Bilayer Mesh Repair for Inguinal Hernia- The Open Alternative to Laparoscopic RepairsCorrespondence Address :
Dr. Chinmaya Ranjan Behera,
Assistant Professor, Department of Surgery, KIMS and PBMH, KIIT Campus 5, Patia, Bubaneswar, Odisha-751024, India.
Introduction: In 1999, Gilbert described the technique of using a bilayer mesh device, Prolene Hernia System (PHS) for tension free repairs of inguinal hernias through an open anterior approach. This provides an anterior, posterior and plug repair, and hence successfully covers the myopectineal orifice, the lack of which is a glaring drawback for the Lichtensteins repair. This also confers the same benefit provided by the laparoscopic hernia repairs which uses the preperitoneal space to cover this same region that is, Transabdominal Preperitoneal Patch Plasty (TAPP) and Total Extraperitoneal patch Plasty (TEP).
Aim: To observe the overall outcome of using the open bi-layered dual mesh in a population of Odisha, attending a tertiary care hospital.
Materials and Methods: All patients admitted with inguinal hernias in the Department of General Surgery, Pradyumna Bal Memorial Hospital, KIMS, Odisha, India were included in the study. They all underwent the PHS bilayer mesh repair. The relevant patient specifics like, preoperative clinical findings and intra and postoperative results were noted in a master chart. Patients were followed-up for one year, and further long-term complications were noted, if any.
Results: There were a total of 40 patients. The mean duration for the procedure was 61 minutes (SD-22.8) and there was no inadvertent injury. The patients were encouraged to resume all physical activities from the first postoperative day. All the patients had an uneventful recovery, with a mean hospital stay of four days. Four patients presented with seroma after one week of surgery, while 22 patients had cord oedema. Both subsided spontaneously within three weeks, without further intervention. No recurrence was noted in any of the patients.
Conclusion: The PHS bilayer dual mesh repair is ideally suited for population in a low resource setting. It ensures coverage of the entire vulnerable area of groin along with a considerably shorter duration of operation, minimal risk of intraoperative injury.
Gilbert, Prolene hernia system, Transabdominal preperitoneal, Totally extra peritoneal
Date of Submission: Jul 06, 2020
Date of Peer Review: Sep 22, 2020
Date of Acceptance: Feb 10, 2021
Date of Publishing: Apr 01, 2021
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
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