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Abdominal Wall Reconstruction Using Retrorectus Self-Adhering Mesh: A Novel Approach
Ibrahim Khansa, MD; Jeffrey E. Janis, MD FACS
The Ohio State University Wexner Medical Center
2016-02-01
Presenter: Ibrahim Khansa, MD
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. This work entirely represents Dr. Khansa's work.
Director Name: Gregory D. Pearson, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction: In abdominal wall reconstruction, mesh placement in the retrorectus plane with closure of the anterior and posterior rectus sheaths is an excellent option, as it avoids contact between mesh and intraabdominal contents, while protecting the mesh from exposure in case of wound healing complication. Mesh fixation in the retrorectus plane is usually achieved using sutures between mesh and semilunar line, or via percutaneous sutures. Both of those techniques risk entrapping intercostal nerves to the rectus muscle, causing chronic pain. A third alternative is the use of sutureless self-gripping mesh (Progrip, Covidien, Dublin, Ireland). While the use of self-gripping mesh in inguinal hernia repair has been well described, studies on its use in ventral hernia repair are lacking.
Methods: All patients who underwent ventral hernia repair using ProGrip were reviewed. All patients were followed for at least 1 year postoperatively. Surgical-site occurrences (SSO) were measured at 30 days, and consisted of hematoma, seroma, infection, dehiscence, mesh exposure and enterocutaneous fistula. The rate of hernia recurrence at 1 year was calculated.
Results: Fourteen patients underwent hernia repair using ProGrip mesh in the retrorectus plane. The rate of SSO was 14.3% (cellulitis in two patients). No hernia recurrences occurred after 1-year follow-up. No patients had chronic pain postoperatively.
Conclusion: This is the first study to examine the long-term outcomes of self-gripping mesh in abdominal wall reconstruction. Our results show low rates of SSO and recurrence. We are currently performing a randomized-controlled trial comparing retrorectus self-gripping mesh to sutured polypropylene mesh.
