Vásquez Del Aguila, Jorge; Semeraro Odds, Candy; Landi, Filippo; Vásquez Del Aguila, Jorge; Semeraro Odds, Candy; Landi, Filippo; López Cano, ManuelLópez Cano, Manuel

Ambulatory Surgery Unit – Parc Sanitari Pere VirgiliHospital Vall d’ Hebron

Barcelona, Spain

Proceed™ Ventral Patch Proceed™ Ventral Patch Ventral Hernia Repair in Ambulatory Ventral Hernia Repair in Ambulatory Surgery. Our Preliminary Experience.Surgery. Our Preliminary Experience.

DISCLOSURE:

Our assistance to this Congress has been paid by Ethicon (Johnson and Johnson).

BACKGROUNDSurgical treatment of umbilical and small ventral hernias ranges from a

simple suture repair to the placement of intrabdominal or retromuscular meshes. Several articles have reported a lower incidence of recurrence after mesh repair.

We describe our preliminary experience with a new type of mesh, the PROCEED® Ventral Patch (PVP); a self-expanding, lighter-weight mesh comprised of multiple layers of absorbable and non-absorbable materials, indicated for use in ventral hernias.

As this is a relatively new device, only one article has been published by a Belgian group, describing their preliminary results(1).

(1)Tollens T, Struyve D, Aelvoet C, Vanrijkel JP. Introducing the proceed ventral patch as a new device in surgical management of umbilical and small ventral hernias: preliminary results. Surg Technol Int. 2010;19:99-103.

PVP: core structureNon resorbable macroporous partially

resorbable polypropilene layer (prolene soft mesh) supported by a PDS self expandable coil ring, covered with a resorbable tissue separating layer of oxidized regenerated cellulose on the visceral side to reduce adhesions.

Surgical Technique

Surgical Technique (2)

Methods

Retrospective analysis of all the ventral hernia repairs with PVP mesh performed at the Ambulatory Surgery Unit of the Vall d’ Hebron Hospital of Barcelona, Spain from 15 of May 2009 to 15 January 2010.

Population Characteristics

Gender

N=52 100%

Male 27 52%

Female 25 48%

POPULATION CHARACTERISTICS (2)

Age Mean Age

Range42,8 (SD 11,12)

25 – 76yearsyears

ASA12

2923

55%45%

BMIMean BMI

Range25,6 (SD 4,5)

17,3 - 36,3m/Kg2

m/Kg2

TYPES OF TREATED HERNIA

N=52 100%

Umbilical 39 76%

Epigastric 8 15%

Trocar hernia 3 5%

Prophylactic 2 4%

Umbilical

Anesthesia

Mesh Size

Position

The mean operatory time (excluding cases with associated interventions) was 41 minutes (DS 10,8).

The postoperatory pain was measured with the VAE, been the median 0,7 (0 – 5, DS 1,3).

The median follow – up time was 82 days (20 – 360. SD 91

COMPLICATIONS

Complications during surgery 0/52 (0%)

Mild Haematoma 8/52 4,8%)

Seroma 1/52 (2,4%)

No complications 42/52 (88%)

Infections 1/52 (4,8%)

Recurrences 0/52 (0%)

Results

DISCUSSIONProper deployment of the device, necessary to prevent formation of

complex adhesion of viscera, was noted in all cases.No statistically significative differences where found between the size or

position of the mesh with the postoperatory complicactions or the postoperatory pain.

Althought our follow up results are preliminary with a mean follow up of only 82 days, currently we have found no recurrences.

CONCLUSIONThe Proceed Ventral Patch seems to be a good device for the treatment of

small umbilical and primary ventral hernias, however, longer – term follow-up is required to confirm the findings, especially regarding recurrence.