Long term outcome and elasticity of a polyester mesh used for laparoscopic ventral hernia repair

Background Repair of a ventral hernia is increasingly being performed by a laparoscopic approach despite lack of good long term follow up data on outcomes. The aim of this study was to examine the long term performance of a polyester mesh and to assess its elastic properties in patients undergoing l...

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Bibliographic Details
Published in:Hernia : the journal of hernias and abdominal wall surgery 2022-04, Vol.26 (2), p.489-493
Main Authors: O’Dwyer, P. J., Chew, C., Qandeel, H.
Format: Article
Language:English
Subjects:
Abdominal Surgery
Elasticity
Hernia
Hernia, Ventral - surgery
Hernias
Herniorrhaphy - adverse effects
Humans
Laparoscopy
Long term
Mechanical properties
Medical imaging
Medicine
Medicine & Public Health
Original
Original Article
Pelvis
Polyesters
Recurrence
Retrospective Studies
Surgical Mesh
Treatment Outcome
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Summary:Background Repair of a ventral hernia is increasingly being performed by a laparoscopic approach despite lack of good long term follow up data on outcomes. The aim of this study was to examine the long term performance of a polyester mesh and to assess its elastic properties in patients undergoing laparoscopic ventral hernia repair. Methods All patients being assessed for a ventral hernia repair between August 2011 and November 2013 were placed on a prospective database. Those undergoing laparoscopic repair with a polyester mesh were seen at clinic at one month and one year, while their electronic records were assessed at 34 months (range 24–48 months) and 104 months (range 92–116 months). In addition, CT scans of the abdomen and pelvis performed for any reason on these patients during the follow up period were reviewed by a consultant gastrointestinal radiologist. Mechanical failure testing of the mesh was also performed. Results Thirty-two of the 100 patients assessed for ventral hernia repair had a laparoscopic repair with a polyester mesh. Nineteen (59%) had CT scans performed during the follow-up period. No recurrence was recorded at 34 months, while three (9.4%) had a recurrence at 104 months. Two had central breakdown of the mesh at 81 and 90 months, while 1 presented acutely at 116 months after operation. Mesh had stretched across the defect by an average of 21% (range 5.7–40%) in nine patients. Mechanical testing showed that this mesh lost its elasticity at low forces ranging between 1.8 and 3.2 N/cm. Conclusion This study shows that late recurrence is a problem following laparoscopic ventral hernia repair with polyester mesh. The mesh loses it elasticity at a low force. This combined with degradation of mesh seems the most likely cause of failure. This is unlikely to be a unique problem of polyester mesh and further long-term studies are required to better assess this operative approach to ventral hernia repair.
ISSN:1265-4906
1248-9204
DOI:10.1007/s10029-021-02486-6