Long-term results of Progrip mesh for retromuscular repair of ventral hernia

BACKGROUND: An issue that has become apparent in using Progrip in ventral hernias is the restriction in the available sizes. The area of dissection for mesh placement can be variable. This report is based on a subgroup analysis of the cases in which a combination of Progrip meshes was used.MATERIALS AND METHODS: This was a retrospective review of our prospective database. Cases were identified of Progrip mesh used in ventral hernia repair from 2016 to 2020. Subgroup analysis was performed of cases which Progrip meshes were combined. Telephone follow-up was done in September 2020. RESULTS: Sixty-eight cases were identified. The mean age of patients was 63.13 (26-87). Thirty-three were female. The mean American Society of Anesthesiologists grade was 2 (range: 1-4). The procedure time was 164.35 min (45-490). The mean defect size was 7.23 (2-25 cm). The mean mesh size was a 20 cm x 15 cm mesh. Follow-up was achieved in 63/68 cases. Follow-up ranged from 1 to 4 years. Recurrence was found in 4 (6%). Nine had ongoing abdominal pain. Fifty-nine (93.65%) returned to normal activity. Three returned to theater for wound dehiscence and seromas. Twelve cases required 2 meshes to be combined. All cases involved a mesh size of 30 cm x 30 cm. The mean age was 64 (44-78 years). Six were male. The mean defect size was 9 cm. The operative time was 235 min (120-320). The mean postoperative stay was 5 days (4-60). Three cases required component separation (2 anterior component separation and 1 posterior component separation). There were no recurrences or further surgery. One had ongoing pain. Nine cases had full return to activity.CONCLUSION: Combining Progrip meshes in ventral hernia is an acceptable practice. Mesh may be sutured together or overlapped with equivalent results. Extending the product range to a 30 cm x 30 cm mesh would obviate the need for mesh overlap in our practice.