Lightweight partially absorbable monofilament mesh (polypropylene/poliglecaprone 25) for TAPP inguinal hernia repair: initial experience.
OBJECTIVE
An ideal mesh should produce slight foreign-body reactions and be compatible with the human organisms. Studies focusing on these aspects indicate that the use of mesh with less nonabsorbable material may reduce postoperative complications, insofar the web structure and its rigidity play an important role in compatibility. We evaluated retrospectively the patients of the past 1 year, who underwent laparoscopic transabdominal preperitoneal (TAPP) hernioplasty (without the use any trocar and/or instrument of 10 mm in diameter) focusing attention on the feasibility of the technique and on the incidence of complications, especially those possibly related to the new type of mesh implanted.


METHODS
Between June 2004 and September 2005, 76 patients have been operated on by using TAPP hernioplasty (bilateral or unilateral) without any 10 mm instrument/optic/trocar, and by applying a lightweight composite mesh fixed by "glues" (fibrin sealant and N-butyl 2-cyanoacrylate).


RESULTS
The mean overall operative time was 55.57 (+/-15.2) minutes. All the procedures have been performed on a day surgery basis. We have registered any kind of major or minor morbidity (early or late), relapse, prosthesis rejection, and/or infection. We have registered no severe pain at 10 days; whereas a mild pain is still reported in 10.5% of our cases at a 3-month follow-up. The mean follow-up is 12.4 (+/-5.1; range 4 to 19) months.


CONCLUSIONS
On the basis of this our initial experience, TAPP hernioplasty with a lightweight composite mesh is feasible, effective, and easy to perform by experienced hands, with good results. The well-known characteristics of a mini-invasive and gentle approach, together with the type of mesh implanted and its fixation of related glues, might explain the encouraging results of our experience.
Agresta
Ferdinando
F
Department of General Surgery, Ospedale Civile, Via Forlanini, 71, 31029 Vittorio Veneto, Italy. fagresta@libero.it
Baldazzi
Gian Andrea
GA
Ciardo
Luigi Francesco
LF
Trentin
Giuseppe
G
Giuseppe
Sansonetti
S
Ferrante
Furio
F
Bedin
Natalino
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D002908:Chronic Disease; D004146:Dioxanes; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010146:Pain; D011091:Polyesters; D011126:Polypropylenes; D011183:Postoperative Complications; D012189:Retrospective Studies; D013526:Surgical Mesh; D013997:Time Factors; D016896:Treatment Outcome
D001672:Biocompatible Materials; D004146:Dioxanes; D011091:Polyesters; D011126:Polypropylenes; C095495:glycolide E-caprolactone copolymer