Publications Laparoscopic ventral hernia repair using a novel i
The use of a surgical mesh is currently considered the gold standard for ventral hernia repair [1]. The prosthesis can be implanted in various positions, including the onlay, retromuscular or intraperitoneal positions, and many different techniques for mesh implantation have been described. In addition, the prosthesis can be implanted either laparoscopically [2] or through classic open procedures [1]. Each technique is associated with advantages and disadvantages [3].
Laparoscopic ventral hernia repair (LVHR) requires a prosthesis specifically designed for intraperitoneal place- ment [4]. This prosthesis must remain strong over time, minimise the risk of adhesions and help to reduce the impact of the hernia repair on patient quality-of-life (QoL). Such prostheses have improved significantly since the first intraperitoneal mesh implantations were performed, with the introduction of bi-layer and lightweight meshes. It has been suggested that the use of lightweight meshes should improve patient QoL in the long term since a significant amount of the mesh is absorbed over time. This could be at the cost of an increased hernia recurrence rate [5]. This requires further investigation.
Ventralight ST™ (Davol Inc., Subsidiary of C.R. Bard Inc., Warwick, Rhode Island, USA) is a novel lightweight intraperitoneal onlay (IPOM) mesh coated with hyaluronic acid. It has a polypropylene anterior layer, which allows rapid tissue ingrowth and a posterior intraperitoneal layer composed of Seprafilm™ (Davol Inc., Subsidiary of C.R. Bard Inc., Warwick, Rhode Island, USA), which minimises the attachment of peritoneal tissue (adhesions) to the prosthesis, as well as visceral erosion. The efficacy of Seprafilm™ in preventing the formation of adhesions has been widely proven, in both experimental [6–8] and clin- ical [9–11] studies. Indeed, a Cochrane review published in 2009 [12] concluded that: ‘"There is evidence that the use of hyaluronic acid/carbomethyl cellulose (HA/CMC) membrane reduces incidence, extent and severity of adhesions in the abdomen."
Preliminary clinical results with Ventralight ST™ are promising [13, 14], but require confirmation in larger clinical trials and comparison with the results from other prostheses. The only comparative study published to date is an experimental research paper in a porcine model [15], in which the results favoured Ventralight ST™ comparative clinical study has yet been reported. We, therefore, conducted a case–control study comparing the results from LVHR using the Ventralight ST™ mesh with those achieved using other types of prostheses using data from the prospective French Hernia-Club registry.