“All-in-one mesh” hernioplasty: A new procedure for primary inguinal hernia open repair

• Published in: Asian journal of surgery 2018-09, Vol.41 (5), p.473-479
• Main Authors: Guttadauro, Angelo, Maternini, Matteo, Frassani, Silvia, De Simone, Matilde, Chiarelli, Marco, Macchini, Daniele, Pecora, Nicoletta, Bertolini, Aimone, Cioffi, Ugo, Gabrielli, Francesco
• Format: Article
• Language: English
• Subjects: Hernioplasty technique; Inguinal hernioplasty; Mesh for groin hernia; Neuralgia post-hernioplasty; Tension free hernia repair
• ISSN: 1015-9584
• DOI: 10.1016/j.asjsur.2017.07.003

We propose a new open mesh hernia repair procedure for the treatment of inguinal hernias in adults aiming to improve patients' comfort and to reduce the incidence of chronic neuralgia. From September 2012 to August 2015, 250 consecutive patients were treated with “all in-one” mesh hernioplasty procedure in our Institution. According to the devised technique, a new smaller prosthesis was placed on the floor of the inguinal canal in order to strengthen all areas of weakness from which hernias may originate. The mesh was enveloped by a fibro-cremasteric sheath avoiding contact with neural structures. Follow-up was carried out at 3, 6, 12, 18 and 24 months for evaluation of postoperative pain using Visual Analogue Scale score, need of medication, patients' comfort and short or long-term complications. All patients were discharged within 24 h from surgery. Slight pain was reported by the majority of patients and 47.6% of them did not require pain medication at home. After the 1st postoperative week 96.8% reported no pain and no other symptoms. No relevant limitation of normal activities was reported. There has been no postoperative neuralgia. One recurrence was observed. This new hernioplasty technique respects the anatomy of the inguinal canal, uses a smaller mesh, and seems to avoid neuralgia with maximum comfort for the patients.