Clinical Outcomes of Ventral Hernia Repair with Ventralex Patch- A Retrospective Study from a Tertiary Care Centre

Abstract

Introduction: There are several described techniques for ventral hernia mesh repair in both laparoscopic and open approach. Both approaches have their own pros and cons. Ventralex patch repair is an open technique using dual mesh in the intraperitoneal plane for ventral hernia repair. Aim: To describe an open technique with the use of ventalex patch in the repair of selected ventral hernias and to compare the open technique in terms of cost, operating time, complications and duration of hospital stay using Ventral patch and available literature for open and laparoscopic repair. Materials and Methods: This retrospective study was conducted on 248 patients over a period of seven years who underwent open ventral hernia repair with the Ventralex Patch, at a tertiary care hospital. A retrospective chart review and telephonic interview was conducted postoperatively and at the end of atleast 24 months to assess for outcomes, particularly recurrence. Descriptive statistics reported using frequency and percentage for categorical variables. Continuous variables were reported using mean±Standard Deviation (SD). Results: A total of 248 patients underwent hernioplasty with ventralex patch. The mean age was 50.57 years and mean BMI was 28.37 kg/m2 . The average duration of operation was 27.5 minutes and hospital stay was 2.275 days. The most common defect size was 2 cm (47.2%). The cost analysis of this technique revealed an average cost of INR 35,142 as opposed to an average cost of INR 88,601 for laparoscopic repair (including disposables) and INR 30,174 for open traditional sublay repair. Twenty-one patients developed surgical site infection (8.5%), and 27 patients (10.9%) developed seroma formation. A total of six patients developed superficial skin necrosis. The cumulative hernia recurrence rate at the end of 24 months was in 16 patients (6.5%). Conclusion: Ventralex patch repair is very efficient and effective in the treatment of selective umbilical, periumbilical, epigastric and incisional hernias with a comparable complication profile in terms of short term complications and recurrence rate compared to available literature.

Keywords

• epigastric
• incisional hernias
• paraumbilical
• recurrence
• umbilical