Cross-linked acellular porcine dermal collagen implant in laparoscopic ventral hernia repair: case-controlled study of operative variables and early complications.

Cross-linked acellular porcine dermal collagen matrix (CPDC) is a new biological implant for use in hernia repair. This study compares operative variables and early complications of all laparoscopic ventral hernia repair (LVHR) procedures by a single surgeon using CPDC to a historical cohort from the same surgeon using composite polypropylene and expanded polytetrafluoroethylene mesh (PP/ePTFE). Eighty-four and 55 patients, respectively, initially underwent attempted LVHR with composite and CPDC prostheses. There was no significant difference between the two groups in the incidence of hernia recurrence. Severe foreign body response with or without mesh infection was noted in three composite group patients, with enterocutaneous fistula in one of these; all mandated removal of the mesh. The referring surgeon removed the CPDC implant in one case upon diagnosis of wound infection. CPDC is safe for use in LVHR and offers an alternative to composite PP/ePTFE mesh that warrants further investigation.