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Background: Mesh reinforcement of small ventral/umbilical hernias has become increasingly popular over the last decade. The Ventralex TM hernia patch has been evaluated for this purpose in a small number of studies with equivocal results, particularly in relation to post-operative hernia recurrence and mesh-related complications. The aim of this study was to examine the short- and long-term clinical outcomes of the technique, and to address the possible limiting factors. Methods: Open mesh repair following strict surgical methodology was performed on 100 consecutive patients with small ventral/ umbilical hernia defects of 1-3cm in diameter between April 2007 and December 2012. Short-term clinical outcome was obtained at 2- and 6-week post-operative visits, and long-term results were assessed by telephone interview with subsequent clinical review if judged necessary. Immediate post-operative complications, hernia recurrence, pain and Quality-of-Life (QoL) were also evaluated. Results: There were no major short-term complications; minor complications including superficial wound infection and haemoserous wound discharge occurred in 9 patients (9%). The mean long-term follow-up was 37.9 months (range 6-75 months), with no hernia recurrences. No pain or mild pain was reported in 93.6% of patients, and 96.1% reported being satisfied or very satisfied with their repair. Conclusions: This study demonstrates that open repair of small ventral/umbilical hernias using the Ventralex TM patch can be extremely safe and effective, with excellent long-term clinical outcome, when following a meticulous but easily reproducible surgical technique. Those main clinical steps include avoidance of large-sized patches, placing the mesh extraperitoneally (sublay) wherever possible, fixing the positioning straps with minimum tension, and always closing the abdominal fascia defect in front of the hernia patch.

Prospective Analysis and Technical Recommendations for Repair of Small Ventral/Umbilical Hernias Using the Ventralex Hernia Patch