The use of pericard for laparoscopic
repair of ventral hernias
Danny Rosin, Moris
Batumsky, Moshe Shabtai, Yaron Munz,
Amram Ayalon
The Department of
General Surgery & Transplantation
Sheba
Medical Center,
Tel Hashomer, Sackler
School of Medicine,
Tel Aviv, Israel
Objective: Laparoscopic repair of ventral hernias is an
accepted technique. The optimal material to reinforce the abdominal wall
has not yet been defined. We have evaluated the effectiveness of bovine
pericard as a biomaterial for laparoscopic ventral hernia repair.
Methods: 52 patients with incisional or primary ventral
hernia were operated laparoscopically over an 18 months period. Pericardial
patch (n=45) or perforated pericardial patch (n=7) was used to cover the fascial
defect. Results were compared to a group of 55 consecutive patients
operated laparoscopically during the preceding 18 months, in whom Goretex
patch was used.
Results: Mean followup duration in the pericard group was
8.2 months, as opposed to 23.9 month in the Goretex group. 7 patients
(13.5%) required removal of the pericard, due to infection, as opposed to 2
(3.6%) removals of infected Goretex. None of the 7 perforated pericardial
patches got infected. 5 recurrences of hernias were noted in the pericard
group (9.6%), as opposed to 16
in the Goretex group (29%). Overall failure rate is
therefore 23.1% in the pericard group, as opposed to 32.6% in the goretex
group.
Conclusions: Overall failure rates were comparable in
the both groups, with some advantage to the pericard group. Recurrence rate
was lower in the pericard group. This may be related to the longer followup
in the Goretex group. High infection rate was found in the pericard group,
but not in the subgroup of perforated pericardial patch.
The use of pericard is a viable alternative for
laparoscopic ventral hernia repair.
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