In the study by Rosen that primarily evaluated the safety of synthetic meshes in 109 patients who received either laparoscopic or open mesh repair for ventral hernia, intra-peritoneal fixation of polyester mesh protected with a collagen hydrogel anti-adhesive barrier and extraperitoneal use of unprotected polyester mesh were associated with an acceptable mesh infection rate (2.7%) and a low recurrence rate (2.7%). In 79 patients with an average fascial defect width of 11 cm, laparoscopic repair was attempted, in which the mesh was sized to achieve overlap of the mesh with the abdominal wall tissue by at least 4 cm and was fixed with tacks as well as transfascial nonabsorbable sutures. In a more complex group of 30 patients with an average defect width of 20 cm, open mesh repair was performed by using the modified Rives-Stoppa technique.
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