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Hollins AW, Atia A, Zhang G, Mateas C, Schmidt M, Fillipo R, Hope WW, Levinson H. Ventral Hernia Reconstruction with GORE ENFORM Biomaterial. Plast Surg (Oakv) 2024; 32:321-328. [PMID: 38681247 PMCID: PMC11046281 DOI: 10.1177/22925503221120575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/23/2022] [Accepted: 06/01/2022] [Indexed: 05/01/2024] Open
Abstract
Introduction: Ventral hernia repair (VHR) is one of the most common surgeries performed in the United States. Degradable mesh is the recommended choice for patients presenting with high-risk co-morbidities or increased risk for infection. GORE® ENFORM BiomaterialTM is a biosynthetic degradable mesh that has recently been approved for use in ventral hernia reconstruction with no reports of its clinical outcomes. Methods: This study was a single surgeon case series. Patients were included in the study if they underwent VHR with GORE® ENFORM BiomaterialTM. The decision to use GORE® ENFORM BiomaterialTM was the senior surgeon's decision based on the patient's center for disease control classification. Patient comorbidities, hernia characteristics, postoperative hernia recurrence, and surgical site occurrences (SSOs) were collected at in-patient follow-up appointments and chart review. Patients were asked to complete preoperative and postoperative patient-reported outcomes (PROs) using the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Intensity short form 3a and the hernia-specific quality of life (HerQLes) survey. Results: A total of 15 patients were included in this study. The average length of follow-up was 315 days. Postoperatively, 26.7% of patients had an SSO with 4 surgical site infections. Two patients required an operative washout with mesh removal. One patient experienced hernia recurrence. Eight of the 15 patients completed preoperative and postoperative PROs. Conclusion: This is the first clinical study to report the outcomes of ventral hernia repair using ENFORM mesh. These results show that Enform mesh is an option to consider in complex ventral hernia reconstruction.
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Affiliation(s)
- Andrew W. Hollins
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, NC, USA
| | - Andrew Atia
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, NC, USA
| | - Gloria Zhang
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, NC, USA
| | - Catalin Mateas
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, NC, USA
| | - Michael Schmidt
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, NC, USA
| | - Rebecca Fillipo
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, NC, USA
| | - William W. Hope
- Department of Surgery, New Hanover Regional Medical Center, South East Area Health Education Center, Wilmington, NC, USA
| | - Howard Levinson
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Health System, Durham, NC, USA
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Dias ERM, Rondini GZ, Amaral PHF, Macret JZ, Carvalho JPV, Pivetta LGA, Malheiros CA, Roll S. Systematic review and meta-analysis of the pre-operative application of botulinum toxin for ventral hernia repair. Hernia 2023:10.1007/s10029-023-02816-w. [PMID: 37329437 DOI: 10.1007/s10029-023-02816-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/28/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE Surgical repair of large hernia defects requires detailed pre-operative planning, particularly in cases with loss of domain. This situation often hampers mid-line reconstruction, even after component separation, when the size of the hernia is disproportional to the volume of the abdominal area. In this case, other strategies may be needed to place the viscera back into the abdominal cavity after reducing the hernia sac. The administration of botulinum toxin prior to the surgical procedure has been indicated as an adjunct for more complex cases. This results in stretching of the lateral musculature of the abdomen, allowing midline approximation. In addition, the application of botulinum toxin alone has been investigated as a means of downstaging in the management of ventral hernias, thereby precluding component separation and enabling primary closure of the midline by placement of mesh within the retromuscular space using the Rives Stoppa technique. METHODS Systematic review of the literature for observational studies involving patients undergoing pre-operative application of botulinum toxin for ventral hernia repair was conducted according to the PRISMA guidelines. RESULTS Advance of the lateral musculature of the abdomen by an average of 4.11 cm with low heterogeneity, as well as low rates of surgical site infection (SSI), surgical site occurrences (SSO) and recurrence, was shown. CONCLUSION Pre-operative application of botulinum toxin for ventral hernia repair promoted an increase in the length of the lateral musculature of the abdomen which can help improve the outcomes of morbidity and recurrence.
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Affiliation(s)
- E R M Dias
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Júnior, 61, Vila Buarque, São Paulo, SP, 01221-020, Brazil.
- Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil.
| | - G Z Rondini
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Júnior, 61, Vila Buarque, São Paulo, SP, 01221-020, Brazil
| | - P H F Amaral
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Júnior, 61, Vila Buarque, São Paulo, SP, 01221-020, Brazil
- Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil
| | - J Z Macret
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Júnior, 61, Vila Buarque, São Paulo, SP, 01221-020, Brazil
- Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil
| | - J P V Carvalho
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Júnior, 61, Vila Buarque, São Paulo, SP, 01221-020, Brazil
- Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil
| | - L G A Pivetta
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Júnior, 61, Vila Buarque, São Paulo, SP, 01221-020, Brazil
- Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil
| | - C A Malheiros
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Júnior, 61, Vila Buarque, São Paulo, SP, 01221-020, Brazil
| | - S Roll
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Dr. Cesário Motta Júnior, 61, Vila Buarque, São Paulo, SP, 01221-020, Brazil
- Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil
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Poulose BK, Schwartzman H, Huang LC, Chouinard S, Coelho D, Macarios D, Master S, Rosen MJ. Multistakeholder Collaborative Effort to Enhance Long-Term Follow-Up in the Abdominal Core Health Quality Collaborative. ANNALS OF SURGERY OPEN 2021; 2:e052. [PMID: 37638249 PMCID: PMC10455236 DOI: 10.1097/as9.0000000000000052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 02/07/2021] [Indexed: 11/25/2022] Open
Abstract
Objective To determine the effectiveness of a clinical call center in performing focused long-term patient reported outcome (PRO)-based follow-up for ventral hernia patients in routine practice. Background Long-term follow-up remains the mainstay of assessing quality of care in hernia management. Achieving acceptable rates of long-term follow-up outside of clinical trials in the routine care of patients has been very difficult to achieve. Methods A prospective quality improvement intervention using a clinical call center in 1000 random patients eligible for long-term (1 year or greater) follow-up after ventral hernia repair in the Abdominal Core Health Quality Collaborative was performed. The primary outcome measure was the proportion of patients with successfully completed PRO-based long-term follow-up. Results Between 2013 and 2017, the baseline long-term follow-up PRO completion rate was 2167/13,950 (15.5%). For the Focus on Follow-Up initiative, 890 patients were eligible for contact; a completion rate of 450/890 (50.6%, P < 0.001) was achieved. Conclusions Clinical call center-based patient contact can greatly facilitate the completion of PROs utilized for long-term follow-up in ventral hernia repair. This has important implications for quality improvement programs and postmarket device surveillance.
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Affiliation(s)
- Benjamin K. Poulose
- From the Division of General and Gastrointestinal Surgery, Department of Surgery, Center for Abdominal Core Health, The Ohio State University Wexner Medical Center, Columbus, OH
| | | | - Li-Ching Huang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
| | | | | | - David Macarios
- Global Evidence and Value Development, Allergan, Madison, NJ
| | - Sundeep Master
- Clinical Affairs, Intuitive Surgical, Sunnyvale, CA; and
| | - Michael J. Rosen
- Department of Surgery, Center for Abdominal Core Health, The Cleveland Clinic Foundation, Lerner College of Medicine, Cleveland, OH
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Advantages of a Fixation-Free Technique for Open Retromuscular Ventral Hernia Repair. Plast Reconstr Surg 2020; 146:883-890. [DOI: 10.1097/prs.0000000000007165] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Kneuertz PJ, Moffatt-Bruce SD. Search for Meaningful Use of Patient-Reported Outcomes in Thoracic Surgery. Ann Thorac Surg 2019; 109:1317-1318. [PMID: 31697907 DOI: 10.1016/j.athoracsur.2019.09.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 09/07/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Peter J Kneuertz
- Thoracic Surgery Division, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
| | - Susan D Moffatt-Bruce
- Thoracic Surgery Division, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Design of a comparative outcome analysis of open, laparoscopic, or robotic-assisted incisional or inguinal hernia repair utilizing surgeon experience and a novel follow-up model. Contemp Clin Trials 2019; 86:105853. [PMID: 31669560 DOI: 10.1016/j.cct.2019.105853] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 10/15/2019] [Accepted: 10/15/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND In a recent publication, the International Guidelines for Groin Hernia Management by the European Hernia Society (EHS) recognized the need to individualize and tailor the surgical approach for hernia repair. There may be different opportunities for optimization of the surgical technique for surgeons performing open, laparoscopic, or robotic-assisted hernia repair. Robotic-assisted hernia repair is a relatively new minimally invasive surgical approach compared to laparoscopic and open repair. Currently, there is a lack of comparative prospective studies designed to evaluate long-term outcomes of patients undergoing robotic-assisted, laparoscopic, or open hernia repair. MATERIALS & METHODS This manuscript presents an innovative study design with two study cohorts (incisional and inguinal hernia repair) that contain three arms (robotic-assisted, laparoscopic, and open). The trial objective is to collect short-term and long-term outcomes for patients undergoing robotic-assisted, laparoscopic, or open hernia repair. The present publication will discuss the trial design, methods used to ensure consistency in surgeon expertise, and provides strategies to obtain long-term (> 3 months) follow-up data for enrolled patients. RESULTS One hundred subjects underwent incisional and one hundred underwent inguinal hernia repair at the time of this manuscript. Surgeon experience was analyzed across the three surgical techniques and follow-up compliance was assessed through 1 year. The follow-up completion rates for both study cohorts were >80% for all visits. CONCLUSIONS The innovative trial design helped to improve the quality and quantity of long-term follow-up. More innovative options to improve patient retention may be tested in future trials of similar design.
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Tastaldi L, Barros PHF, Krpata DM, Prabhu AS, Rosenblatt S, Petro CC, Alkhatib H, Szutan LA, Silva RA, Olson MA, Stewart TG, Roll S, Rosen MJ, Poulose BK. Hernia recurrence inventory: inguinal hernia recurrence can be accurately assessed using patient-reported outcomes. Hernia 2019; 24:127-135. [DOI: 10.1007/s10029-019-02000-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 06/28/2019] [Indexed: 11/29/2022]
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