First-in-man permanent laparoscopic fixation free obliteration of inguinal hernia defect with the 3D dynamic responsive implant ProFlor-E®. Case report

Abstract

Introduction In the case of inguinal hernia recurrence after primary anterior repair, international guidelines strongly suggest a posterior laparoscopic approach. The 3D dynamic-responsive prosthesis for inguinal hernia repair ProFlor-E® has recently been introduced to the market. The present report describes the results of the first-in-man laparoscopic inguinal hernia repair carried out with ProFlor-E®. Presentation of case A 71-year-old male Caucasian presented with recurrent inguinal hernia after primary anterior repair. A fixation free TAPP procedure with ProFlor-E® was planned. Implant delivery and placement to obliterate the defect was quick and safe. Postoperatively, starting from 2nd postop day, pain was practically absent allowing quick return to normal activities. During follow up, US and MRI scans confirmed the permanence of ProFlor-E® in the hernial gap. During 16-month follow-up no complications were reported. Discussion Flat meshes used to reinforce the herniated inguinal area is a well-established concept. Notwithstanding, such static and passive implants leave the defect patent and cause specific complications related to mesh fixation and uncontrolled poor quality fibrotic ingrowth. ProFlor-E® respects the inguinal physiology resolving these issues. Its centrifugal expansion and dynamic responsivity allows for fixation-free defect obliteration, thus avoiding complications, above all tissue tear, bleeding, mesh invagination, discomfort and chronic pain. In accord with the degenerative pathogenesis of hernia disease, by acting as a regenerative scaffold, ProFlor-E® restores the inguinal barrier promoting the regeneration of the typical inguinal components. Conclusion This initial experience seems to prove that ProFlor-E® can also be used with the laparoscopic approach achieving excellent results.

Physiologic Cyclical Load on Inguinal Hernia Scaffold ProFlor Turns Biological Response into Tissue Regeneration

“…Aiming to improve such controversial treatment results, a new concept has been conceived for a more physiological and pathogenetic coherent method. It concerns a 3D scaffold, ProFlor, designed with a multilamellar shape, available for open and laparoscopic approaches and made of polypropylene, similar to conventional hernia implants [ 37 , 38 , 39 ]. Compressible on all planes with recoil memory, the 3D core of the scaffold takes advantage of its natural centrifugal expansion to achieve a permanent fixation-free obliteration of the hernia defect.…”

Dynamic Responsive Inguinal Scaffold Activates Myogenic Growth Factors Finalizing the Regeneration of the Herniated Groin

“…A 3D multilamellar scaffold made of the same material as conventional flat hernia meshes, polypropylene, with an intrinsic compressibility has been developed for hernia repair. This device, named ProFlor, is delivered fixation free with an open and laparoscopic approach to permanently obliterate the hernia defect thanks to an inherent centrifugal expansion [ 27 , 28 , 29 ]. It is designed to be dynamically responsive since it compresses and relaxes in synchrony with the groin.…”

Current status and progress of laparoscopic inguinal hernia repair: A review

“…Due to these innovative features, ProFlor may represent a turning point in the treatment of inguinal hernias. [66] Patch fixation methods include bonding with medical adhesive, stapling with a stapler and placing absorbable sutures. At present, there is no consensus on the best method for mesh fixation.…”