Assessment of the effectiveness of a polypropylene onlay mesh in the prevention of laparoscopic trocar-site incisional hernia in high-risk patients. A randomized clinical trial - Summary - MDSpire
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Assessment of the effectiveness of a polypropylene onlay mesh in the prevention of laparoscopic trocar-site incisional hernia in high-risk patients. A randomized clinical trial
To evaluate the efficacy of an onlay mesh in reducing the rate of Trocar Site Incisional Hernia (TSIH) in high-risk patients undergoing laparoscopic cholecystectomy, specifically those with risk factors such as age ≥ 70 years, BMI ≥ 30 kg/m2, or diabetes mellitus.
Key Findings:
The incidence of TSIH in the intervention group was significantly lower than in the control group (p-value needed).
No significant increase in surgical site complications was observed in the intervention group.
The use of an onlay mesh effectively reduced the TSIH rate below the hypothesized threshold of 23%.
Interpretation:
The study supports the use of prophylactic onlay mesh in high-risk patients to prevent TSIH without increasing complications, suggesting a viable preventive strategy in laparoscopic surgery.
Limitations:
The study was limited to a specific patient population and surgical procedure, which may affect generalizability.
Follow-up loss of 25% could impact the reliability of the findings, potentially skewing the incidence rates.
Conclusion:
The insertion of a polypropylene onlay mesh at the umbilical port site during laparoscopic cholecystectomy significantly reduces the incidence of TSIH in high-risk patients, suggesting a viable preventive strategy in laparoscopic surgery.
by Ana Ciscar, Emma Sánchez-Sáez, Marina Vila Tura, Patricia Ruiz de Leon, Marta Gomez Pallarès, Daniel Troyano Escribano, Marta Abadal Prades, Esther Mans Muntwyler, José-Antonio Pereira, Josep M. Badia
