Purpose: Biologic prostheses are designed to support tissue regeneration rather than just result in a strong scar plate, as is the case with synthetic mesh. It is not known if these newer materials will result in earlier return to normal activities and/or less post-herniorrhaphy groin pain. METHOD/STUDY DESIGN: A prospective, randomized, controlled, third-party-blinded multicenter trial was designed to compare the use of a non-cross linked porcine dermis biologic graft [Strattice(TM) Reconstructive Tissue Matrix (RTM), LifeCell, Branchburg, NJ] versus light weight, large pore polypropylene mesh (UltraPro(TM), Ethicon, Somerville, NJ). The study design called for recruitment of 170 men. These men are being followed for a minimum of 2 years. The primary aim of this study is to compare the safety and effectiveness of the two materials in a Lichtenstein inguinal hernia repair as measured by resumption of activities of daily living. Secondary outcomes include chronic pain, postoperative complications and the incidence of re-herniation at 12 and 24 months.
Results: This paper discusses the study design, patient recruitment and the current status of the clinical trial. The study involves nine medical centers, all with extensive experience in hernia repair. After 24 months of enrollment, 172 men were randomized and recruitment was then closed. All patients underwent elective repair of primary unilateral inguinal hernias as an outpatient operation. Follow up data are being collected. Data analyses are scheduled at 3, 12, and 24 months postoperatively.
Conclusion: We report the design of a multi-center, third-party blinded, randomized clinical trial comparing a new surgical device with existing technology in the repair of inguinal hernias. We believe this investigator-designed and conducted trial could serve as a model for similar trials examining surgical devices performed in collaboration with industry.
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http://dx.doi.org/10.1007/s10029-010-0773-x | DOI Listing |
Wiad Lek
January 2025
DEPARTMENT OF GENERAL, ONCOLOGICAL AND DIGESTIVE TRACT SURGERY, MEDICAL CENTRE OF POSTGRADUATE EDUCATION, ORŁOWSKI HOSPITAL, MEDICAL CENTRE OF POSTGRADUATE EDUCATION, WARSAW, POLAND.
The aim of this study is to present a case of laparoscopic treatment of perineal hernia in a patient after abdominoperineal resection od the rectum. We present the case of a 63-year-old woman who was operated on laparoscopically with a mesh sewn in at the level of the sacrum, iliac vessels and pubic symphysis. And covered with a peritoneal flap above the urinary bladder.
View Article and Find Full Text PDFSurg Endosc
January 2025
Division of Minimally Invasive and Bariatric Surgery, Penn State Health Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA.
Background: Defect closure with mesh suture is a novel technique for hernia repair. Originally described as the construction of lightweight macroporous polypropylene mesh strips as a suture material, it is now available as an FDA-approved product. Mesh suture better distributes tensile forces and reduces fascial tearing compared to traditional suture but requires less implanted material and tissue dissection compared to planar mesh.
View Article and Find Full Text PDFCureus
January 2025
Pediatric Surgery, Bahrain Defence Force Royal Medical Services, Riffa, BHR.
We report the case of a four-month-old male infant diagnosed incidentally with bilateral congenital diaphragmatic hernias. Our patient was found to have chest asymmetry during an unrelated hospital visit and bilateral diaphragmatic defects were confirmed on cross-sectional imaging. Surgical repair of a right-sided Bochdalek hernia and a left-sided Morgagni hernia was performed with excellent outcomes.
View Article and Find Full Text PDFSurg Innov
January 2025
Division of General, Minimally Invasive, and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.
Background: Transabdominal pre-peritoneal inguinal hernia repair using the da Vinci Single-Port robot (SP-TAPP) is currently performed in few centers. We aimed to define the learning curve for SP-TAPP by analyzing operative times.
Methods: The operative times of 122 SP-TAPP performed between 2019 and 2024 were retrospectively analyzed.
Sci Rep
January 2025
Department of General Surgery, Shaoxing Central Hospital (The Central Affiliated Hospital, Shaoxing University), Shaoxing, 312030, Zhejiang Province, China.
Ventral hernias pose a prevalent challenge in abdominal wall surgery, with ongoing advancements in repair techniques designed to enhance patient outcomes. This study evaluates the efficacy, safety, and socio-economic impact of Totally Extraperitoneal Sublay Repair (TES) versus Laparoscopic Intraperitoneal Onlay Mesh Repair (IPOM) for small to medium-sized ventral hernias, with a particular focus on postoperative quality of life and patient satisfaction. A retrospective cohort study was conducted, encompassing 125 patients who underwent ventral hernia repair between May 2018 and November 2023.
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