Prospective evaluation of the giant prosthetic reinforcement of the visceral sac for recurrent and complex bilateral inguinal hernias.
BACKGROUND
Recurrent and complex bilateral inguinal hernias are associated with a high recurrence rate. This study evaluates prospectively the efficacy and safety of giant prosthetic reinforcement of the visceral sac (GPRVS) in a group of patients at high risk for recurrence.


METHODS
Sixty-four patients with 124 inguinal hernias (60 bilateral and 4 unilateral) underwent repair using a large polyester mesh based on Stoppa's preperitoneal technique. Mean age was 61 years (63 men and 1 woman), and 69% had one or more comorbid medical conditions.


RESULTS
Factors predicating a high risk for recurrence included large hernia size (> or =5 cm; 31%, 20 of 64), failure of one or more previous repairs (39%, 25 of 64), and chronic obstructive pulmonary disease (28%, 18 of 64). Mean operative time was 115 minutes (range 45 to 235). Mean length of stay was 3+/-3 days. There were 2 major and 15 minor complications, no mesh infections, and no death. Follow-up was obtained in 95% (61 of 64). After a mean follow-up of 24 months, the recurrence rate was 1% (1 of 124) per inguinal hernia repaired or 2% (1 of 64) per patient.


CONCLUSIONS
GPRVS is a safe and effective addition to the surgeon's armamentarium to treat selected patients with recurrent or complex bilateral inguinal hernias.
Department of Surgery, University of Florida, Gainesville, USA.
C C
CC
Solorzano
R M
RM
Minter
T C
TC
Childers
J W
JW
Kilkenny
J N
JN
Vauthey
D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011091:Polyesters; D019919:Prosthesis Implantation; D012008:Recurrence; D012086:Reoperation; D012307:Risk Factors; D013526:Surgical Mesh
D011091:Polyesters