Progrip self-gripping mesh in Rives-Stoppa repair: Are there any differences in outcomes versus a retromuscular polypropylene mesh fixed with sutures? A “case series” study

•The Rives-Stoppa technique is an excellent repair in midline incisional hernia.•Prospective comparative analysis between retromuscular Self-gripping mesh and PPL fixed with sutures.•Self-gripping mesh is related to less postoperative pain the first 48 h after repair.•There were more postoperative hematomas in Non-Progrip group.•There were no differences in hernia recurrence in both groups.

BackgroundRives-Stoppa repair is widely accepted technique in large midline IH, and appears to be advantageous compared to other surgical techniques concerning complications and recurrence rates. The aim of this case series study was to analyze 1-year outcomes in patients with IH treated with Progrip self-gripping mesh compared to polypropylene (PPL) mesh fixed with sutures during the Rives-Stoppa technique.MethodsBetween June 2014 and June 2015, we performed a prospective comparative non-randomized (case series) analysis between 25 patients with IH using retromuscular Progrip self-gripping mesh and 25 patients with retromuscular PPL mesh fixed with sutures, under Rives-Stoppa repair. All intraoperative and perioperative morbidities were reported with particular attention to wound infection, seroma or hematoma formation, duration of hospital stay, presence of abdominal wall pain (VAS) and recurrence during long-term follow-up.ResultsMean operative time in Progrip group was shorter than Non-Progrip group (101 ± 29.5 versus 121 ± 39.8 min). In Progrip group, the only postoperative complication was seroma in two patients; however, in Non-Progrip group, we reported seroma in three patients, and hematoma in 4 patients (p = 0.03). The median hospital stay was shorter in Progrip group (5.8 ± 2.2 days versus 6.6 ± 2.9 days). Mean VAS score in the first 48 h was higher in Non-Progrip group than Progrip group (4.9 ± 2.1 versus 8.1 ± 2)(p = 0.01). The median follow-up was 13 months (range 12-20 months) and none of the 50 patients had a hernia recurrence.ConclusionsIn Rives-Stoppa repair, retromuscular Progrip mesh causes less postoperative pain in the first 48 h and lower rate of hematoma than PPL mesh fixed with sutures in the short term follow-up.