This document describes a study on the use of the Proceed Ventral Patch (PVP) mesh for ventral hernia repair in an ambulatory surgery unit in Spain. The study included 52 patients who underwent ventral hernia repair with PVP mesh between May 2009 and January 2010. Results found the mean operation time was 41 minutes, post-operative pain levels were low, and short term follow-up found no recurrences. The authors conclude that PVP mesh seems to be a good device for small umbilical and ventral hernia repair, but longer term follow-up is still needed.

1. Vásquez Del Aguila, Jorge; Semeraro Odds, Candy; Landi, Filippo;Vásquez Del Aguila, Jorge; Semeraro Odds, Candy; Landi, Filippo;
López Cano, ManuelLópez Cano, Manuel
Ambulatory Surgery Unit – Parc Sanitari Pere Virgili
Hospital Vall d’ Hebron
Barcelona, Spain
Proceed™ Ventral PatchProceed™ Ventral Patch
Ventral Hernia Repair in AmbulatoryVentral Hernia Repair in Ambulatory
Surgery. Our Preliminary Experience.Surgery. Our Preliminary Experience.

2. DISCLOSURE:
Our assistance to this Congress has been paid by Ethicon (Johnson and
Johnson).

3. BACKGROUND
Surgical treatment of umbilical and small ventral hernias ranges from a
simple suture repair to the placement of intrabdominal or retromuscular
meshes. Several articles have reported a lower incidence of recurrence
after mesh repair.
We describe our preliminary experience with a new type of mesh, the
PROCEED® Ventral Patch (PVP); a self-expanding, lighter-weight mesh
comprised of multiple layers of absorbable and non-absorbable materials,
indicated for use in ventral hernias.
As this is a relatively new device, only one article has been published by a
Belgian group, describing their preliminary results(1).
(1)Tollens T, Struyve D, Aelvoet C, Vanrijkel JP. Introducing the proceed ventral patch as a new device in surgical management of umbilical
and small ventral hernias: preliminary results. Surg Technol Int. 2010;19:99-103.

4. PVP: core structure
Non resorbable macroporous partially
resorbable polypropilene layer (prolene
soft mesh) supported by a PDS self
expandable coil ring, covered with a
resorbable tissue separating layer of
oxidized regenerated cellulose on the
visceral side to reduce adhesions.

6. Surgical Technique

7. Surgical Technique (2)

8. Methods
Retrospective analysis of all the ventral hernia repairs with
PVP mesh performed at the Ambulatory Surgery Unit of the
Vall d’ Hebron Hospital of Barcelona, Spain from 15 of May
2009 to 15 January 2010.

9. Population Characteristics
Gender
N=52 100%
Male 27 52%
Female 25 48%

10. POPULATION CHARACTERISTICS (2)
Age
Mean Age
Range
42,8 (SD 11,12)
25 – 76
years
years
ASA
1
2
29
23
55%
45%
BMI
Mean BMI
Range
25,6 (SD 4,5)
17,3 - 36,3
m/Kg2
m/Kg2

11. TYPES OF TREATED HERNIA
N=52 100%
Umbilical 39 76%
Epigastric 8 15%
Trocar hernia 3 5%
Prophylactic 2 4%
Umbilical

12. Anesthesia

13. Mesh Size

14. Position

15. The mean operatory time (excluding cases with
associated interventions) was 41 minutes (DS 10,8).
The postoperatory pain was measured with the VAE,
been the median 0,7 (0 – 5, DS 1,3).
The median follow – up time was 82 days (20 – 360.
SD 91

16. COMPLICATIONS
Complications during surgery 0/52 (0%)
Mild Haematoma 8/52 4,8%)
Seroma 1/52 (2,4%)
No complications 42/52 (88%)
Infections 1/52 (4,8%)
Recurrences 0/52 (0%)
Results

17. DISCUSSION
Proper deployment of the device, necessary to prevent formation of
complex adhesion of viscera, was noted in all cases.
No statistically significative differences where found between the size or
position of the mesh with the postoperatory complicactions or the
postoperatory pain.
Althought our follow up results are preliminary with a mean follow up of
only 82 days, currently we have found no recurrences.

18. CONCLUSION
The Proceed Ventral Patch seems to be a good device for the treatment of
small umbilical and primary ventral hernias, however, longer – term
follow-up is required to confirm the findings, especially regarding
recurrence.