Polyester (Parietex) mesh for total extraperitoneal laparoscopic inguinal hernia repair |
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Authors: | B Ramshaw F Abiad G Voeller R Wilson E Mason |
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Institution: | (1) Emory University, 1364 Clifton Road NE, Suite H-124, Atlanta, GA 30322, USA, US;(2) University of Tennessee, Memphis, Memphis TN, USA, US;(3) Atlanta Medical Center, Atlanta, USA, US |
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Abstract: | Polypropylene mesh is the most commonly used mesh for open and laparoscopic hernia repair in the United States. A variety
of newly developed polyester mesh products have recently become available. This is the first U.S. multiinstitutional study
evaluating the initial experience of polyester mesh use for total extraperitoneal (TEP) laparoscopic inguinal hernia repair.
Between January 2000 and June 2001, 337 patients underwent 495 TEP laparoscopic inguinal hernia repairs using polyester mesh.
There were 309 men and 28 women in the study, whose average age was 45 years (range, 17–80 years). The average operative time
for all cases was 54.3 min (range, 18–157 min). There were no conversions to open repair and no mortality. Complications included
12 seromas/hematomas (six aspirated), chronic pain in three patients, urinary retention in two patients, and one incidence
each of the following: epididimitis, prostatitis, hydrocele, and port-site cellulitis. Additionally, one patient had carbon
dioxide (CO2) in the Foley bag at the end of the surgery, but a normal cystogram showed no identified bladder injury. There
has been one recurrence (0.2%), occurring 4 months after surgery, which was repaired using a transabdominal laparoscopic approach.
The mean follow-up period was 11 months (range, 2–22 months). There have been no documented infections of the mesh, and no
mesh has been removed. This study documents a favorable initial experience with polyester mesh for TEP laparoscopic inguinal
hernia repair. There were no complications related to the mesh. There may be technical and long-term advantages with the use
of polyester mesh for laparoscopic inguinal hernia repair. Longer follow-up evaluation and additional studies are warranted
to evaluate these potential advantages. |
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