Open ventral hernia repair using ProGrip™ self-gripping mesh

Abstract

PurposeSecure mesh fixation in incisional hernia repair is mandatory to prevent mesh dislocation and possible recurrence. Traditional fixation methods have been implicated as a source of chronic postoperative pain. We report 2-year outcomes with a self-gripping mesh for open tension-free repair of large incisional hernia. MethodsThis prospective case series enrolled 20 patients with large primary incisional hernia (mean defect size: 84 cm2). Patients were electively treated by a single surgeon using a macroporous polyester mesh with resorbable polylactic acid microgrips (ProGrip™, Covidien, Mansfield, MA, USA) using open onlay technique. Main outcomes included pain severity, Carolinas Comfort Scale (CCS), complications, and hernia recurrence. Patients returned for follow-up at 1, 3, 6, 12, and 24 months. ResultsMedian mesh fixation time was 2 min. Mean operative time was 38 min and blood loss was minimal (50 cc). Most patients (75%) were discharged same day. The only perioperative complication was a minor seroma in one patient. Patient follow-up compliance through 2 years was 100%. Mean pain score was 1.8 at discharge, 0.9 at 1 month, 0.7 at 1 year, and 0 at 2 years. At 2-years, all patients were “very satisfied” with treatment and hernia-specific quality of life was excellent (mean CCS score = 0). No infection, mesh removal, or hernia recurrence occurred during follow-up. ConclusionsOpen repair using a self-gripping mesh is a viable treatment option in patients with large incisional hernia. Immediate mesh fixation facilitates a safe and durable tension-free repair.