title: Modified fixation free plug technique using a new 3D multilamellar implant for inguinal hernia repair: a retrospective study of a single operator case series.
abstract: OBJECTIVE
  Implant fixation, mesh shrinkage and poor quality of tissue ingrowth are unresolved issues in modern hernia repair. Many complications reported in the literature such as bleeding, nerve entrapment, hematoma, pain, discomfort, and testicular complications, are considered to be a direct results of implant fixation. This article describes the outcomes of a procedure carried out using a handcrafted implant that addresses the issues consequent to point fixation.
  
  
  METHODS
  This was a retrospective study on the short, medium and long-term results of placing a-modified, fixation free three-dimensional polypropylene implant in 61 patients who underwent inguinal hernia repair using a novel delivery technique. The follow up length was at least 36 months postop.
  
  
  RESULTS
  Only minor adverse events and a low complication rate of the procedure were observed in this patient sample. There were no long- term complications. Postoperative pain was very low in both the short and long term. No chronic pain was reported. No recurrences occurred.
  
  
  CONCLUSIONS
  The results of this retrospective study on a new method of inguinal hernia repair using a three dimensional handcrafted multilamellar implant delivered with a modified placement technique are promising. The short-, medium- and long-term complications were notably low. No recurrences were noticed but, more importantly, no chronic pain and extremely low discomfort rates were observed even in the long term.
authors: Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Via Rapisardi 66, 90144, Palermo, Italy, amatomed@gmail.com.
authors: G
authors: G
authors: Amato
authors: A
authors: A
authors: Agrusa
authors: G
authors: G
authors: Romano
authors: G
authors: G
authors: Cocorullo
authors: G
authors: G
authors: Di Buono
authors: S
authors: S
authors: Mularo
authors: G
authors: G
authors: Gulotta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000453:epidemiology; D011126:Polypropylenes; D011183:Postoperative Complications / Q000453:epidemiology; D011474:Prosthesis Design; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome
chemical_list: D011126:Polypropylenes
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