Minimal adhesions to ePTFE mesh after laparoscopic ventral incisional hernia repair: Reoperative findings in 65 cases

Richard H. Koehler, D. Begos, D. Berger, S. Carey, K. LeBlanc, A. Park, B. Ramshaw, R. Smoot, G. Voellers

Research output: Contribution to journalArticlepeer-review


Background and Objectives: Laparoscopic ventral incisional hernia repair involves intraabdominal placement of a synthetic mesh, and the possibility of formation of severe visceral adhesions to the prosthesis is a principal concern. Little clinical information based on reoperative findings is available about adhesions to biomaterials placed intraabdominally. We conducted a multi-institutional study of adhesions to implanted expanded polytetrafluoroethylene (ePTFE) mesh at reoperation in patients who had previously undergone laparoscopic incisional hernia repair done with the same mesh implantation technique. Methods: Nine surgeons retrospectively assessed the severity of adhesions to ePTFE mesh at reoperation in 65 patients. For each case, adhesions were assigned a score of 0 to 3, with 0 indicating no adhesions and 3 severe adhesions. Results: The mean time from mesh implantation to reoperation was 420 days (range, 2-1739 days). No adhesions were observed in 15 cases. Forty-four cases received an adhesion score of 1, and 6 cases a score of 2; no scores of 3 were assigned. Thus, 59 patients (91%) had either no or filmy, avascular adhesions. No enterotomies occurred during adhesiolysis. Conclusions: In this large series of reoperations after laparoscopic incisional hernia repair, no or minimal formation of adhesions to implanted ePTFE mesh was observed in 91% of cases, and no severe cohesive adhesions were found. Comparative analyses of newer materials based on clinical reoperative findings are warranted to assess the safety of intraabdominally placed meshes.

Original languageEnglish (US)
Pages (from-to)625-630
Number of pages6
JournalZentralblatt fur Chirurgie
Issue number8
StatePublished - Aug 1 2003
Externally publishedYes


  • Adhesions
  • Laparoscopy
  • Polytetrafluoroethylene
  • Ventral incisional hernia

ASJC Scopus subject areas

  • Surgery

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