Successful mesh plug repair using a hybrid method for recurrent inguinal hernia after laparoscopic transabdominal preperitoneal approach: A case report

Kikugawa, Rina; Tsujinaka, Shingo; Tamaki, Sawako; Takenami, Tsutomu; Maemoto, Ryo; Fukuda, Ryosuke; Toyama, Nobuyuki; Rikiyama, Toshiki

doi:10.1016/j.ijscr.2019.05.017

Cited by 2 publications

(6 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Implants available on the market are characterized by several disadvantages, such as: the random arrangement of monofilament and the difference in the kind of the polymer in the hybrid knitted implants, resulting in a reduction in the assumed performance and safety and a significant rise in the risk of internal organ/implant adhesion if the hernia mesh is implanted using laparoscopic surgery [ 15 , 16 , 17 ]; a significantly high surface density (e.g., for hernia meshes made entirely of PVDF monofilament, surface density >> 120 g/m 2 relative to the surface density of knitted, polypropylene implants < 80 g/m 2 ), resulting in a lack of biomimetics and risk of thick postoperative scar formation (reduction in patient comfort, complications long after surgery, breathing problems, pain, etc.) [ 15 , 17 , 18 , 19 ]; a prolonged period of soft tissue over-growth in the case of implants made entirely of synthetic materials and at the same time a decrease in the strength of the created implant/tissue composition [ 15 , 18 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Design of New Concept of Knitted Hernia Implant

et al. 2022

View full text Add to dashboard Cite

A knitted implant, unilaterally modified with plasma-assisted chemical-vapor deposition (PACVD), and with a nano-layer of fluorine derivative supplementation, for reducing the risk of complications related to adhesions, and the formation of a thick postoperative scar was prepared. The biological evaluation of designed or modified medical devices is the main aspect of preclinical research. If such studies use a medical device with prolonged contact with connective tissue (more than 30 days), biocompatibility studies require a safety assessment in terms of toxicity in vitro and in vivo, allergenicity, irritation, and cancerogenicity, reproductive and developmental toxicity. The ultimate aspect of biological evaluation is biofunctionality, and evaluation of the local tissue response after implantation, resulting in the determination of all aspects of local biocompatibility with the implemented synthetic material. The implantation of PACVD-modified materials in muscle allows us to estimate the local irritation effect on the connective tissue, determining the risk of scar formation, whereas implantation of the above-mentioned knitted fabric into the abdominal wall, assists with evaluating the risk of fistula formation—the main post-surgical complications. The research aimed to evaluate the local reaction of the soft tissues after the implantation of the knitted implants modified with PACVD of the fluoropolymer in the nanostuctural form. The local effect that occurred during the implantation of the designed implants was quantitatively and qualitatively evaluated when PACVD unmodified (reference), and modified medical devices were implanted in the abdominal cavity (intra-abdominal position) for 12 or into the muscles for 56 weeks. The comparative semi-quantitative histological assessment included the severity of inflammatory cells (multinucleated cells, lymphocytes, plasma cells, macrophages, giant cells) and the tissue response (necrosis, neovascularization, fibrosis, and fat infiltration) on a five-point scale. The knitted implants modified by PACVD did not indicate cumulative tissue response when they were implanted in the muscle and intra-abdominally with direct contact with the viscera. They reduced local tissue reaction (score −2.71 after 56 weeks of the implantation) and internal organ adhesion (irritation score −2.01 and adhesion susceptibility −0.3 after 12 weeks of the implantation) compared with the reference (unmodified by PACVD) knitted implant, which had an identical structure and was made of the same source.

show abstract

Section: Introductionmentioning

confidence: 99%

Design of New Concept of Knitted Hernia Implant

et al. 2022

View full text Add to dashboard Cite

show abstract

“…3,4 After OPMR, totally extraperitoneal repair or TAPP seems difficult because the previously placed mesh may be an obstacle during the exfoliation of the parietal peritoneum. During exfoliation, these laparoscopic procedures appear likely to cause chronic pain if the "trapezoid of disaster," 1,[3][4][5] to which the previously placed mesh was adhered, especially in TIPPMR, is injured. For these reasons, even in Europe and the United States, surgeons tend to avoid performing CLR for RIH after OPMR for fear of patients developing chronic pain.…”

Section: Introductionmentioning

confidence: 99%

“…1 As such, CLR for RIH after OPMR is not widely performed. [1][2][3][4][5] However, a meta-analysis showed that the incidence of chronic pain was similar between the open and laparoscopic approaches for RIH. Despite this, open repair for RIH is considered more likely than laparoscopic repair to cause chronic pain.…”

Section: Introductionmentioning

confidence: 99%

“…However, in Japan, LPR is less common than in Europe and the United States 2 ; rather, open posterior mesh repair (OPMR), including mesh plug repair (MPR) and transinguinal preperitoneal mesh repair (TIPPMR), is the most common open repair. Therefore, completely laparoscopic repair (CLR) for RIH that develops after PAOR has been rarely reported in Japan 3,4 …”

Section: Introductionmentioning

confidence: 99%

“…For these reasons, even in Europe and the United States, surgeons tend to avoid performing CLR for RIH after OPMR for fear of patients developing chronic pain 1 . As such, CLR for RIH after OPMR is not widely performed 1‐5 . However, a meta‐analysis showed that the incidence of chronic pain was similar between the open and laparoscopic approaches for RIH.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Completely laparoscopic repair for recurrent inguinal hernia that developed after open posterior mesh repair

Morioka

Izumisawa

Ohyama

et al. 2020

Asian J Endoscop Surgery

View full text Add to dashboard Cite

Surgeons tend to avoid performing completely laparoscopic repair (CLR) for recurrent inguinal hernia (RIH) that developed after the open posterior mesh repair (OPMR). For many, totally extraperitoneal repair or transabdominal preperitoneal repair after OPMR seems difficult because the previously placed mesh may pose an obstacle during the exfoliation of the parietal peritoneum. Moreover, these procedures could cause chronic pain if the "trapezoid of disaster" is injured. In this small case series, we describe our operative technique for CLR for RIH after OPMR, including modified transabdominal preperitoneal repair and modified intraperitoneal onlay mesh repair. The short-term and midterm outcomes of this procedure are also reported. Although we recognize the need for further analysis involving many more cases and a longer follow-up period, we will continue to perform CLR for RIH after OPMR because the results of this small case series were favorable.

show abstract

Successful mesh plug repair using a hybrid method for recurrent inguinal hernia after laparoscopic transabdominal preperitoneal approach: A case report

Cited by 2 publications

References 13 publications

Design of New Concept of Knitted Hernia Implant

Design of New Concept of Knitted Hernia Implant

Completely laparoscopic repair for recurrent inguinal hernia that developed after open posterior mesh repair

Contact Info

Product

Resources

About