Mesh Repair Of Hernia Research Articles

Peritoneal Bridging Versus Nonclosure in Laparoscopic Ventral Hernia Repair: A Randomized Controlled Trial.

Postoperative seroma and pain are common problems following laparoscopic intraperitoneal onlay mesh (IPOM) repair of ventral hernias. These adverse outcomes may be avoided by dissecting and using the peritoneum in the hernial sac to bridge the hernia defect. This was a patient- and outcome assessor-blinded, parallel-design, randomized controlled trial comparing nonclosure and peritoneal bridging approaches in patients scheduled for elective midline ventral hernia repair. The primary endpoint was seroma volume on ultrasonography. The secondary endpoints were postoperative pain, recurrence, and complications. Between November 2018 and December 2020, 112 patients were randomized, of whom 60 were in the nonclosure group and 52 were in the peritoneal bridging group. The seroma volume in the nonclosure and peritoneal bridging groups were 17 cm3 (6-53 cm3) versus 0 cm3 (0-26 cm3) at 1-month follow-up (P = 0.013). The median volume was zero at the 3-, 6-, and 12-month follow-ups in both groups. No significant differences were observed in early postoperative pain (P = 0.447) and in recurrence rate (P = 0.684). There were 4 (7%) and 1 (2%) perioperative complications that lead to reoperations in simple IPOM (sIPOM) and IPOM with peritoneal bridging (IPOM-pb), respectively. Seroma was less prevalent after IPOM-pb at 1-month follow-up compared with sIPOM, with similar postoperative pain 1 week after index surgery in both groups. At subsequent follow-ups, the differences in seroma were not statistically significant. Further studies are required to confirm these results. Trial registration (NCT04229940).

A Clinical Study on the Outcomes in the Preservation and Elective Division of the Ilioinguinal Nerve in Open Mesh Repair of Inguinal Hernia

A Clinical Study on the Outcomes in the Preservation and Elective Division of the Ilioinguinal Nerve in Open Mesh Repair of Inguinal Hernia

Early sigmoid perforation involving left inguinal hernia mesh repair: a case report.

Injury to the underlying bowel is a serious potential complication following inguinal hernia mesh repair. Here the authors describe a rare case of a 69-year-old gentleman who initially presented with a deep collection in the retroperitoneum, which extended into the extraperitoneal space on the anterior abdominal wall 3 weeks following left inguinal hernioplasty. Early sigmoid perforation involving the inguinal hernia mesh repair was diagnosed, and he underwent a successful Hartmann's procedure with mesh removal.

A 20-Year Analysis of Medicare Reimbursement for Abdominal Wall Reconstruction (2000 to 2020).

The purpose of this study was to evaluate monetary trends in Medicare reimbursement rates for 30 abdominal wall reconstruction surgical procedures over a 20-year period (2000 to 2020). The Physician Fee Schedule Look-Up Tool from the Centers for Medicare and Medicaid Services was used for each of the 30 included current CPT codes, and reimbursement data were extracted. Monetary data were adjusted for inflation to 2020 U.S. dollars using changes to the United States consumer price index. The R 2 values for the average annual percentage change and the average total percentage change in reimbursement were calculated based on these adjusted trends for all included procedures. After adjusting for inflation, the average reimbursement for all procedures decreased by 17.1% from 2000 to 2020. The greatest mean decrease was observed for CPT code 49568 (the implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of débridement for necrotizing soft-tissue infection, -34.4%). The only procedure with an increased adjusted reimbursement rate throughout the study period was CPT code 20680 (+3.9%). From 2000 to 2020, the adjusted reimbursement rate for all included procedures decreased by an average of 0.85% each year, with an average R 2 value of 0.78, indicating a stable decline throughout the study period. Reimbursement rates are declining when adjusted for inflation. Increased awareness of these trends is helpful to maintain access to optimal abdominal reconstruction care in the United States.

Reoperation for Recurrence is Affected by Type of Mesh in Laparoscopic Ventral Hernia Repair: A Nationwide Cohort Study.

To compare the reoperation rate for recurrence between different mesh types in laparoscopic ventral hernia repair. Ventral hernia repair has improved over the last decades. Nevertheless, recurrence rates are still high, and one type of mesh was recently found to increase it even more. A nationwide cohort study based on prospectively collected data from the Danish Ventral Hernia Database. We included adult patients that had undergone a laparoscopic ventral hernia repair for either an incisional or a primary hernia. The primary and incisional hernias were analyzed in separate cohorts. The mesh-group with the lowest reoperation for recurrence curve was used as the reference. The outcome was reoperation for recurrence. Study population comprised 2874 patients with primary hernias and 2726 with incisional hernias. For primary hernias, Physiomesh [HR = 3.45 (2.16-5.51)] and Proceed Surgical Mesh [HR = 2.53 (1.35-4.75)] had a significantly higher risk of reoperation for recurrence than DynaMesh-IPOM. For incisional hernias, Physiomesh [HR = 3.90 (1.80-8.46), Ventralex Hernia Patch (HR = 2.99 (1.13-7.93), Parietex Composite (incl. Optimized) (HR = 2.55 (1.17-5.55), and Proceed Surgical Mesh (HR = 2.63 (1.11-6.20)] all had a significantly higher risk of reoperation for recurrence than Ventralight ST Mesh. For primary hernias, Physiomesh and Proceed Surgical Mesh had a significantly higher risk of reoperation for recurrence compared with DynaMesh-IPOM. For incisional hernias, the risk was significantly higher for Physiomesh, Parietex Composite, Ventralex Hernia Patch, and Proceed Surgical Mesh compared with Ventralight ST Mesh. This indicates that type of mesh may be associated with outcomes, and mesh choice could therefore depend on hernia type.

A Rare Presentation of Vesicocutaneous Fistula as Groin Abscess after 8 Years of Laparoscopic Mesh Repair of Inguinal Hernia

Laparoscopic mesh repair of inguinal hernia is common but rarely associated with vesicocutaneous fistula as a complication. The most common implications are mesh erosion and migration due to inappropriate strategies in the selection of the mesh type, size, and placement of mesh. This case study reports a 74-year-old man who suffered immense physical, mental, and cosmetic hardship due to a vesicocutaneous fistula postlaparoscopic mesh repair of an inguinal hernia performed 8 years ago. He presented with groin abscess secondary to vesicocutaneous fistula, diagnosed with high inflammatory markers and computed tomography abdomen pelvis. Groin abscess was drained and identified vesicocutaneous fistula which was managed conservatively.

Amyand's hernia; a case report in King Fahad Hospital, Medina

Background: Hernia is the protrusion of an organ or its fascia through the wall of a containing cavity. Ventral abdominal and inguinal hernias typically contain bowel or omentum; only rarely and incidentally the appendix is discovered within the herniated region known as Amyand's hernia (AH). Case Presentation: A 72-year-old male patient with a past surgical history of bilateral hernia repair and prostatectomy presented to the emergency department complaining of lower abdominal and severe scrotal pain with progressive scrotal swelling for 4 months associated with urinary retention and anorexia. On examination, the right scrotum was hugely enlarged and severely tender. Computed tomography (CT) concluded a large (wide neck 7 cm) right inguinal hernia causing mass effect on the urethra, intra-hernia appendix with radiological signs of acute inflamed appendix. The patient was admitted to the general surgical ward and underwent appendectomy and hernia mesh repair. The patient was observed for 1 week and no postoperative complications were seen. The patient was discharged on post-operative day 7 and followed up in the outpatient clinic. Conclusion: A definitive preoperative diagnosis of asymptomatic AH is rare as most cases are usually diagnosed during surgery. CT abdomen and pelvis remains the imaging modality of choice with groin mass or symptomatic hernia.

Gastric Outlet Obstruction Secondary to Incarcerated Stomach in Parastomal Hernia

Gastric outlet obstruction due to an incarcerated stomach in a parastomal hernia is extremely rare. Here, we present the management of such a case with a review of the literature. A 79-year-old woman presented with a 3-week history of postprandial vomiting and associated parastomal and epigastric pain. She had a loop colostomy created for severe fecal incontinence secondary to anal stenosis. Imaging revealed a large parastomal hernia with an incarcerated gastric antrum. She was initially managed nonoperatively with a nasogastric tube. She underwent a semi-elective open Sugarbaker mesh repair of the parastomal hernia with good results. Gastric outlet obstruction secondary to incarceration of the stomach in a parastomal hernia is uncommon. A conservative approach with nasogastric tube decompression is a reasonable initial approach in a patient who is not critically unwell, which allows time for consideration of different parastomal hernia repair techniques.

Intraperitoneal onlay mesh versus laparoscopy-assisted ventral hernia patch mesh repair in small primary ventral hernias

Aims: The aim of this study is to compare and evaluate short-term outcomes of laparoscopy-assisted composite patch mesh repair versus laparoscopic intraperitoneal onlay mesh in small primary midline ventral hernias. Materials and Methods: Eighty consecutive patients with small (<2 cm) midline ventral hernia admitted to the Department of General and Laparoscopic surgery at Sir Ganga Ram Hospital, New Delhi, from January 2017 to May 2019 were included in the study and randomised into two groups. Group A included patients who underwent laparoscopic intraperitoneal onlay mesh repair with the classical barrier flat mesh and Group B patients underwent laparoscopy-assisted ventral hernia patch-mesh repair. Parameters assessed at the follow-up were early post-operative pain by Visual Analogue Scale score, wound complications, early recurrence and hospital stay. Results: Early post-operative pain was more in the laparoscopic intraperitoneal onlay mesh group and the difference was statistically significant. Usage of additional analgesia in the post-operative period was required only in the laparoscopic intraperitoneal onlay mesh group. There was a statistically significant difference between the two groups in terms of hospital stay. Conclusion: For primary midline ventral hernia, with defect size <2 cm, laparoscopy-assisted composite patch mesh repair is feasible and safe. It causes less pain and necessitates less usage of additional analgesia enabling patients to be discharged earlier.

Subcutaneous Onlay Laparoscopic Approach versus Laparoscopic Intraperitoneal Onlay Mesh Repair for Paraumbilical Hernias: A Randomised Clinical Trial

Introduction: Paraumbilical hernias are currently treated most effectively with a minimally invasive strategy. After the introduction of Intraperitoneal Onlay Mesh Placement (IPOM), it has been performed as a traditional technique for paraumbilical hernias, though there are many techniques such as placement of mesh in the preperitoneal/retromuscular space or subcutaneous space. However, there has been a constant debate over the choice of a better approach. Aim: To compare the short-term outcomes of IPOM and Subcutaneous Onlay Laparoscopic Approach (SCOLA) repair (subcutaneous onlay mesh placement) for paraumbilical hernias. Materials and Methods: A randomised clinical trial was conducted in the Department of General Surgery, SRM medical college hospital and research centre, Chennai, Tamil Nadu, India, from March 2021 to August 2022. Study was conducted on patients undergoing laparoscopic hernia mesh repair for paraumbilical hernia. A total of 60 individuals were included in the study. They were placed in groups A and B according to block randomisation with concealed cover. Group A got laparoscopic SCOLA repair and group B got laparoscopic IPOM repair. The patients were tracked for a total of six months. A comparison of two groups was done to evaluate which technique is superior over the other in terms of duration of hospitalization, cost-effectiveness, duration of surgery, postoperative pain, postoperative complications, speed of recovery and returning to routine activity and recurrence. Results: Total 60 participants were divided into two groups, 30 subjects each in group A and group B with a mean±Standard Deviation (SD) age of the subjects in SCOLA group and IPOM group was 37.50±8.41 years and 37.87±9.18 years, respectively. Laparoscopic SCOLA repair for paraumbilical hernia has a comparable outcome to the traditional laparoscopic approach like IPOM in terms of postoperative wound healing (p-value=0.25). A 6-month follow-up revealed no recurrence in either group. Being a newer procedure that requires extensive dissection, the operating time (p-value=0.001), seroma formation (p-value=0.057) and number of hospital days (p-value=0.001) was higher for SCOLA. Also, it was noted that patients who underwent IPOM had significantly more pain experienced as compared to those undergoing SCOLA (p-value 0.45, 0.01 and 0.66 on postoperative days 1, 3 and 5, respectively). Moreover, a significant advantage of SCOLA is its cost-effectiveness. Conclusion: With the advantages of cost-effectiveness and lesser pain, SCOLA approach may be used more frequently in selected patients.

Laparoscopic subcutaneous onlay mesh repair for ventral hernia: Our early experience.

Repair of the ventral hernia is an ongoing challenge in surgery, and a number of surgical techniques have been developed ranging from direct suturing techniques to the use of various mesh types in different planes of the abdominal wall to close the defect and strengthen the musculofascial tissue. Laparoscopic subcutaneous onlay mesh (SCOM) repair is a novel procedure developed recently for ventral hernia repair. We would like to share our experience with laparoscopic SCOM repair. This is a prospective observational study of patients who have undergone ventral hernia repair at Bangalore Endoscopic Surgery Training Institute and Research Centre from June 2020 to June 2022. A total of 20 patients are included in this study. The data were entered into MS Excel and analysed. A total of 20 patients underwent SCOM repair with a defect size measuring up to 8 cm × 8 cm and a mean operative time of 117 min. Three patients had seroma formation and one patient had surgical site infection. No recurrence is seen after 1-year 2-month follow-up. SCOM repair is the newer approach to ventral hernia repair with the advantage over open onlay mesh repair in terms of less pain and better cosmesis. SCOM repair avoids intraperitoneal dissection which may lead to visceral injuries as well as subsequent intraperitoneal adhesions. The acceptance of such surgeries would depend on further long-term studies.

Desarda's Tissue Repair: An Efficient and Affordable Alternative to Mesh repair for Inguinal Hernia

Desarda's Tissue Repair: An Efficient and Affordable Alternative to Mesh repair for Inguinal Hernia

SJLA_2024_A19: Outcomes of Slow Absorbable Biosynthetic Mesh (Phasix™) in Ventral Hernia Repair in National Guard Health Affairs

Introduction: Mesh has become the preferred method due to its ability to integrate with the host’s tissue, reducing recurrence rates compared to primary suture repairs. While synthetic mesh reduces recurrence rates, it may lead to inflammation and infection. To evaluate its performance, this study aims to assess the short-term outcome following ventral hernia repair with biosynthetic mesh. Background: In Ventral Hernia Working Group Grade 3 hernias, which are often contaminated due to factors like prior wound infections, the presence of a stoma, or gastrointestinal tract violations, the heightened risk of infection poses significant challenges. In such cases, the success of mesh repair is jeopardized by potential contamination, complicating the surgical process; prompting consideration of resorbable or biological meshes despite higher costs. A recent advancement is biosynthetic mesh, notably poly-4-hydroxybutyrate, which offers strength comparable to polypropylene mesh and undergoes resorption. However, it retains only 70% strength after 12 weeks, potentially contributing to recurrence. Its efficacy in contaminated sites requires further exploration. Methods: We conducted a retrospective cohort study to thoroughly assess the potential complications following ventral hernia repair. This study will include all patients whose ages are >16 and underwent either open or laparoscopic ventral hernia repair with a biosynthetic mesh at King Abdulaziz Medical City, Saudi Arabia, Riyadh National Guard Health Affairs. The study period extends from January 2020 to December 2023. The study data were extracted from patients’ medical records through the BestCare system. Results: The mean age of our cohort was 58.65 with body mass index 39.6 when looking at comorbidities diabetes mellitus and HTN were the most common comorbidities with 32% affected with diabetes, and 39% affected with hypertension. The most common hernia type observed in our study was incision hernia accounting for 36% of all hernia types followed by inguinal hernia 24.6%. Complications were assessed at 4 time intervals of 1, 3, and 6 months and 1 year. The majority of the patients with complications presented at the 1st month with seroma accounting for 2.2% followed by surgical site infection (SSI) 1.8% and only three patients had 1-year postoperative recurrence. Discussion: The long-term effects of using a permanent synthetic mesh have not been fully understood. However, examining the outcomes associated with absorbable mesh can provide a useful framework for discussing potential risks with patients. Reported outcomes include rates of hernia recurrence and various surgical site occurrences requiring intervention, such as SSI, seroma, wound dehiscence, skin necrosis, hematoma, and fistula. It is important to note that this study is a retrospective cohort study with long-term follow-up, rather than a randomized controlled trial. In addition, other peer-reviewed studies have assessed alternative resorbable synthetic or biologic hernia repair materials, including TIGR® Matrix, Gore® Bio-A®, and Strattice™. Conclusion: In short, our results are comparable to the published reports. No statistically significant improvement in quality of life or reduction of pain was observed. Few patients report the lasting presence of mesh sensation. Results of the biosynthetic mesh after longer periods of follow-up on recurrences and remodeling will provide further valuable information to make clear recommendations.

OUTCOMES OF LAPAROSCOPIC VERSUS OPEN VENTRAL HERNIA REPAIR

The study is a prospective cohort study conducted in the department of surgery at Lisie Hospital and was performed in a restricted period of time (one year) comprising 25 patients with laparoscopic repair and 25 patients with open mesh repair, selected randomly. Laparoscopic ventral hernia mesh repair was done for the LVHR group and onlay mesh repair was done for the OVHR group. The study was divided into two groups (LVHR and OVHR).The patient distribution in the LVHR group consisted of 72% Umbilical hernias(UH), 20% Incisional hernia(IH), 4% Epigastric hernia(EH), 4% Infra Umbilical Hernia(IUH) while the OVHR group included 64% Umbilical Hernia(UH),16% Incisional hernia(IH), 12% Para Umbilical hernia(PUH), 4% Epigastric hernia(EH), 4% Supra Umbilical hernia(SUH). There was no mortality in either group. Recurrence rate of 0% was seen for both the groups due to less period of follow up. The Complication rate was 4% for the LVHR group and 24% for the OVHR group. The only complication in the laparoscopic group was seroma. The recovery period is faster for a laparoscopic hernia repair with a mean postoperative hospital stay of 2.160days as compared to 4.84 days for open mesh repair. The postoperative pain for laparoscopic hernia repair was of a lower score when compared to open mesh repair by visual analog scale measurement. Laparoscopic hernia repair is associated with a faster return to normal activities (avg 13.76 days) when compared to open mesh repair(avg 21 days).

Outcomes of Laproscopic Hysterectomies: An assessment of a learning curve experience of a Gynae laparoscopic surgeries

Among the most frequent gynecological operations conducted is the hysterectomy. Objective: To determine the outcome of TLH in benign uterine pathology of up to 12-week size uterus. Methods: It was a prospective case series carried out at Obstetrics and Gynecology department of Memon medical institute hospital, Karachi from January 2019 to January 2021. All patients who underwent laparoscopic hysterectomy secondary to benign utero- ovarian pathology were consecutively enrolled. Demographic characteristics of the patients along with the presence of co-morbidities, hospital admission details, surgical procedure and intra and post-operative complications were noted. The surgery performed with similar technique in all cases. If patients were deemed to be fit for release after 48 hours following surgery, they were discharged. The postoperative follow-ups were performed at 10th, 30th, and 3 months. Results: Of 50 patients, the mean age was 50.5 years. The main indication of hysterectomy is adenomyosis diagnosed in 20 patients. There were 4 laparoscopic assisted vaginal hysterectomies and 46 were total laparoscopic hysterectomies. History of previous laparotomies was observed in 12, previous cesarean and bilateral tubal ligation in 6 each, history of mesh repair of umbilical hernia in 4 while history of VP shunt was observed in 2 patients. Eight patients converted into laparotomy due to technical difficulty in controlling hemorrhage of uterine artery. Total rate of intra and post-operative complications was 40%. Conclusion: Laparoscopic approach for hysterectomy is a safe alternative to conventional hysterectomy for benign uterine pathology of up to 12 weeks size uterus.

Comparative Study on Laparoscopic Hernia Repair: Totally Extra Peritoneal Repair (TEP) and Transabdominal Preperitoneal (TAPP) at a Tertiary Care Centre

Background Minimal invasive surgery (MIS) procedures in the early 90's as laparoscopic transabdominal preperitoneal repair (TAPP) and totally extra peritoneal repair (TEP), have gained popularity worldwide over open hernia mesh repair with low recurrences, complications and early return to work and activities. This retrospective study aims to compare the two laparoscopic procedures regarding various parameters like duration of surgery, postoperative complications and duration of hospital stay in various ages and different sexes as described in the methodology. Methods This is a retrospective study for over 2 years which included patients with unilateral inguinal hernia both direct and indirect using either (TAAP) or (TEP) technique. Results Among sixty patients with an inguinal hernia, 30 patients had undergone (TAPP) and 30 had undergone (TEP). The duration of surgery for (TAPP) was observed 111.03±13.71 minutes which was significantly higher than that of (TEP) (92.80±8.24 minutes) at P<0.001. The pain score at 6 hours for (TEP) was 6.97±1.01 in comparison to 8±0.00 for (TAPP) (P<0.001). The pain score at 24 hours for (TAPP) was 5.18±1.00 in contrast to 4.27±0.70 for (TEP) (P<0.001). Conclusion Both (TAPP) and (TEP) are feasible surgical options to treat an inguinal hernia. (TAPP) had significantly longer operating time and more early post-operative pain as compared to (TEP). However, there was no significant difference in hospital stay, post-operative complications in both the group.

Fascia defect closure versus non-closure in minimal invasive direct inguinal hernia mesh repair: a systematic review and meta-analysis of real-world evidence.

Laparoscopic and robotic inguinal hernia mesh repair are both common surgical procedures worldwide. Postoperative hernia recurrence and seroma formation are important concerns. In ventral hernia, primary defect closure in laparoscopic surgery reduces the recurrence rate. However, there is no synthetic evidence of direct inguinal hernia defect closure versus non-closure in minimal invasive surgery. Therefore, this study investigated the efficacy of defect closure in patients undergoing minimal invasive direct inguinal hernia mesh repair. Eligible studies were identified through a search of PubMed, Embase, Cochrane Library, and CINAHL from their inception until March 2022. Studies examining defect closure in laparoscopic direct inguinal hernia repair were included, and a meta-analysis was performed using the random-effect model. Sensitivity analyses were performed by removing one study at a time. The primary outcomes were hernia recurrence and seroma formation. Acute and chronic postoperative pain, operation time, and length of hospital stay were the secondary outcomes. Five nonrandomized studies and one randomized controlled trial were included. Pooled analysis revealed defect closure might reduce the hernia recurrence rate (risk difference, -0.02; 95% confidence interval [CI] -0.04 to -0.00; p = 0.02). The result of seroma formation (odds ratio, 0.49; 95% CI 0.17-1.46; p = 0.20) showed no significant difference. Moreover, no significant differences were observed in acute postoperative pain, chronic pain, length of hospital stay, and operation time. Our study indicated defect closure seems to be an option to reduce the direct inguinal hernia recurrence rate. No significant benefits were shown in seroma formation and other secondary outcomes. Our study was mostly based on nonrandomized studies and underestimated the effect of defect closure; thus, further high-quality studies are required to draw definitive conclusions.

Drain Versus No Drain in Open Mesh Repair for Incisional Hernia, Results of a Prospective Randomized Controlled Trial

BackgroundOpen mesh repair of incisional hernia is associated with different local complications, particularly bleeding and seroma formation. Traditionally, drains have been placed perioperatively to prevent these complications, despite the lack of scientific evidence or expert consensus. We formulated the hypothesis that the absence of drainage would reduce number of patients presenting collections or complications. The present study aimed to compare postoperative complication rates after open mesh repair for incisional hernia with or without prophylactic wound drainage.MethodsProspective randomized study using standardized surgical technique and drain placement. The primary endpoint was the evaluation of residual fluid collection with ultrasound on postoperative day 30. Other complications, subdivided into medical and surgical, were analyzed as secondary endpoints.ResultsThere were 144 patients randomized (70 with drain, 74 without drain). No difference was identified between both groups for fluid collection at 30 days (60.3% vs. 62%, p = 0.844). However, less surgical complications were identified in the drain group (21.7% vs. 42.7%, p = 0.007), with a lower wound dehiscence rate (1.5% vs. 9.3%, p = 0.041).ConclusionsProphylactic drainage in open incisional hernia repair does not objectively reduce the rate of postoperative fluid collections. Therefore, our results do not support the use of routine drainage in incisional hernia repair.Trial registrationTrial registration on clinicaltrials.gov (NCT00478348).

LIGHT WEIGHT VERSUS MEDIUM WEIGHT MESH IN LAPAROSCOPIC INGUINAL HERNIA MESH REPAIR

Hernia is repaired by laparoscopic or open approach. Laparoscopic inguinal hernia repairs performed are trans-abdominal preperitoneal repair (TAPP) and totally extra-peritoneal repair (TEP). This study aimed to update the previous reviews and to compare Light Weight versus Medium Weight Mesh in LIHR. Previous studies have shown benets of LWM compared to MWM in terms of decreased pain, discomfort, and early return to normal activity. Method: 50 patients operated for Laparoscopic Inguinal Hernia Mesh Repair were evaluated from Inpatient department of Sahyadri Speciality Hospital, Deccan, Pune between January 2020 to May 2021. 30 patients were operated using Anatomical 3D Light weight Mesh and 20 were operated using Paritene Flat Sheet Medium Weight Mesh; allocation done by simple randomization. It is a prospective, observational study. Aim was to evaluate the post-operative outcome and return to normal activities in LWM versus MWM in LIHR. Result: Mean duration of hospital stay, mean duration of days taken to resume daily activities, intensity of pain by VAS and NRS, foreign body sensation, incidence of seroma formation and inuence on male sexual life and fertility did not differ between patients of both groups. No signicant difference in post-operative pain and foreign body sensation between use of LWM and MWM.

Outcomes of Biosynthetic and Synthetic Mesh in Ventral Hernia Repair.

We performed a retrospective analysis on 109 patients, who underwent VHR with RBOR (n = 50) or synthetic polypropylene mesh (n = 59). Demographic characteristics, comorbidities, postoperative complications, and recurrence rates were analyzed and compared between the groups. Multivariate logistic regression models were fit to assess associations of mesh type with overall complications and surgical site occurrence (SSO). Patients who underwent VHR with RBOR were older (mean age 63.7 versus 58.8 years, P = 0.02) and had a higher rate of renal disease (28.0 versus 10.2%, P = 0.01) compared with patients with synthetic mesh. Despite an unfavorable risk profile, patients with RBOR had lower rates of SSO (16.0 versus 30.5%, P = 0.12) and similar hernia recurrence rates (4.0 versus 6.78%, P = 0.68) compared with patients with synthetic mesh. The use of synthetic mesh was significantly associated with higher odds for overall complications (3.78, P < 0.05) and SSO (3.87, P < 0.05). Compared with synthetic polypropylene mesh, the use of RBOR for VHR mitigates SSO while maintaining low hernia recurrence rates at 30-month follow-up.