethylene Aged Retrospective Studies Titanium Aged 80 and over medicine.diagnostic_test business.industry Incisional hernia repair Middle Aged Surgical Mesh medicine.disease Hernia Ventral Surgery Female Safety business Follow-Up Studies |
| Zdroj: | JSLS : Journal of the Society of Laparoendoscopic Surgeons |
| ISSN: | 1438-9592 0044-409X |
| DOI: | 10.1055/s-2003-41365 |
| Popis: | Background and Objectives: Laparoscopic ventral incisional hernia repair involves intraabdominal placement of a synthetic mesh, and the possibility of formation of severe visceral adhesions to the prosthesis is a principal concern. Little clinical information based on reoperative findings is available about adhesions to biomaterials placed intraabdominally. We conducted a multi-institutional study of adhesions to implanted expanded polytetrafluoroethylene (ePTFE) mesh at reoperation in patients who had previously undergone laparoscopic incisional hernia repair done with the same mesh implantation technique. Methods: Nine surgeons retrospectively assessed the severity of adhesions to ePTFE mesh at reoperation in 65 patients. For each case, adhesions were assigned a score of 0 to 3, with 0 indicating no adhesions and 3 severe adhesions. Results: The mean time from mesh implantation to reoperation was 420 days (range, 2-1739 days). No adhesions were observed in 15 cases. Forty-four cases received an adhesion score of 1, and 6 cases a score of 2; no scores of 3 were assigned. Thus, 59 patients (91 %) had either no or filmy, avascular adhesions. No enterotomies occurred during adhesiolysis. Conclusions: In this large series of reoperations after laparoscopic incisional hernia repair, no or minimal formation of adhesions to implanted ePTFE mesh was observed in 91% of cases, and no severe cohesive adhesions were found. Comparative analyses of newer materials based on clinical reoperative findings are warranted to assess the safety of intraabdominally placed meshes. |
| Databáze: | OpenAIRE |
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