Laparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prosthetic patch repair of ventral hernia - Prospective comparison to open prefascial polypropylene mesh repair

Background: The purpose of this study was to determine whether laparoscopic intraperitoneal polytetrafluoroethylene (PTFE) prosthetic patch (LIPP) rep air of a ventral hernia is superior to open prefascial polypropylene mesh ( OPPM) repair in a tertiary care university hospital in an urban environment . Methods: Data on 39 consecutive patients undergoing either LIPP repair (n = 21) or OPPM repair (n = 18) were compared. Results: Findings showed that LIPP repair is characterized by less painful recovery and shorter hospital stay, with 90% of patients treated successful ly as outpatients as compared with 7% in the OPPM group. The total facility costs for the LIPP repair ($8,273 +/- $2,950) was significantly lower than for the OPPM repair ($12,461 +/- $5,987) (p < 0.05). Two serious delayed c omplications in the LIPP group were treated by reoperation (colocutaneous f istula, mesh infection), but the higher readmission costs in this group did not negate the overall cost advantage for LIPP repair. In the follow-up ev aluation, 1 hernia recurrence was found in the LIPP repair group, and none in the OPPM group. Conclusions: Initial experience suggests that LIPP repair has advantages ov er OPPM repair in terms of decreased hospitalization, postoperative pain, a nd disability. Refinements in the technique to reduce complications may mak e LIPP repair the procedure of choice for repair of ventral hernias.