Document Detail

Optimal mesh size for endoscopic inguinal hernia repair: a study in a porcine model.
MedLine Citation:
PMID:  11965468     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although the recurrence rate for endoscopic herniorraphy is low (0-3%), it can still be improved. In addition to using an expert technique that will minimize the risk of recurrence, it is essential that the mesh be large enough to cover the hernial defect adequately. To gain an impression of the optimal mesh size for such repairs, we performed an experimental study in a porcine model. METHODS: To mimic inguinal hernial defects, circular holes of different diameters were cut in the pigs' abdominal walls after the peritoneum was lifted from the transverse fascia. The abdominal walls were positioned in a hermetically sealed chamber in which air pressure was applied to replicate intraabdominal pressure. Measurements were obtained to relate the protrusion of the mesh to the following three variables: intraabdominal pressure, defect size, and mesh overlap over the defect after positioning of the mesh between the abdominal wall and the peritoneum. RESULTS: Mesh protrusion increased as defect size and intraabdominal pressure increased. Mesh protrusion decreased as overlap of the mesh over the defect increased. Protrusion was found to level off when the mesh overlapped the defect by 3 cm and adequate positioning of the mesh was maintained. CONCLUSION: Recurrences after endoscopic inguinal hernia repair due to inadequate mesh size and mesh protrusion can be reduced by using a mesh that overlaps the defect by > or = 3 cm.
M T Knook; A C van Rosmalen; B E Yoder; G J Kleinrensink; C J Snijders; C W Looman; C J van Steensel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgical endoscopy     Volume:  15     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2002-04-19     Completed Date:  2002-05-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1471-7     Citation Subset:  IM    
Department of Surgery, University Hospital Rotterdam Dijkzigt, Dr. Molewaterplein 50, 3015 GD Rotterdam, TheNetherlands.
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MeSH Terms
Abdominal Muscles / surgery
Disease Models, Animal*
Endoscopy / methods*,  standards
Hernia, Inguinal / surgery*
Implants, Experimental / standards
Recurrence / prevention & control
Surgical Mesh / standards*

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