Deperitoneum biological mesh repair for abdominal wall hernia: a novel wound healing promotion idea.

PURPOSE: Nowadays, biological matrix has become more widely applied than synthetic mesh for the surgical management of ventral hernia. Conventionally, such biodegradable matrix is commonly placed in an intraperitoneal or extraperitoneal position to reinforce the abdominal wall during surgery. Herein, we introduce our novel idea to deliver such biological material.

MATERIAL AND METHODS: After contrast-enhanced CT-scan via lateral decubitus confirmed the position of ventral hernias, 11 patients underwent deperitoneum biological mesh repair by open or laparoscopic approach. During surgery, biological material was placed in preperitoneal position with elimination of matrix-covered peritoneum meanwhile. No bridge repair was allowed for this technique. Postoperative complications were prospectively documented.

RESULTS: Laparoscopic and open repair were performed in six and five patients, respectively. The mean operative time was 115 min, with no significant difference between the two procedures. All patients had quick recovery and returned to their normal life, with median five days (range, 3-12 days) of hospital stay after surgery. Although wound dehiscence and chronic pain occurred in three (27.3%) patients, no additional surgery was required. No recurrence case was observed within the one-year follow-up period.

CONCLUSION: This novel approach could be safely performed in ventral hernia patients. Early evaluation of this surgical technique demonstrates quick recovery and minimal complications.