Allograft AlloDerm(®) tissue for laparoscopic transabdominal preperitoneal groin hernia repair: A case report.
BACKGROUND
Synthetic mesh is the prosthetic material used for most inguinal hernioplasties. However, when left in contact with intra-abdominal viscera, it often becomes associated with infection and migration, particularly in irradiated tissues, contaminated fields, immunosuppressed individuals, and patients with intestinal obstruction or fistula. AlloDerm(®) Regenerative Tissue Matrix (LifeCell Corporation, Branchburg, NJ) is derived from human cadaver skin and may be associated with fewer visceral adhesions and more durability in infected fields than synthetic mesh.


METHODS
We report the first case in which AlloDerm was used in a laparoscopic transabdominal preperitoneal repair of a multiple recurrent right inguinal hernia, a left femoral hernia, and an umbilical hernia in the same patient. Use of AlloDerm greatly enhanced the maneuverability during laparoscopic hernia repair due to its pliability and strength and eliminated the need to cover the prosthetic with peritoneum.


CONCLUSIONS
Previous pelvic radiation and multiple previous groin repairs can render the peritoneum friable, resulting in obstacles to successful closure. AlloDerm is a reasonable choice for groin hernia repairs when such factors are present.


CONCLUSIONS
The long-term durability of AlloDerm for laparoscopic groin hernia repairs is yet to be determined, but based on current data it seems prudent to use this technique in laparoscopic repair of complex groin hernias where infection is suspected or inadequate prosthetic coverage with peritoneum is anticipated.
University of Texas Southwestern Medical Center, Department of Plastic and Reconstructive Surgery, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States. Electronic address: bardiaamirlak@gmail.com.
Bardia
B
Amirlak
Louisiana State University Health Sciences Center, School of Medicine, 1901 Perdido Street, New Orleans, LA 70112, United States.
Jodi
J
Gerdes
Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, United States.
Varun
V
Puri
Creighton University School of Medicine, 2500 California Plaza, Omaha, NE 68131, United States.
Robert J
RJ
Fitzgibbons
AlloDerm; Femoral hernia; Inguinal hernia; Laparoscopic hernia repair; Recurrent hernia