Abed Mariam, Bradley Angus, Ghazanfar Abbas
Department of Renal Transplantation, St George's University Hospital, London SW17 0QT, United Kingdom.
Renal and Transplant Unit, St Georges University Hospitals NHS Foundation Trust, London SW17 0QT, United Kingdom.
World J Clin Cases. 2025 Jun 26;13(18):99749. doi: 10.12998/wjcc.v13.i18.99749.
Incisional hernia is one of the known complications of renal transplant surgery, with a reported incidence between 1.1% to 3.8%. Depending on the site and extent of incisional hernia, it may require surgery particularly if it contains the transplanted kidney either partially or completely. The current common clinical practice is to repair incisional hernias using polypropylene meshes, which have their own risks and benefits. Biological meshes, which are made from human or animal-derived connective tissue, are also in use and have a less inflammatory response. Recently, hybrid meshes have been developed. These are composed of both biological and synthetic products. One such example is OviTex 1S permanent, which is a sterile reinforced tissue matrix composed of ovine (sheep) derived extracellular matrix and monofilament polypropylene. In this case report, we are sharing our experience with the use of OviTex 1S in the repair of post-renal transplant incisional hernias.
We report four cases of post-renal transplant incisional hernia with a median time of 27 months post-surgery. The median size of the defect was 15 cm long. There was no post-operative complication. One patient required renal transplant biopsy after mesh repair, which was easily performed compared with polypropylene meshes repaired hernias in the past.
The OviTex 1S mesh provides benefits in hernial repairs pKTx, but cost is an issue, and their long-term viability is unclear. Continued use and reporting will help build a more informed picture.
切口疝是肾移植手术已知的并发症之一,报道的发生率在1.1%至3.8%之间。根据切口疝的部位和范围,可能需要进行手术,特别是当疝内容物部分或完全包含移植肾时。目前常见的临床做法是使用聚丙烯网片修复切口疝,这种方法有其自身的风险和益处。由人或动物来源的结缔组织制成的生物网片也在使用中,且炎症反应较小。最近,混合网片已被开发出来。这些网片由生物和合成产品组成。一个例子是OviTex 1S永久性网片,它是一种无菌的增强组织基质,由绵羊来源的细胞外基质和单丝聚丙烯组成。在本病例报告中,我们分享了使用OviTex 1S修复肾移植术后切口疝的经验。
我们报告了4例肾移植术后切口疝病例,术后中位时间为27个月。缺损的中位大小为15厘米长。无术后并发症。1例患者在网片修复后需要进行肾移植活检,与过去使用聚丙烯网片修复的疝相比,该操作更容易进行。
OviTex 1S网片在肾移植术后切口疝修补中具有优势,但成本是一个问题,其长期可行性尚不清楚。持续使用和报告将有助于形成更全面的认识。