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Mesh Repair (mesh + repair)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Randomized clinical trial of non-mesh versus mesh repair of primary inguinal hernia,

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2002
W. W. Vrijland
Background: The optimum method for inguinal hernia repair has not yet been determined. The recurrence rate for non-mesh methods varies between 0·2 and 33 per cent. The value of tension-free repair with prosthetic mesh remains to be confirmed. The aim of this study was to compare mesh and non-mesh suture repair of primary inguinal hernias with respect to clinical outcome, quality of life and cost in a multicentre randomized trial in general hospitals. Methods: Between September 1993 and January 1996, all patients scheduled for repair of a unilateral primary inguinal hernia were randomized to non-mesh or mesh repair. The patients were followed up at 1 week and at 1, 6, 12, 18, 24 and 36 months. Clinical outcome, quality of life and costs were registered. Results: Three hundred patients were randomized of whom 11 were excluded. Three-year recurrence rates differed significantly: 7 per cent for non-mesh repair (n = 143) and 1 per cent for mesh repair (n = 146) (P = 0·009). There were no differences in clinical variables, quality of life and costs. Conclusion: Mesh repair of primary inguinal hernia repair is superior to non-mesh repair with regard to hernia recurrence and is cost-effective. Postoperative complications, pain and quality of life did not differ between groups. © 2002 British Journal of Surgery Society Ltd [source]

Inguinal hernia repair: Where to next?

ANZ JOURNAL OF SURGERY, Issue 8 2002
Martina Zib
Background: Hernia repair is one of the most frequently performed operations in general surgery , a total of 39 000 elective inguinal hernia repairs were performed in public and private hospitals in Australia between July 1998 and June 1999 , and, as such, even minor alterations in outcome and resource use have appreciable impact. However, decisions regarding choice of operation for hernia repair remain controversial. The purpose of the present paper is to critically evaluate the evidence available regarding recently introduced open mesh repair techniques and to try to identify meaningful directions for future hernia research. Methods: A thorough search of all published surgical literature was undertaken. Medline, EMBASE and the Cochrane databases were searched by title, by key words and by author. References in review articles and in textbooks were pursued. The manufacturing companies were contacted for trials evaluating their product. Results: Eight original articles evaluating either the Kugel Patch, the PerFix Plug or the Prolene Hernia System were located. None of these trials directly compared two or more of these repair systems. To date, there has been no published review of the evidence regarding the newer mesh repair techniques. With one exception, all of these articles qualify as Level IV evidence. Highlighted is the lack of evidence regarding chronic significant posthernioplasty pain , this has an incidence of 6,12%. This complication is 3,5 times more common than recurrence after open repair, is clinically relevant, is poorly understood and has been poorly studied. Arguably it is a more important end point than recurrence. Conclusion: Only one study comparing the newer techniques of open hernia repair (PerFix Plug) constitutes Level II evidence. The PerFix Plug appears to be quicker to insert and uses a smaller incision. Chronic significant posthernioplasty pain is a more important endpoint in hernia research than is recurrence, and this review concludes with a proposal for a multicentre, randomized, controlled trial evaluating the incidence of chronic significant posthernioplasty pain following elective mesh repair of primary, unilateral hernias. [source]

Survey of current management of prolapse in Australia and New Zealand

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2010
Ruben VANSPAUWEN
Objective:, To compare current practice in the treatment of pelvic organ prolapse between Australian/New Zealand and United Kingdom (UK) gynaecologists. Methods:, A postal questionnaire containing questions on four case scenarios, which examined contentious areas of contemporary prolapse management, was sent to 1471 Australian and New Zealand gynaecologists in mid-2007. The results were compared with those of an identical survey conducted in the UK in 2006. Results:, The response rate was 13% as only 196 complete responses were received. For primary anterior vaginal prolapse, anterior colporrhaphy was the procedure of choice in 54% followed by vaginal repair with graft in 20%. For recurrence, 75% used a graft. Procedure of choice for uterovaginal prolapse was a vaginal hysterectomy with anterior colporrhaphy (79%) and for vault support, 54% performed uterosacral colpopexy. In women wishing to retain their fertility, 23% would operate and a laparoscopic uterosacral hysteropexy (39%) was preferred. For posterior vaginal prolapse, the procedure of choice was midline plication in 56% and site-specific repair in 24%. A graft was used in 13% for primary repair and 61% for recurrence, most preferring permanent mesh. Procedure of choice for apical prolapse was sacrospinous fixation with anterior and posterior colporrhaphy (37%), followed by vaginal mesh repair (33%) and abdominal sacrocolpopexy (11%). Few respondents objectively measured prolapse (20%) or followed up patients over one year (12%). Conclusions:, Australian/New Zealand gynaecologists used fewer traditional transvaginal procedures and more vaginal grafts than their UK colleagues in all compartments. Most respondents favoured permanent mesh (eg mesh kits) and many are missing an opportunity to gather valuable prospective data on these new procedures. [source]

Chronic pain after laparoscopic and open mesh repair of groin hernia (Br J Surg 2002; 89: 1476,1479)

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2003
J. E. Losanoff
No abstract is available for this article. [source]

Randomized clinical trial of non-mesh versus mesh repair of primary inguinal hernia,

Randomized clinical trial of suture repair, polypropylene mesh or autodermal hernioplasty for incisional hernia

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 1 2002
Dr M. Korenkov
Background: Since conventional suture repair for incisional hernia is associated with high recurrence rates, alloplastic and autoplastic prosthetic techniques have been suggested. Methods: In a randomized trial, 160 patients with simple or complex hernias underwent either suture repair, autodermal skin graft or onlay polypropylene mesh repair. Suture repair was not done in complex hernias. This report concerns a planned interim analysis. Results: At mean follow-up of 16 months, there were 17 hernia recurrences that were distributed similarly between the surgical techniques. There were fewer infectious complications after suture repair (three of 33 patients) than after skin graft or mesh repair (seven of 39 and five of 28 for simple hernias; seven of 31 and ten of 29 respectively for complex hernias) (P not significant). The severity of infections after polypropylene mesh implantation prompted the trial committee to discontinue the study. No differences were noted in duration of stay in hospital and quality of life. However, pain was significantly more frequent after polypropylene mesh repair (pooled risk ratio 2·9 and 1·8 at 6 weeks and 1 year respectively). Conclusion: Suture repair was safe for small incisional hernias. Both autoplastic and alloplastic hernia repair yielded comparably low recurrence rates, but led to a high rate of wound infection. © 2002 British Journal of Surgery Society Ltd [source]

Prospective study of open preperitoneal mesh repair for recurrent inguinal hernia,

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 1 2002
M. Kurzer
Background: Recurrent inguinal hernia presents a significant clinical problem with high re-recurrence and complication rates, particularly when an anterior approach is used. This study evaluated the open preperitoneal approach for repair of recurrent inguinal hernia. Methods: This was a prospective cohort study of 101 consecutive patients with 114 recurrent inguinal hernias. All were operated on using an open preperitoneal technique and prosthetic mesh by the method of Stoppa or Wantz. Follow-up was at 2,6 weeks, 15 and between 42 and 54 months. Results: There were no major complications. There was one infection and one case of retention of urine. There were no testicular complications. There were five recurrences, all within 6 months of operation, four of which were among the first 20 cases. Modifications to the original technique were made, and one recurrence occurred in the remaining 81 patients (1 per cent) or 106 hernias (1 per cent). Conclusion: Preperitoneal mesh repair gives results far superior to those of the commonly used anterior approach. It is safer and easier to learn than laparoscopic repair and is the procedure of choice for complex multirecurrent inguinal hernia. © 2002 British Journal of Surgery Society Ltd [source]