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Open IPOMs for medium/large incisional ventral hernia repairs in the French Hernia Registry: factors associated with their use and mesh-related outcomes

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Abstract

Purpose

The use of open intra-peritoneal onlay mesh repairs (O-IPOMs) for treating medium/large incisional ventral hernias has come into question due to the development of minimally invasive and sublay procedures. This study aimed to identify factors that are associated with the use of O-IPOMs in France.

Methods

We analysed prospectively collected data from the French Hernia Registry on incisional ventral hernia repairs (IVHR) for hernias ≥ 4 cm in width.

Results

We obtained data for 2261 IVHR (from 11/09/2011 to 30/03/2020): 733 O-IPOMs and 1,528 other techniques. We found that the O-IPOMs were performed on patients with more patient-related risk factors compared with the other techniques. Specifically, there was a higher proportion of patients with ASA III/IV (40.47% vs. 28.02%; p < 0.00001) and at least one patient-related risk factor (66.17% vs. 58.51%; p = 0.0005). Of the 733 O-IPOMs, 195 used Ventrio ST™ (VST), the most commonly used mesh for such IPOMs in our database; the other 538 O-IPOMs used other meshes (OM). The VST subgroup had a higher proportion of patients with ASA III/IV (52.58% vs. 36.07%; p < 0.0001) and on anticoagulants (26.04% vs. 18.41%; p = 0.0229) compared with the OM subgroup; they also had a lower recurrence rate after 2 years (5.83% vs. 15.41%; p = 0.008). However, large (≥ 10 cm) or lateral defects were more common in the OM subgroup, and their mesh/defect area ratio was lower.

Conclusion

O-IPOMs were performed on patients with more comorbidities and/or complex incisional hernias compared with other techniques.

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Data availability statement

Data was extracted from Club-Hernie registry (club-hernie.com).

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Acknowledgements

We thank those involved in the AFC study (17) for the data acquisition. We also thank the Hernia Club members for data acquisition. L. Arnalsteen (Hôpital Privé La Louvière, Lille, France), J. Atger (Polyclinique des Alpes du Sud, Gap, France), M. Beck (Clinique Ambroise Paré, Thionville, France), A. Belhassen (Clinique Blomet, Paris, France), T. Bensignor (Groupe Hospitalier Paris St Joseph, Paris, France), P. Bernard (Hôpital de Macon, Macon, France), D. Binot (MCO Côte d’Opale, Boulogne sur Mer, France), J. Bousquet (Hôpital Privé de la Chataigneraie, Montpellier, France), D. Blazquez (Clinique Jeanne d’Arc, Paris, France), A. Bonan (Hôpital Privé d’Antony, Antony, France), J. Bousquet (Hôpital Privé de la Chataigneraie, Montpellier, France), J. Cahais (Clinique Saint Hilaire, Rouen, France), O. Cas (Centre Médico Chirurgical–Fondation Wallerstein, Arès, France), A. Champault-Fezais (Groupe Hospitalier Paris St Joseph, Paris, France), P. Chastan (Bordeaux, France), J-M. Chollet (Hôpital Privé d’Antony, Antony, France), N. Christou (CHU, Limoges, France), J-P. Cossa (CMC Bizet, Paris, France), A.C. Couchard (Hôpital Privé d’Antony, Antony, France), T. Crespy (Hôpital Privé de Provence, Aix-en-Provence, France), A. Dabrowski (Clinique de Saint Omer, Saint Omer, France), T. Delaunay (Clinique St Hilaire, Rouen, France), S. Démaret (Clinique Saint Vincent, Besançon, France), S. Derieux (Hôpital de la Croix Saint Simon, Paris, France), F. Drissi (CHU Nantes, Nantes, France), V. Dubuisson (CHU Pellegrin, Bordeaux, France), C. Duchamp (Clinique du Val d’Ouest, Ecully, France), T. Dugué (Clinique Saint-Pierre, Perpignan, France), R. Fara (Hôpital Européen, Marseille, France), S. Frey (CHU, Nantes, France), G. Fromont (Clinique de Bois Bernard, Bois Bernard, France), J-F. Gillion (Hôpital Privé d’Antony, Antony, France), N. Goasguen (Hôpital de la Croix Saint Simon, Paris, France), P. Guéroult (CHU, Angers, France), A. Guillaud (Clinique du Parc, Montpellier, France), C. Jacquin (CH du Prado, Marseille, France), F. Jurczak (Clinique Mutualiste, Saint Nazaire, France), H. Khalil (CHRU Rouen, Rouen, France), G. Hoch (Hôpital UNEOS, Metz, France), C. Kupéras (Clinique Joly, Dijon, France), A. Lamblin (Hôpital Privé La Louvière, Lille, France), P. Ledaguenel (Polyclinique Jean Villar, Av. Maryse Bastié, Bruges, France), M. Lepère (Clinique Saint Charles, La Roche-sur-Yon, France), D. Lépront (Polyclinique de Navarre, Pau, France), J. H. Longeville (Clinique du Val-de-Loire, Nevers, France), N. Le Toux (Clinique Jeanne d’Arc, Paris, France), E. Magne (Clinique Tivoli, Bordeaux, France), N. Maillot (Clinique du Parc, Cholet, France), A. Mensier (Hôpital d’Arras, clinique de Béthune, Béthune, France), D. Moszkowicz (CHU Louis Mourier Colombes, France), P. Ngo (Hôpital Américain, Neuilly, France), O. Oberlin (Croix St Simon Diaconesses, Paris, France), G. Passot (CHU de Lyon Sud, Lyon, France), X. Pavis d’Escurac (Strasbourg, France), J. B. Putinier (CH Mutualiste, Grenoble, France), Y. Renard (CHRU Reims, Reims, France), B. Romain (CHU Strasbourg, Strasbourg, France), D. Sebbar (Hôpital de Saint Brieuc, Saint Brieuc, France), M. Soler (Polyclinique Saint Jean, Cagnes-sur-Mer, France), S. Roos (Clinique Claude Bernard, Albi, France), J-M. Thillois (Hôpital Privé d’Antony, Antony, France), P. Tiry (Clinique de Saint Omer, Saint Omer, France), P. Vu (HPMV, Bry sur Marne, France), R. Verhaeghe (MCO Côte d’Opale, Boulogne sur Mer, France), M. Warlaumont (CHRU Lille, Lille, France), and C. Zaranis (Clinique de La Rochelle, France).

Funding

This study was planned, conducted, and analysed under the auspices of the Hernia Club (https://www.club-hernie.com). The work was supported by an unrestricted educational grant to the Hernia Club CRO from Becton Dickinson Benelux N.V., Erembodegem-Dorp 86, 9320 Erembodegem, Belgium ("BD"). This article contains the personal and professional opinions of the individual authors and does not necessarily reflect the views and opinions of BD or any Business Unit or affiliate of BD. The funder of the present study had no role in the design and conduct of the study (collection, management, analysis, and interpretation of the data).

Author information

Authors and Affiliations

  1. Ramsay Sante, Antony Private Hospital, 1 rue Velpeau, 92160, Antony, France

    J.-F. Gillion

  2. Bois Bernard Private Hospital, 62320, Rouvroy, France

    G. Fromont

  3. MCO Côte d’Opale, 62280, Saint-Martin-Boulogne, France

    R. Verhaeghe & D. Binot

  4. Saint-Omer Clinic, 62500, Saint-Omer, France

    P. Tiry & A. Dabrowski

  5. Saint-Pierre Clinic, 66000, Perpignan, France

    T. Dugué

Authors
  1. J.-F. Gillion
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  2. G. Fromont
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  3. R. Verhaeghe
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  4. P. Tiry
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  5. D. Binot
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  6. T. Dugué
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  7. A. Dabrowski
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Consortia

the Hernia Club members

  • L. Arnalsteen
  • , J. Atger
  • , M. Beck
  • , A. Belhassen
  • , T. Bensignor
  • , P. Bernard
  • , D. Binot
  • , J. Bousquet
  • , D. Blazquez
  • , A. Bonan
  • , J. Bousquet
  • , J. Cahais
  • , O. Cas
  • , A. Champault-Fezais
  • , P. Chastan
  • , J.-M. Chollet
  • , N. Christou
  • , J.-P. Cossa
  • , A. C. Couchard
  • , T. Crespy
  • , A. Dabrowski
  • , T. Delaunay
  • , S. Démaret
  • , S. Derieux
  • , F. Drissi
  • , V. Dubuisson
  • , C. Duchamp
  • , T. Dugué
  • , R. Fara
  • , S. Frey
  • , G. Fromont
  • , J.-F. Gillion
  • , N. Goasguen
  • , P. Guéroult
  • , A. Guillaud
  • , C. Jacquin
  • , F. Jurczak
  • , H. Khalil
  • , G. Hoch
  • , C. Kupéras
  • , A. Lamblin
  • , P. Ledaguenel
  • , M. Lepère
  • , D. Lépront
  • , J. H. Longeville
  • , N. Le Toux
  • , E. Magne
  • , N. Maillot
  • , A. Mensier
  • , D. Moszkowicz
  • , P. Ngo
  • , O. Oberlin
  • , G. Passot
  • , X. Pavis d’Escurac
  • , J. B. Putinier
  • , Y. Renard
  • , B. Romain
  • , D. Sebbar
  • , M. Soler
  • , S. Roos
  • , J-M. Thillois
  • , P. Tiry
  • , P. Vu
  • , R. Verhaeghe
  • , M. Warlaumont
  •  & C. Zaranis

Contributions

Concept and design: JFG; Acquisition of data: Co-authors and Hernia-Club members; Data analysis: JFG; Drafting of the manuscript: JFG; Critical revision of the manuscript: All authors; Supervision: JFG (Statistical analysis: SAS HORIANA; Editing: NEWMED Publishing).

Corresponding author

Correspondence to J.-F. Gillion.

Ethics declarations

Conflict of interest

JFG has received honoraria as a consultant from BD, Cousin-Surgery, Intuitive, Medtronic, Microval, and Swing THT. GF has received honoraria as a consultant from Medtronic. Other co-authors: No competing interests related to this study.

Ethics approval

This retrospective study was approved by the local (IORG0009085) institutional review board (number: IRB00010835).

Human and animal rights

No animals involved in this study.

Informed consent

All participants provided informed consent prior to their participation.

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The members of the Hernia Club members are mentioned in Acknowledgements section.

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Gillion, JF., Fromont, G., Verhaeghe, R. et al. Open IPOMs for medium/large incisional ventral hernia repairs in the French Hernia Registry: factors associated with their use and mesh-related outcomes. Hernia (2023). https://doi.org/10.1007/s10029-023-02853-5

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