A Belgian multicenter prospective observational cohort study shows safe and efficient use of a composite mesh with incorporated oxidized regenerated cellulose in laparoscopic ventral hernia repair

Background : A variety of anti-adhesive composite mesh products have become available to use inside the peritoneal cavity. However, reimbursement of these meshes by the Belgian Governemental Health Agency (RIZIV/INAMI) can only be obtained after conducting a prospective study with at least one year of clinical follow-up. This Belgian multicentric cohort study evaluated the experience with the use of Proceed(R)-mesh in laparoscopic ventral hernia repair. Patients and methods : During a 25 month period 210 adult patients underwent a laparoscopic primary or incisional hernia repair using an intra-abdominal placement of Proceed(R)-mesh. According to RIZIV/INAMI criteria recurrence rate after 1 year was the primary objective, while postoperative morbidity, including seroma formation, wound and mesh infections, quality of life and recurrences after 2 years were evaluated as secondary endpoints (NCT00572962). Results : In total 97 primary ventral and 103 incisional hernias were repaired, of which 28 (13%) were recurrent. There were no conversions to open repair, no enterotomies, no mesh infections and no mortality. One year cumulative follow-up showed 10 recurrences (n = 192, 5.2%) and chronic discomfort or pain in 4.7% of the patients. Quality of life could not be analyzed due to incomplete data set. Conclusions : More than 5 years after introduction of this mesh to the market, this prospective multicentric study documents a favorable experience with the Proceed mesh in laparoscopic ventral hernia repair. However, it remains to be discussed whether reimbursement of these meshes in Belgium should be limited to the current strict criteria and therefore can only be obtained after at least 3-4 years of clinical data gathering and necessary follow-up

Laparoscopic ventral hernia repair using a composite mesh with polypropylene and expanded polytetrafluoroethylene: a prospective, multicentre registry

Background: Abdominal wall hernias are a common problem. Composite meshes placed intraperitoneally for abdominal wall hernia repair are widely used. This registry evaluated the safety and efficacy of one specific composite mesh with polypropylene and expanded polytetrafluoroethylene (Intramesh® T1) in laparoscopic ventral hernia repair. Methods: A prospective multicentre registry with data from seven centres was collected between January 2013 and September 2014. Primary endpoint was recurrence rate at 12 months determined by clinical examination. Secondary outcome measures included intraoperative complications, complications during hospitalisation and at 1-month and 12-months follow-up. Results: The registry included 90 patients (30 female and 60 male). Fifty-five patients (61.1%) presented with primary ventral hernias and 35 patients (38.9%) with incisional ventral hernias. Median hernia size was 4 cm2. Intraoperative complications were reported in two patients (2.2%). Complications during hospitalisation were reported in four (4.4%) patients. At 1-month follow-up, 17 (18.9%) patients had postoperative complications, of which 5 complications were major and 19 were minor. Late complications at 12-months were observed in 10 patients (11.1%), of which 2 were major and 8 minor complications. Conclusion: Intramesh® T1 is a safe and effective composite mesh with favourable short and midterm outcome and morbidity. (NCT01816867).SCOPUS: ar.jinfo:eu-repo/semantics/publishe