Closure of small and medium size umbilical hernias with the Proceed Ventral Patch in obese patients: a single center experience.

Dirk Wassenberg,Nikolaos Zarmpis,Nora Seip,Peter C Ambe

doi:10.1186/2193-1801-3-686

Abstract

Obesity is a risk factor for the development of umbilical hernia. Open hernia closure could be challenging in obese patients leading to high rates of recurrence. The aim of this study was to investigate the effectiveness and safety of hernia patches in the management of obese patients with umbilical hernias. All the patients included in this study were managed in the department of surgery of a primary care hospital in Germany. The data of patients undergoing umbilical hernia repair within a two-year period was retrospectively reviewed. Patients managed with the PVP were included for analysis. 24 obese patients were analyzed. Small and medium size patches were used in 15 and 9 patients respectively. The median duration of surgery was 40 min and the median length of hospital stay was 4d. The mean length of follow-up was 12 ± 9 months (range: 6–30 months). The rate of recurrence was 4.1% and the rate of complication was 8.3%. Obese patients presenting with small and medium size umbilical hernias could be safely and effectively managed with prosthetic patches like the Proceed Ventral Patch. However, the limited overlap zone following hernia closure with such a patch can be an issue.

Highlights

Obesity predisposes to a number of medical conditions
The aim of this series was to investigate the safety and effectiveness of multilayered polytetrafluoroethylene free, partially absorbable and self-expanding hernia patches in the closure of small and medium size umbilical hernias in obese patients
Within the period of investigation 105 patients with umbilical hernias were surgically managed in our department

Summary

Introduction

Obesity predisposes to a number of medical conditions. Current literature suggests obesity to be a risk factor for the development of umbilical hernias (UH) (Shenkman et al 1993; Smith et al 2004). Minimal invasive mesh associated techniques have been shown to reduce postoperative complications in obese patients undergoing ventral hernia repair (Birgisson et al 2001; Colon et al 2013; Eid et al 2013). Current data supports hernia patches to be safe and effective in the management of small and medium size ventral hernias including UH (Iversen et al 2010; Ambe et al 2013; Martin et al 2008). No data exists on the use of hernia patches in obese patients. The aim of this series was to investigate the safety and effectiveness of multilayered polytetrafluoroethylene (ePTFE) free, partially absorbable and self-expanding hernia patches in the closure of small and medium size umbilical hernias in obese patients

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