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Hernia

, Volume 22, Issue 5, pp 781–784 | Cite as

Prophylactic mesh used in ileal conduit formation following radical cystectomy: a retrospective cohort

  • P. L. Tenzel
  • Z. F. Williams
  • R. A. McCarthy
  • W. W. Hope
Original Article

Abstract

Purpose

Given the difficulty of durable repairs, there is continued interest in hernia prevention. One emerging prevention technique for parastomal hernias is prophylactic mesh placement, whereby mesh is inserted during the index procedure as hernia prophylaxis. We evaluated our experience using prophylactic mesh when creating an ileal conduit.

Methods

We retrospectively reviewed patients undergoing robotic cystectomy with ileal conduit from 6/2010 to 8/2017. Patient demographics and operative/perioperative outcomes were documented. We evaluated hernia recurrence using postoperative computed tomography scanning or physical exam. Prophylactic mesh was inserted at the operating surgeon’s discretion using a synthetic resorbable or biologic mesh.

Results

During the study period, 38 patients underwent robotic-assisted cystectomy with ileal conduit formation. Average patient age was 68 years, with 28 (74%) male and 35 (92%) Caucasian patients. Three patients (8%) required conversion to open, and one patient (3%) had a concomitant colorectal resection. Thirty-one (88%) patients had postoperative computed tomography scanning. Prophylactic mesh was used in 18 patients (47%) in a retrorectus position. Of these, 15 (83%) patients had synthetic resorbable mesh and 3 (17%) patients had biologic mesh. At average follow-up of 21 months, one hernia recurred (5%) in a patient without mesh placement at the time of ileal conduit. At an average follow-up of 11 months, there have been no recurrences and no mesh-related complications in the prophylactic mesh group.

Conclusions

Using prophylactic mesh in ileal conduit, creation is feasible and may decrease the parastomal hernia formation rate. Further study of using synthetic resorbable and biologic meshes for hernia prophylaxis is warranted.

Keywords

Hernia Prevention Prophylaxis Ostomy Ileal conduit 

Notes

Funding

No financial support was received for this study.

Compliance with ethical standards

Conflict of interest

PLT declares no conflict of interest. ZFW declares no conflict of interest. RAM declares no conflict of interest. WH declares conflicts of interest not directly related to the submitted work. WH has consulted for CR Bard, served as a speaker for Bard, WL Gore and Intuitive Surgical, and has received research funding from Bard and Gore.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Human and animal rights

All procedures were approved by the New Hanover Regional Medical Center Institutional Review Board.

Informed consent

For this type of study formal consent is not required.

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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • P. L. Tenzel
    • 1
  • Z. F. Williams
    • 1
  • R. A. McCarthy
    • 1
  • W. W. Hope
    • 1
  1. 1.Department of SurgeryNew Hanover Regional Medical CenterWilmingtonUSA

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