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Postoperative ileus after laparoscopic primary and incisional abdominal hernia repair with intraperitoneal mesh (DynaMesh®-IPOM versus Parietex™ Composite): a single institution experience

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Abstract

Purpose

Laparoscopic primary or incisional abdominal hernia repair with intraperitoneal mesh placement is a well-accepted and safe technique. Evidence for complications however remains inconclusive, and little is known about the occurrence of postoperative ileus secondary to postoperative intra-abdominal adhesions with different types of IPOM meshes used. Therefore, we retrospectively compared the occurrence of postoperative ileus between two of the different meshes used in our center.

Methods

Three hundred seventy-five patients who underwent ventral hernia repair with intraperitoneal mesh placement, either with a DynaMesh®-IPOM (FEG Textiltechnik mbH, Aachen, Nordrhein-Westfalen, Germany) or a Parietex™ Composite mesh (Medtronic, Minneapolis, MN, USA), at the Heilig-Hart Hospital in Lier (Antwerp, Belgium) between 2012 and 2017 were retrospectively compared with regard to the occurrence of postoperative ileus until 6 weeks postoperatively. Baseline demographics and clinical data up to 6 weeks postoperatively of the patients in the two mesh groups are provided.

Results

The DynaMesh®-IPOM mesh group was associated with a significantly higher incidence of postoperative ileus compared with the Parietex™ Composite mesh group with a cutoff limit at postoperative day 1 (n = 17, 6.8% vs. n = 0, 0.0%; P = 0.003) and postoperative day 4 (n = 13, 5.2% vs. n = 0, 0.0%, P = 0.006), even with a mesh surface area of ≤ 300 cm2 and when both meshes were fixated with the same method of fixation (Securestrap™) with a cutoff limit for postoperative ileus at postoperative day 1 (n = 4, 7.7% vs. n = 0, 0.0%; P = 0.013) and postoperative day 4 (n = 3, 5.8% vs. n = 0, 0.0%, P = 0.040). Of the 17 patients with a postoperative ileus, 9 (52.9%) had a suspicion of adhesive small bowel obstruction on CT scan (P = 0.033) with definitive confirmation of small bowel adhesions with the DynaMesh®-IPOM mesh at laparoscopy in 2 patients.

Conclusion

Our results confirm current literature available regarding postoperative ileus secondary to postoperative intra-abdominal adhesions with the DynaMesh®-IPOM mesh. However, further research with well-designed, multicenter randomized controlled studies to evaluate the use and related complications of these meshes is needed.

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Authors and Affiliations

  1. Department of General Surgery, Heilig-Hart Hospital, Mechelsestraat 24, Lier, Belgium

    Andreas Domen, Cedric Stabel, Rami Jawad, Nicolas Duchateau, Patrick Vanclooster & Charles de Gheldere

  2. StatUa Center for Statistics, University of Antwerp, Wilrijk, Antwerp, Belgium

    Erik Fransen

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  1. Andreas Domen
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Contributions

Andreas Domen, Cedric Stabel, and Charles de Gheldere contributed to the study conception and design. Material preparation and data collection were performed by Andreas Domen, Cedric Stabel, Rami Jawad, Nicolas Duchateau, Patrick Vanclooster, and Charles de Gheldere. Analysis was performed by Andreas Domen, Cedric Stabel, and Erik Fransen. The first draft of the manuscript was written by Andreas Domen and Cedric Stabel, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Charles de Gheldere.

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Domen, A., Stabel, C., Jawad, R. et al. Postoperative ileus after laparoscopic primary and incisional abdominal hernia repair with intraperitoneal mesh (DynaMesh®-IPOM versus Parietex™ Composite): a single institution experience. Langenbecks Arch Surg 406, 209–218 (2021). https://doi.org/10.1007/s00423-020-01898-9

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