Skip to main content
SpringerLink
Log in

Decreased re-operation rate for recurrence after defect closure in laparoscopic ventral hernia repair with a permanent tack fixated mesh: a nationwide cohort study

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Purpose

To investigate whether defect closure in laparoscopic ventral hernia repair reduces the re-operation rate for recurrence compared with no defect closure.

Methods

Data were extracted from the Danish Ventral Hernia Database. Adults with an elective laparoscopic ventral hernia repair with tacks used as mesh fixation were included, if their first repair was between the 1st of January 2007 and the 1st of January 2017. Patients with defect closure were compared with no defect closure. Re-operation rates are presented as crude rates and cumulated adjusted re-operation rates. Sub-analyses assessed the effect of the suture material used during defect closure and also whether defect closure affected both primary and incisional hernias equally.

Results

Among patients with absorbable tacks as mesh fixation, 443 received defect closure and 532 did not. For patients with permanent tacks, 393 had defect closure and 442 did not. For patients with permanent tacks as mesh fixation, the crude re-operation rates were 3.6% with defect closure and 7.2% without defect closure (p = 0.02). The adjusted cumulated re-operation rate was significantly reduced with defect closure and permanent tacks (hazard ratio = 0.53, 95% confidence interval = 0.28–0.999, p = 0.05). The sub-analysis suggested that defect closure was only beneficial for incisional hernias, and not primary hernias. We did not find any benefits of defect closure for patients with absorbable tacks as mesh fixation.

Conclusion

This nationwide cohort study showed a reduced risk of re-operation for recurrence if defect closure was performed in addition to permanent tacks as mesh fixation during laparoscopic incisional hernia repair.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Helgstrand F, Jorgensen LN (2016) The Danish Ventral Hernia Database—a valuable tool for quality assessment and research. Clin Epidemiol 8:719–723. https://doi.org/10.2147/CLEP.S99501

    Article  PubMed  PubMed Central  Google Scholar 

  2. Helgstrand F, Rosenberg J, Kehlet H, Jorgensen LN, Bisgaard T (2013) Nationwide prospective study of outcomes after elective incisional hernia repair. J Am Coll Surg 216:217–228. https://doi.org/10.1016/j.jamcollsurg.2012.10.013

    Article  PubMed  Google Scholar 

  3. Christoffersen MW, Brandt E, Helgstrand F, Westen M, Rosenberg J, Kehlet H et al (2015) Recurrence rate after absorbable tack fixation of mesh in laparoscopic incisional hernia repair. Br J Surg 102:541–547. https://doi.org/10.1002/bjs.9750

    Article  PubMed  CAS  Google Scholar 

  4. Bittner R, Bingener-Casey J, Dietz U, Fabian M, Ferzli GS, Fortelny RH et al (2014) Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS)—Part 1. Surg Endosc 28:2–29. https://doi.org/10.1007/s00464-013-3170-6

    Article  PubMed  CAS  Google Scholar 

  5. Benchimol EI, Smeeth L, Guttmann A, Harron K, Moher D, Petersen I et al (2015) The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement. PLoS Med 12:e1001885. https://doi.org/10.1371/journal.pmed

    Article  PubMed  PubMed Central  Google Scholar 

  6. Herniedatabasen (2017) Dansk Herniedatabase, National Årsrapport 2016. https://docs.wixstatic.com/ugd/02befe_0a3cf443334f4576b21143d811ccb8fc.pdf. Accessed 30 Nov 2017

  7. Helgstrand F, Tenma J, Rosenberg J, Kehlet H, Bisgaard T (2013) High agreement between the Danish Ventral Hernia Database and hospital files. Dan Med J 60:A4708

    PubMed  Google Scholar 

  8. Lynge E, Sandegaard JL, Rebolj M (2011) The Danish national patient register. Scand J Public Health 39:30–33. https://doi.org/10.1177/1403494811401482

    Article  PubMed  Google Scholar 

  9. Food and drug administration (2016) Department of Health and Human Services. Ethicon voluntarily withdraws physiomesh. http://www.fdanews.com/articles/177311-ethicon-voluntarily-recalls-physiomesh. Accessed 30 Nov 2017

  10. Earle D, Roth JS, Saber A, Haggerty S, Bradley JF IIIrd, Fanelli R et al (2016) SAGES guidelines for laparoscopic ventral hernia repair. Surg Endosc 30:3163–3183. https://doi.org/10.1007/s00464-016-5072-x

    Article  PubMed  Google Scholar 

  11. Tandon A, Pathak S, Lyons NJ, Nunes QM, Daniels IR, Smart NJ (2016) Meta-analysis of closure of the fascial defect during laparoscopic incisional and ventral hernia repair. Br J Surg 103:1598–1607. https://doi.org/10.1002/bjs.10268

    Article  PubMed  CAS  Google Scholar 

  12. Burcharth J, Pommergaard HC, Rosenberg J (2015) Performing and evaluating meta-analyses. Surgery 157:189–193. https://doi.org/10.1016/j.surg.2014.08.087

    Article  PubMed  Google Scholar 

  13. Lambrecht JR, Vaktskjold A, Trondsen E, Oyen OM, Reiertsen O (2015) Laparoscopic ventral hernia repair: outcomes in primary versus incisional hernias: no effect of defect closure. Hernia 19:479–486. https://doi.org/10.1007/s10029-015-1345-x

    Article  PubMed  CAS  Google Scholar 

  14. Light D, Bawa S (2016) Trans-fascial closure in laparoscopic ventral hernia repair. Surg Endosc 30(12):5228–5231. https://doi.org/10.1007/s00464-016-4868-z

    Article  PubMed  Google Scholar 

  15. Stirler VM, Schoenmaeckers EJ, de Haas RJ, Raymakers JT, Rakic S (2014) Laparoscopic repair of primary and incisional ventral hernias: the differences must be acknowledged: a prospective cohort analysis of 1,088 consecutive patients. Surg Endosc 28:891–895. https://doi.org/10.1007/s00464-013-3243-6

    Article  PubMed  Google Scholar 

  16. Subramanian A, Clapp ML, Hicks SC, Awad SS, Liang MK (2013) Laparoscopic ventral hernia repair: primary versus secondary hernias. J Surg Res 181:e1–e5. https://doi.org/10.1016/j.jss.2012.06.028

    Article  PubMed  Google Scholar 

  17. LeBlanc K (2016) Proper mesh overlap is a key determinant in hernia recurrence following laparoscopic ventral and incisional hernia repair. Hernia 20:85–99. https://doi.org/10.1007/s10029-015-1399-9

    Article  PubMed  CAS  Google Scholar 

  18. Holihan JL, Alawadi ZM, Harris JW, Harvin J, Shah SK, Goodenough CJ et al (2016) Ventral hernia: patient selection, treatment, and management. Curr Probl Surg 53:307–354. https://doi.org/10.1067/j.cpsurg.2016.06.003

    Article  PubMed  Google Scholar 

  19. Helgstrand F, Rosenberg J, Kehlet H, Strandfelt P, Bisgaard T (2012) Reoperation versus clinical recurrence rate after ventral hernia repair. Ann Surg 256:955–958. https://doi.org/10.1097/SLA.0b013e318254f5b9

    Article  PubMed  Google Scholar 

  20. Suwa K, Okamoto T, Yanaga K (2016) Closure versus non-closure of fascial defects in laparoscopic ventral and incisional hernia repairs: a review of the literature. Surg Today 46:764–773. https://doi.org/10.1007/s00595-015-1219-y

    Article  PubMed  Google Scholar 

  21. Clapp ML, Hicks SC, Awad SS, Liang MK (2013) Trans-cutaneous Closure of Central Defects (TCCD) in laparoscopic ventral hernia repairs (LVHR). World J Surg 37:42–51. https://doi.org/10.1007/s00268-012-1810-y

    Article  PubMed  Google Scholar 

Download references

Funding

This study received no financial support from extramural sources.

Author information

Authors and Affiliations

  1. Department of Surgery, Center for Perioperative Optimization, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark

    J. J. Baker, S. Öberg, K. Andresen & J. Rosenberg

Authors
  1. J. J. Baker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Öberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. Andresen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Rosenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. J. Baker.

Ethics declarations

Conflict of interest

JJB and SÖ declare that they have no conflict of interest. KA has received personal fees from Bard outside the submitted work. JR has received personal fees from Bard and Merck, outside the submitted work.

Ethical approval

This article did not require ethical approval of any kind.

Human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Baker, J.J., Öberg, S., Andresen, K. et al. Decreased re-operation rate for recurrence after defect closure in laparoscopic ventral hernia repair with a permanent tack fixated mesh: a nationwide cohort study. Hernia 22, 577–584 (2018). https://doi.org/10.1007/s10029-018-1776-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-018-1776-2

Keywords

Search

Navigation