E J DeMaria1, J M Moss, H J Sugerman. 1. Department of Surgery, Section of General and Endoscopic Surgery, MCV Station Box 980519, Medical College of Virginia of Virginia Commonwealth University, Richmond, VA 23298, USA.
Abstract
BACKGROUND: The purpose of this study was to determine whether laparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prosthetic patch (LIPP) repair of a ventral hernia is superior to open prefascial polypropylene mesh (OPPM) repair in a tertiary care university hospital in an urban environment. METHODS: Data on 39 consecutive patients undergoing either LIPP repair (n = 21) or OPPM repair (n = 18) were compared. RESULTS: Findings showed that LIPP repair is characterized by less painful recovery and shorter hospital stay, with 90% of patients treated successfully as outpatients as compared with 7% in the OPPM group. The total facility costs for the LIPP repair ($8,273+/-$2,950) was significantly lower than for the OPPM repair ($12,461+/-$5,987) (p<0.05). Two serious delayed complications in the LIPP group were treated by reoperation (colocutaneous fistula, mesh infection), but the higher readmission costs in this group did not negate the overall cost advantage for LIPP repair. In the follow-up evaluation, 1 hernia recurrence was found in the LIPP repair group, and none in the OPPM group. CONCLUSIONS: Initial experience suggests that LIPP repair has advantages over OPPM repair in terms of decreased hospitalization, postoperative pain, and disability. Refinements in the technique to reduce complications may make LIPP repair the procedure of choice for repair of ventral hernias.
BACKGROUND: The purpose of this study was to determine whether laparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prosthetic patch (LIPP) repair of a ventral hernia is superior to open prefascial polypropylene mesh (OPPM) repair in a tertiary care university hospital in an urban environment. METHODS: Data on 39 consecutive patients undergoing either LIPP repair (n = 21) or OPPM repair (n = 18) were compared. RESULTS: Findings showed that LIPP repair is characterized by less painful recovery and shorter hospital stay, with 90% of patients treated successfully as outpatients as compared with 7% in the OPPM group. The total facility costs for the LIPP repair ($8,273+/-$2,950) was significantly lower than for the OPPM repair ($12,461+/-$5,987) (p<0.05). Two serious delayed complications in the LIPP group were treated by reoperation (colocutaneous fistula, mesh infection), but the higher readmission costs in this group did not negate the overall cost advantage for LIPP repair. In the follow-up evaluation, 1 hernia recurrence was found in the LIPP repair group, and none in the OPPM group. CONCLUSIONS: Initial experience suggests that LIPP repair has advantages over OPPM repair in terms of decreased hospitalization, postoperative pain, and disability. Refinements in the technique to reduce complications may make LIPP repair the procedure of choice for repair of ventral hernias.
Authors: Parvinder S Sains; Henry S Tilney; Sanjay Purkayastha; Ara W Darzi; Thanos Athanasiou; Paris P Tekkis; Alexander G Heriot Journal: World J Surg Date: 2006-11 Impact factor: 3.352
Authors: Falk Müller-Riemenschneider; Stephanie Roll; Meik Friedrich; Juergen Zieren; Thomas Reinhold; J-Matthias Graf von der Schulenburg; Wolfgang Greiner; Stefan N Willich Journal: Surg Endosc Date: 2007-09-01 Impact factor: 4.584
Authors: Jacobus W A Burger; Roland W Luijendijk; Wim C J Hop; Jens A Halm; Emiel G G Verdaasdonk; Johannes Jeekel Journal: Ann Surg Date: 2004-10 Impact factor: 12.969