Takako Tanaka, MD, Shinichiro Mori, PhD, MD, Yoshiaki Kita, PhD, MD, Kenji Baba, PhD, MD, Kan Tanabe, MD, Shigehiro Yanagita, PhD, MD, Masayuki Yanagi, PhD, MD, Yoshikazu Uenosono, PhD, MD, Yasuto Uchikado, PhD, MD, Hiroshi Okumura, PhD, MD, Kosei Maemura, PhD, MD, Shoji Natsugoe, PhD, MD. Kagoshima UniversitDepartment of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University School of Medicine
Background: Funada-style Gastropexy Device II (FGD II, Create Medic Co., Ltd) was invented to make easy fixing stomach to abdominal wall with two needles and a thread at once. We made practical use of FGD II to mesh fixation, which is complicated in spite of main procedure in laparoscopic incisional hernia repair. We also evaluated the safety and feasibility of the mesh fixation using FGD II for the patients with incisional hernia.
METHODS: Ten patients who underwent laparoscopic incisional hernia repair between July 2014 and June 2016 were enrolled. Operative data, a mesh fixation time, complications and length of hospital stay were also assessed.
Surgical procedure: A 12mm trocar for a flexible laparoscope and three to four of 5-mm trocars were inserted. Hernia content was removed and hernia detect was measured. We tied two of 2-0 nylon to the mesh before inserting it to the intraperitoneal. After inserting and spreading out a mesh, we picked up 2-0 nylon using FGD II 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 intentionally to abdominal wall using FGD II with a thread to be tied in the subcutaneous layer. Just in case, we added tacks among threads.
Results: Mean of operative time and blood loss were 160 min and 5 mL, respectively. Mean of a mesh fixation time was 90 minutes. No intraoperative complications occurred in any patient. Two patients developed a postoperative seroma, but recovered after conservative treatments. The mean of postoperative hospital stay was 12 days.
Conclusion: We emerged practical use of FGD II for mesh fixation ensuring the intended puncture, which is safety and feasibility during laparoscopic incisional hernia repair.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 82881
Program Number: ETP716
Presentation Session: Emerging Technology Poster
Presentation Type: Poster