Mesh fixation with Funada-style Gastropexy Device II for laparoscopic incisional hernia repair

Kan Tanabe, MD, Shinichiro Mori, Kenji Baba, Yoshiaki Kita, Sigehiro Yanagita, Masayuki Yanagi, Yasuto Uchikado, Hiroshi Okumura, Sumiya Ishigami, Shoji Natsugoe. Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University School of Medicine

Background: There are many methods for mesh fixation in laparoscopic incisional hernia repair, which is complicated in spite of main procedure in this operation. Funada-style Gastropexy Device II (FGII, Create Medic Co., Ltd) was invented to make easy fixing stomach to abdominal wall with two needles and a thread at once. We evaluated the safety and feasibility of the mesh fixation using FGII for the patients with incisional hernia.

Methods: A 12mm trocar for a flexible laparoscope was inserted using an open technique. A pneumoperitoneum was maintained at 10 mm Hg using CO2. Under laparoscopic guidance, 5-mm trocars for the operator and assistant were placed. Hernia content was reduced and hernia detect was measured. We tied some 2-0 nylon to the mesh before inserting it to the intraperitoneal. After inserting and spreading out the mesh, we picked up 2-0 nylon using FGII and attached the mesh temporarily. The hernia detect was covered with the mesh of appropriate size overlapping by at least 3cm. Then we fixed the mesh to abdominal wall using FGII with a thread to be tied in the subcutaneous layer. Just in case, we added tacks among threads.

Results: Eight patients with incisional hernia who performed laparoscopic incisional hernia repair using FGII were enrolled. The median surgical duration and blood loss were 160 min and 5 mL, respectively. No intraoperative complications occurred in any patient. Two patients developed a postoperative seroma, but recovered after conservative treatments. The median postoperative hospital stay was 12 days.

Conclusion: Laparoscopic incisional hernia repair using FGII is safety and feasibility for the patients with incisional hernia, which ensure the intended puncture and convenient procedure for mesh fixation.