Abstract
Intraperitoneal (IP) ventral hernia repair has been proposed with the advantages of reducing dissection, operative time, and postoperative pain. The IP position of the mesh is suspected of increasing the risk of visceral adhesion and inducing complications. To overcome these drawbacks, a mesh protected on one side by a hydrophilic resorbable film (Parietex Composite) has been validated [1]. Using a previously described ultrasound procedure [2], the purpose of this study was to compare the rate of visceral adhesion after intraperitoneal placement of a polyester mesh versus this protected mesh. Fifty-one patients who received a Parietex Composite mesh were prospectively compared to a retrospective series of 22 consecutive asymptomatic patients who received a Mersilene mesh. To objectively assess visceral adhesion toward the abdominal wall, an ultrasound (US) specific examination was firstly validated and secondly used to evaluate the adhesion incidence in both groups. Both groups were equivalent in terms of inclusion criteria and body mass index (BMI). Pre-operative US versus perioperative macroscopical findings determined the following parameters: sensitivity 83%, accuracy 78%, negative predictive value 81%. Using this procedure, 77% of the patients exhibited visceral adhesion to the mesh in the Mersilene group, against 18% in the Parietex Composite group (P<0.001, chi-square). US examination represents a suitable tool to evaluate postoperative adhesions to the abdominal wall. Using this procedure, a significant reduction of visceral adhesion in the Parietex Composite group was shown.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Balique JG, Alexandre JH, Arnaud JP, Benchetrit S, Bouillot JL, Fagniez PL, Flament JB, Gouillat C, Jarsaillon P, Lepère M, Magne E, Mantion G (2000) Intraperitoneal treatment of incisional and umbilical hernias: intermediate results of a multicenter prospective clinical trial using an innovative composite mesh. Hernia 4 (Suppl.) S10-S16
Sigel B, Golub RM, Loiacono LA, Parsons RE, Kodama I, Machi J, Justin J, Sachdeva AK, Zaren HA (1991) Technique of ultrasonic detection and mapping of abdominal wall adhesions. Surg Endosc 5:161–165
Bourgeon R, Borelli JP, Lanfranchi JP (1972) Utilisation des prothèses de mersilène dans le traitement des éventrations postopératoires. Ann Chir 26:541–545
Arnaud JP, Eloy R, Adloff M, Grenier JF (1977) Critical evaluation of prosthetic materials in repair of abdominal wall hernia: new criteria of tolerance and resistance. Ann Surg 133:338–345
Arnaud JP, Cervi C, Tuech JJ, Cattan F (1997) Surgical treatment of postoperative incisional hernias by intra-peritoneal insertion of a Dacron mesh. A report on 220 cases. Hernia 1:97–99
Welti H, Eudel F (1941) Un procédé de cure radicale des éventrations postopératoires par auto-étalement des muscles grands droits après incision du feuillet antérieur de leur gaine. Mem Acad Chir 12:791–798
Kodama I, Loiacono LA, Sigel B, Machi J, Golub RM, Parsons RE, Zaren HA, Sachdeva AK (1992) Ultrasonic detection of visceral slide as an indicator of abdominal wall adhesions. J Clin Ultrasound 20:275–380
Deguzman LJ, Nyphus LM, Yared G (1995) Colocutaneous fistula formation following polypropylene mesh placement for repair of a ventral hernia: diagnosis by colonoscopy. Endoscopy 27:257–261
Marchal F, Brunaud L, Sebbag H, Bresler L, Tortuyaux JM, Boissel P (1999) Treatment of incisional hernias by placement of an intraperitoneal prothesis: a series of 128 patients. Hernia 31:141–147
Goldberg JM, Toledu AA, Mitchell DR (1987) An evaluation of the gore-tex surgical membrane for the prevention of post-operative peritoneal adhesions. Surg Gynecol Obstet 70:846–8
Ambrosiani N, Harb J, Gavelli A, Huguet C (1994) Echec de la cure des éventrations et des hernies par plaque de PTFE. Ann Chir 48:917–20
Amid PK, Shulman AG, Lishtenstein L (1994) Experimental evaluation of a new composite mesh with the selective property of incorporation to the abdominal wall without adhering to the intestine. J Biomed Mater Res. 28:373–375
Amid PK, Schulman AG, Lichtenstein L, Sostrin S, Young J, Hakakha (1995) Preliminary evaluation of composite materials for the repair of incisional hernias. Ann Chir 49:539–543
Bendavid R (1997) Composite mesh (polypropylene- ePTFE) in the intraperitoneal position. Hernia 12:5-8
Alponat A, Lakshminatasappa SR, Yeh M, Rajnakova A, Moochhala S, Guh PM, Chan ST (1997) Effects of physical barriers in prevention of adhesions: an incisional hernia model in rats. J Surg Res 68:126–132
Dizerega GS (1994) Contemporary adhesion prevention. Fertil Steril 61:219–235
Becker JM, Dayton MT Fario VW, Beck DE, Stryker SJ, Wexner SD, Wolff BG, Roberts PL, Smith LE, Moore M, Beart RW (1995) Sodium hyaluronate-based bioresorbable membrane (HAL F) in the prevention of postoperative abdominal adhesions: a prospective, randomized, double-blinded multicenter study. Br J Surg 82: Suppl. 1
Mutter D, Rodeheaver GT, Diemunsh P, Therin M, Moody DL, Raffaelli M, Marescaux J (1998) A new composite mesh (collagen-polyester) for intra-abdominal laparoscopic hernia repair. Surg Endosc 12:595
Rodeheaver GT, Harris ES, Morgan RF (1995) Analysis of the kinetics of peritoneal adhesions formation in the rat and evaluation of potential antiadhesive agents. Surgery 117:663–9
Author information
Authors and Affiliations
Corresponding author
Additional information
An erratum to this article can be found at http://dx.doi.org/10.1007/s10029-003-0149-6
Rights and permissions
About this article
Cite this article
Arnaud, J.P., Hennekinne-Mucci, S., Pessaux, P. et al. Ultrasound detection of visceral adhesion after intraperitoneal ventral hernia treatment: A comparative study of protected versus unprotected meshes. Hernia 7, 85–88 (2003). https://doi.org/10.1007/s10029-003-0116-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10029-003-0116-2