Retrospective Study of 710 Patients Treated with 4DDome® Mesh: A New Chance for Open Inguinal Hernia Repair

Abstract

Introduction:Although mesh techniques are used with increasing frequency, they are correlated to major long-term complications such as chronic inguinal pain (8.6%) and recurrence (1.6-8.6%). It is due to a non-development of an ideal mesh, which simultaneously ensures inguinal wall strength and a lower inflammatory foreign body reaction, which also seems to be correlated to the use of a nonabsorbable mesh. Materials and methods:They were retrospectively analyzed from January 2007 to June 2014, 710 patients (103 women with mean age of 62, (14.54%) and 607 men with mean age of 51.8, (85.45%) underwent a surgical groin hernia repair. In 96 patients (13.66%), we used the dome only and in 614 patients (86.36%), both the dome and the onlay mesh were used for inguinal hernia repair. In all cases, we used a 4DDome ® mesh (dome, lay patch) for reconstruction. This prosthesis is made of 10% light polypropylene and 90% absorbable poly-L-Lactic Acid (PLLA).Results: Mean operative time was 45 minutes (range: 20-70 minutes). There were no intraoperative complications. The majority of patients were discharged after a mean time of 12 hours (range: 12-72 hours). In 12 (1.81%) cases, there were a subcutaneous hematoma and a seroma in one case. Fifty (7.2%) patients presented with incisional scar swelling. There were no wound infections. These minor complications resolved within 1 month. Three (0.42%) patients had chronic inguinal pain (>3 months). Five (0.70%) recurrent hernias were observed. Conclusion:In our study, we observed an adequate mesh tolerance: the majority of patients did not present chronic pain at 1 year, except in 0.42% of cases, with a low rate or recurrence of only 0.70%. Postoperative stay was reduced with an immediate return to physical activities. Consequently, according to our initial experience, absorbable meshes for inguinal hernia repair seem stand.