A comparative study of the use of a domestic composite prolenic mushroom-shaped prosthesis in obese patients

INTRODUCTION. The laparoscopic IPOM hernioplasty technique using the domestic composite prolenic mushroom shaped prosthesis with polytetrafluoroethylene coating technology has been developed for the correction of ventral hernias with orifices up to 4 cm. However, publications on the use of this technique in patients with morbid obesity are limited.

The OBJECTIVE was the comparative evaluation of the results of using the domestic composite prolenic mushroom-shaped prosthesis with polytetrafluoroethylene coating alone and in combination with bariatric intervention in patients with ventral hernias and morbid obesity.

METHODS AND MATERIALS. The comparative study included 64 subjects with ventral hernias <4 cm and abdominal obesity. The body mass index (BMI) in the sample was ≥35 kg/m2. The patients were divided into 2 groups: group 1 (n=35) consisted of patients who underwent laparoscopic hernioplasty using the domestic composite prolenic mushroom-shaped prosthesis with polytetrafluoroethylene coating (LLC «Icon Lab GmbH», Russia) composite endoprosthesis, and group 2 (n=29) consisted of patients whose hernioplasty was supplemented by bariatric intervention.

RESULTS. Of the early postoperative complications: in 1 case, a hematoma was observed (in a patient of group 1), 1 case in each group – the appearance of seromas. Recurrence of hernia occurred in 1 case in a patient of group 2. Weight loss over 12 months of observation in group 2 of patients was noted to be up to 28 kg/m2, while in patients in group 1, on the contrary, an increase in body weight of 8–12 kg was recorded (p<0.05).

CONCLUSIONS. Performing bariatric intervention does not increase the time of hernioplasty surgery, does not increase the percentage of postoperative complications, while contributing to a 25 % reduction in patients’ weight over a 12-month observation period. In the case of a combination of a small (W1) ventral hernia with morbid obesity, in our opinion, it is advisable to perform hernioplasty using the domestic composite prolenic mushroom-shaped prosthesis with polytetrafluoroethylene coating, simultaneously with bariatric intervention.

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