[Titanised polypropylene meshes: first clinical experience with the implantation in TAPP technique and the results of a survey in 22 German surgical departments].
Titanised polypropylene meshes for the treatment of inguinal hernias are available since 2001. The reduced weight of the mesh, the increased size of the net meshes amounting to 1 mm, and the titan surface are supposed to improve the tissue compatibility and lower the risk of post implant mesh dislocation.


OBJECTIVE
It was the aim of the study to examine the characteristics of the mesh concerning the feasability for implantation in TAPP technique as well as the tolerability of titanised polypropylene meshes under short term observation.


METHODS
80 titanised polypropylene meshes were implanted in TAPP technique into patients with inguinal hernias. The operation, the clinical course and complications were prospectively documented including a median follow up of 2 months.A survey of 22 German surgical departments was carried out. In a period of 8.3 months each institution gained experience with a median of 83 titanised polypropylene meshes in the treatment of inguinal hernias. The characteristics of the departments, certain aspects of implantation technique and reported complications were evaluated.


RESULTS
The median operation time amounted to 52 minutes. In 5 patients umbilical hernias were simultaneously repaired. In our own series in 2/3 (rd) of the cases the 35 g/m (2) and in 1/3 (rd) of the cases the 16 g/m (2) version of the mesh was used. 17 % of the meshes in our series were not fixed with staples. Only minor reversible complications occurred in our patient group. Mesh related major complications were observed neither in our patients nor in the patients of the departments we surveyed. None of our patients required analgesic medication. Postoperatively 89 % of the patients were highly satisfied with the operation. The heavier version of the mesh was used more often by surgeons of the other departments. Only in 3 departments both versions of the mesh were used regularly. The trend to use less or no staples at all could also be observed at the other departments.


CONCLUSIONS
The implantation of the titanised polypropylene meshes for the repair of inguinal hernia in TAPP technique is feasable. The intraoperative handling and the early clinical results are good. There were no major or mesh related complications or incompatibilities. Whether the rate of recurrence is comparable to conventional meshes and whether chronic pain syndromes can be reduced must be evaluated in long-term studies.
Abteilung für Allgemein-, Viszeral- und Gefässchirurgie, Krankenhaus Agatharied. schardey@khagatharied.de
H M
HM
Schardey
S
S
Schopf
W
W
Rudert
P
P
Knappich
T
T
Hernandez-Richter
D003625:Data Collection; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006552:Hernia, Inguinal / Q000601:surgery*; D006554:Hernia, Umbilical / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011126:Polypropylenes; D011183:Postoperative Complications; D013503:Surgery Department, Hospital; D013526:Surgical Mesh; D013997:Time Factors; D014025:Titanium
D011126:Polypropylenes; D014025:Titanium