Advertisement

“Sports” hernia: treatment with biologic mesh (Surgisis)

A preliminary study
  • D. S. Edelman
  • H. Selesnick
Original Article

Abstract

Background

Groin pain in athletes is caused by a wide range of musculoskeletal disorders. Occasionally, a palpable bulge at the external ring or ultrasound may not demonstrate a hernia. When athletes do not respond to conservative treatment, a “sports” hernia should be considered.

Methods

A retrospective review of 750 laparoscopic preperitoneal hernias was performed. A sports hernia was defined as a tear in the transversalis fascia that was not evident by preoperative physical exam. A 7 × 10-cm biologic mesh, Surgisis, was placed, uncut, over the myopectinate orifice and fixed with five tacks or fibrin glue. Patients were followed up at 2 and 6 weeks, 6 months, and 1 year.

Results

Ten professional and amateur athletes were found to have sports hernias. Operative time averaged 32 min. There were no major complications. All athletes returned to full activities in 4 weeks. Only one patient did not show improvement in his symptoms. No patient developed a recurrent hernia.

Conclusions

Laparoscopic exploration should be considered in athletes with chronic groin pain that does not improve after conventional treatments have failed. Furthermore, biologic mesh (Surgisis) should be considered for the repair of inguinal sports hernias.

Keywords

Hernia Laparoscopic Sports hernia Sportsman’s hernia Pubalgia Biologic mesh 

References

  1. 1.
    Badylak SF, Lantz G, Coffey A, Geddes LA (1989) Small intestinal submucosa as a large diameter vascular graft in the dog. J Surg Res 47: 74–80PubMedCrossRefGoogle Scholar
  2. 2.
    Brooks DC (1994) A prospective comparison of laparoscopic and tension-free open herniorrhaphy. Arch Surg 129: 361–366PubMedGoogle Scholar
  3. 3.
    Clarke KM, Lantz GC, Salisbury SK, Badylak SF, Hiles MC, Voytik SL (1996) Intestinal submucosa and polypropylene mesh for abdominal wall repair in dogs. J Surg Res 60: 107–114PubMedCrossRefGoogle Scholar
  4. 4.
    Edelman DE (2002) Laparoscopic herniorrhaphy using porcine small intestine submucosa—a preliminary study. J Soc Laparoendosc Surg 6: 203–205Google Scholar
  5. 5.
    Franklin ME, Gonzalez JJ, Glass JL (2004) Use of porcine small intestinal submucosa as a prosthetic device for laparoscopic repair of hernias in contaminated fields: 2-year follow-up. Hernia 8: 3–6Google Scholar
  6. 6.
    Hackney RG (1993) The sports hernia: a cause of chronic pain. Br J Sports Med 27: 58–62PubMedGoogle Scholar
  7. 7.
    Ingoldby CJ (1997) Laparoscopic and conventional repair of groin disruption in sportsmen. Br J Surg 84: 213–215PubMedCrossRefGoogle Scholar
  8. 8.
    Kozol R, Lange PM, Kosir M, Beleski K, Mason K, Tennenberg S, Kubinec SM, Wilson RF (1997) A prospective, randomized study of open vs laparoscopic inguinal hernia repair. Arch Surg 132: 292–295PubMedGoogle Scholar
  9. 9.
    Liem MS, Graaf YV, Steensel CJ, et al. (1997) Comparison of conventional anterior surgery and laparoscopic surgery for inguinal hernia repair. N Engl J Med 336: 1541–1547PubMedCrossRefGoogle Scholar
  10. 10.
    Morelli V, Smith V (2001) Groin injuries in athletes. Am Family Physician 64: 1405–1414Google Scholar
  11. 11.
    Orchard JW, Read JW, Neophyton J, Garlick D (1998) Groin pain associated with ultrasound finding of inguinal canal posterior wall deficiency in Australian rules footballers. Br J Sports Med 32: 134–139PubMedCrossRefGoogle Scholar
  12. 12.
    Payne JH, Grininger LM, Izawa MT, Podoll EF, Lindahl PJ, Balfour J (1994) Laparoscopic or open inguinal herniorrhaphy? Arch Surg 129: 973–979PubMedGoogle Scholar
  13. 13.
    Prevel CD, Eppley BL, Summerlin DJ, Jackson JR, McCarty M, Badylak SF (1995) Small intestinal submucosa: utilization for repair of rodent abdominal wall defects. Ann Plastic Surg 35: 374–380CrossRefGoogle Scholar
  14. 14.
    Srinivasan A, Schuricht A (2002) Long term follow-up of laparoscopic preperitoneal hernia repair in professional athletes. J Laparoendosc Advanced Surg Tech 12: 101–106CrossRefGoogle Scholar
  15. 15.
    Taylor DC, Meyers WC, Moylan JA, Lohnes J, Bassett FH, Garrett WE (1991) Abdominal musculature abnormalities as a cause of groin pain in athletes. Am J Sports Med 19: 239–242PubMedGoogle Scholar
  16. 16.
    Tuite JM, DeSmet AA (1994) MRI of selected sports injuries: muscle tears, groin pain and osteochondritis dessecans. Semin Ultrasound CT MRI 15: 318–340Google Scholar
  17. 17.
    Voeller GR, Mangiante EC, Wilson C (1995) Totally preperitoneal laparoscopic inguinal herniorrhaphy using balloon dissection. Surgical Rounds 3: 107–112Google Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  1. 1.The Gallbladder & Laparoscopic Surgery Center of Miami, Baptist HospitalMiamiUSA
  2. 2.Doctor’s Hospital, Baptist HealthCoral GablesUSA

Personalised recommendations