Mesh repair of medium sized midline incisional hernias: Prolene mesh versus Vypro mesh

Document Type : Original Article

Authors

Department of General Surgery, Ain Shams University, Cairo, Egypt

Abstract

Incisional hernia is a complication in 10-20 % of patients after laparotomy. The standard flat mesh made from polypropylene has a tensile strength that is far greater than that required physiologically. Reducing the amount of polypropylene by increasing pore size produces a lighter weight mesh that may improve the functional properties and diminish local complications. The low-weight mesh was found to be feasible, with no additional short-term mesh-related complications in the experimental model and no negative side effect on biocompatibility. Also the introduction of the retromuscular, sublay technique using polypropylene meshes had significantly  decreased  the  recurrence  rates  after  open  incisional  hernia  repair.
The aim of this study: To evaluate the sublay technique using light weight Vypro mesh in comparison to the same technique using heavy weight Prolene mesh for moderate size midline incisional hernias, as regard operative difficulties and postoperative complications.
Patient and method: Between Aug. 2008 and Aug. 2009, 30 patients with moderate size (5-
10cm) midline incisional hernias were randomized to receive lightweight composite (Vypro) mesh, or standard polypropylene (Prolene) mesh. The clinical course of all patients was registered during   the   hospital   stay   as   well   as   3,   6,   9,   and   12   months   after   surgery.
Results: No significant differences were determined concerning age and gender. In contrast, length of hospital stay was lower in the low-weight mesh group. Minor complications as seroma, mild wound infection and abdominal discomfort were significantly lower among patients in whom we used Vypro meshes in the repair than patients with prolene meshes. No hernia recurrences occurred in both studied groups.