Total Preperitoneal Biological Patch Indirect Inguinal Hernioplasty

Andrew Dobradin, MD PhD. Winter Park Memorial Hospital, University of Central Florida

 The mesh repair of the inguinal hernia is consider as a standard of care in the contemporary surgery. The commonly use material is polypropylene. Tension-free repair with the use of reinforecement mesh provides best results in the area of recurrence, pain control, return to routine daily activity. Newly available biological mesh material provides possibility of treating different type of hernias without necessity of leaving artificial material in the site of operation that might lead to neuralgia, excessive scarring, difficulty in the future surgical  access to the operated area.

Between March and September 2011,  11 patients had TEP procedure for the indirect inguinal hernia repair performed with the use of Veritas patch. One patient underwent transperitoneal repair of the recurrent indirect inguinal hernia. Unilateral hernia repair was done on 10 patients (including two patients with bilateral inguinal hernia when for the other site hernia 3DMax mesh was used). Two patients had bilateral inguinal hernia repaired with the bovine pericardium patches. In every case the patch was secured with the use of the absorbable tacks. 

The placement of the patch did not complicated the procedure despite it soft texture and need for fixation with standard laparoscopic technique. All cases were performed as a same day surgery. There were no immediate postoperative complications and patients not required any additional interventions related to the pain control, hematoma or seroma formation.

Early results of the TEP biological patch repair shows no evidence of short time recurrence or complications. Veritas patch might provide adequate reinforcement of the groin for indirect inguinal hernia repair. Long term study is necessary to validate the outcome. Research for less expensive biological grafts might be beneficial in application of this technique.

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