Novel Mesh for Laparoscopic Inguinal Hernia Repairs – Self-Gripping, Minimal Fixation

Kenric M Murayama, MD. University of Pennsylvania Medical School – Dept. of Surgery

Objective: Demonstrate feasibility of using a new mesh for laparoscopic inguinal hernia repair that requires minimal fixation.

Methods: A retrospective review of a single surgeon experience from March 2010-January 2011 with a novel monofilament polyester mesh with a resorbable polylactic acid (PLA) gripping system (Parietex Progrip, Covidien, Inc., Norwalk, CT). Standard TEP laparoscopic inguinal hernia repair was performed. Mesh was trimmed to appropriate size, rolled into a loose scroll, placed and unrolled in the preperitoneal space (a brief video will be included in the presentation). One to three fixation tacks were used to secure each piece of mesh (1-2 for indirect and 2-3 for direct hernias).

Results: Laparoscopic TEP repair was performed in 22 patients with placement of 31 pieces of mesh (bilateral-9 pts, left only-8 pts, right only-5 pts). Average total OR time was 86.7 min (bilateral), 69.0 min (right), and 54.4 min (left). Blood loss was minimal with a maximum of 25cc. Time for placement of each piece of mesh was <3 minutes in all cases. There are no recurrences to date and three seromas resulted in patients with large hernias all of which have been treated non-surgically.

Conclusion: This novel mesh can be placed quickly and requires minimal fixation with good outcomes. Additionally, the mesh is malleable conforming to the contours of the pelvic floor and the gripping system minimizes the risk of recurrence resulting from the hernia sac sliding under the mesh in the early postoperative period.
 


Session: Emerging Technology Poster
Program Number: ETP074
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