Comparison of Polypropylene Mesh with Covered Meshes in Patients Undergoing Intraperitoneal Onlay Mesh Repair of Incisional and Ventral Hernia—Our Experience and Review of Literature

Literature continues to be ambiguous on the type of mesh to be used in laparoscopic incisional and ventral hernia repair. This study presents non-randomised comparison of polypropylene and covered mesh in laparoscopic incisional and ventral hernia repair. Patients undergoing laparoscopic ventral hernia repair from 2004 to 2018 were divided into two groups, i.e. polypropylene or covered mesh. Laparoscopic ventral hernia repair was done following a standard protocol. Patient outcomes were measured in terms of re-exploration, wound/ mesh infection, seroma, subacute intestinal obstruction, fistula formation and recurrence. Patients were followed up regularly. Laparoscopic repair was performed in 527 patients. Conversion to open repair was done in 30 patients. Polypropylene mesh was used in 175 patients and covered mesh in 352 patients. Subacute intestinal obstruction was seen in 12 patients (6.9%) in polypropylene group and in 18 patients (5.1%) in covered mesh group. There were 28 recurrences, 11 (6.2%) in polypropylene group and 17 (4.8%) in covered mesh group. The median duration of recurrence was 2 years with a range of 16–48 months. Outcomes with polypropylene mesh were comparable to covered mesh for laparoscopic ventral hernia repair with regards to early and late post-operative outcomes. The incidence of fistulisation and obstruction was also similar between the two groups. It is safe to use polypropylene mesh in situations where covered mesh is not affordable or available especially in low resource countries.