Abstract
Self-gripping mesh can be difficult to handle during spread to the inguinal floor because it can stick or adhere to the undesired structures because of micro-grips available on its underneath surface. This article aims to describe a new technique; we named it a four-fold technique to spread the self-gripping mesh to avoid this problem. The present study was a prospective comparative study between self-gripping mesh (polyester mesh with polylactic acid grips) and sutured mesh (polypropylene) in open inguinal hernioplasty under spinal anesthesia. This study was conducted from 1 November 2018 to 31 March 2020 in ABVIMS & Dr. R.M.L. Hospital, New Delhi. The potential candidates for the study were patients of 18 years age and above, presenting with a unilateral uncomplicated inguinal hernia that underwent open inguinal hernioplasty under spinal anesthesia. Sixty patients were alternatively allotted to group A (30 patients) and group B (30 patients) for comparison between self-gripping and sutured mesh. We used a 14 × 9-cm-size self-gripping mesh, which has semi-resorbable surface on one side and resorbable micro-grips on the other side to provide immediate fixation. Mesh was folded four times in a specific sequence before placing it, thus hiding the majority of the absorbable micro-grips. In this way, only the lower medial half of the mesh has the micro-grips exposed, and the mesh can now be fixed to the inguinal ligament without fixation to unintended tissues and structures underneath. Once the mesh is placed over the pubic tubercle and medial part of the inguinal ligament, it can be unfolded in the reverse order. The four-fold technique is an excellent method to spread the self-gripping mesh in inguinal hernia surgery to avoid sticking with undesired tissues.
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References
Sabiston D (2017) Sabiston Textbook of surgery. In: Courtney M. Townsend, Jr, R. Daniel Beauchamp, B. Mark Evers KLM, editor. Sabiston Textbook of surgery: the biological basis of modern surgical practice. 20th ed.Elsevier Inc.; p 2176. Available from:https://www.elsevier.com/books/sabiston-textbook-of-surgery/townsend/978-0-323-29987-9
Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The ‘tension-free’ hernioplasty. Am J Surg 157(2):188–193
Amid PK, Lichtenstein IL (1998) Long-term results and current status of Lichtenstein open tension-free hernioplasty. Hernia 2(3):89–94
EU Hernia Triallists Collaboration (2000) Mesh compared with non-mesh methods of open groin hernia repair: a systematic review of randomized controlled trials. Br J Surg 87:854–859
Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, John G (2015) Schwartz’s principles of surgery. 10th edn. p 2096
Elsebae MMA, Nasr M, Said M (2008) Tension-free repair versus Bassini technique for strangulated inguinal hernia: a controlled randomized study. Int J Surg. 6(4):302–305
Chatzimavroudis G, Papaziogas B, Koutelidakis I, Galanis I, Atmatzidis S, Christopoulos P, Doulias T, Atmatzidis K, Makris J (2014) Lichtenstein technique for inguinal hernia repair using 61 polypropylene mesh fixed with sutures vs. self-fixating polypropylene mesh: a prospective randomized comparative study. Hernia. 18(2):193–198
Persistent Post-surgical pain: risk factors and prevention. 2010;138(1):2010
Kingsnorth A, Gingell-Littlejohn M, Nienhuijs S, Schü Le S, Appel P, Ziprin P et al (2012) Randomized controlled multicenter international clinical trial of self-gripping Parietex TM ProGrip TM polyester mesh versus lightweight polypropylene mesh in open inguinal hernia repair: interim results at 3 months. Hernia. 16(3):287–294
Yilmaz A, Yener O, Kaynak B, Yiǧitbaşi R, Demir M, Burcu B et al (2013) Self-gripping Covidien TM ProGripTM mesh versus polypropylene mesh in open inguinal hernia repair: multicenter short term results. Prague Med Rep. 114(4):231–238
Wang Y, Zhang X (2016) Short-term results of open inguinal hernia repair with self-gripping Parietex ProGrip mesh in China: a retrospective study of 90 cases. Asian J Surg. 39(4):218–224
Porrero JL, Cano-Valderrama O, Castillo MJ, Alonso MT (2015) Proposed technique for inguinal hernia repair with self-gripping mesh: avoiding fixation to undesired structures. Hernia. 19(5):771–774
Lechner MN, Jäger T, Buchner S et al (2016) Rail or roll: a new, convenient and safe way to position self gripping meshes in open inguinal hernia repair. Hernia 20:417–422. https://doi.org/10.1007/s10029-015-1389-y
Tarchi P, Cosola D, Germani P, Troian M, De Manzini N (2014) Self-adhesive mesh for Lichtenstein inguinal hernia repair. Experience of a single center. Minerva Chir 69(3):167–176
Sahoo R, Samal D, Abdullah M (2018) An institutional comparative study of self-gripping ProGrip mesh with prolene mesh in repair of inguinal hernia: a single center study. Int Surg J 5(2):456–459
Axman E, Holmberg H, Nordin P, Nilsson H (2020) Chronic pain and risk for reoperation for recurrence after inguinal hernia repair using self-gripping mesh. Surg (United States). 167(3):609–613
Molegraaf MJ, Grotenhuis B, Torensma B, De Ridder V, Lange JF, Swank DJ (2017) The HIPPO trial, a randomized double-blind trial comparing self-gripping Parietex ProGrip ProGrip mesh and sutured Parietex mesh in Lichtenstein hernioplasty. In: Annals of Surgery. Lippincott Williams and Wilkins; pp 939–45.
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Gupta, A.K., Raj, A., Poddar, D. et al. New Four-fold Technique to Spread the Self-Gripping Mesh in Open Inguinal Hernia Surgery. Indian J Surg (2021). https://doi.org/10.1007/s12262-021-02718-0
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DOI: https://doi.org/10.1007/s12262-021-02718-0