Laparoscopic Inguinal Hernia Repair: Mesh and Fixation Overview
Explore the classification, immune response, fixation methods, and complications associated with mesh in laparoscopic inguinal hernia repair. Learn about chronic pain, wound complications, recurrence, and the value versus cost factors. References to international guidelines and the past, present, and future of surgical meshes are included.
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Presentation Transcript
Mesh and fixation in Laparoscopic inguinal hernia repair Mr Duncan Light Consultant upper GI surgeon Northumbria NHS Trust www.nugit.nhs.uk
Mesh classification Structure/weave Pore size > 1mm Weight 80gm2 Mechanical properties Tensile strength Stiffness Elasticity Complicance Synthetic Polypropylene PVDF Polyester Biosynthetic PGA P4HB Biological Porcine Bovine Fetal Cadaver
Mesh immune response Foreign body response Fibroblasts and immune response Chronic process Granuloma formation Scar plate Implicated in mesh shrinkage Potential reduction with large pore size (>1mm)
CHRONIC PAIN WOUND COMPLICATIONS RECURRENCE QUALITY -------------------- VALUE = COST HOSPITAL VISITS LOS READMISSIONS RESOURCES
Fixation Tacks Absorbable Non-absorbable Staples? Glue Fibrin Cyanoacylate Self-fixating mesh
CHRONIC PAIN WOUND COMPLICATIONS RECURRENCE QUALITY -------------------- VALUE = COST HOSPITAL VISITS LOS READMISSIONS RESOURCES
References International guidelines for groin hernia management. Herniasurge group. Hernia 2018. 22 (1): 1-65 Past, Present and Future of Surgical Meshes: A Review. Baylon, Karen & Rodr guez-Camarillo, Perla & El as-Z iga, Alex & D az-Elizondo, Jos & Gilkerson, Robert & Lozano, Karen. (2017). Membranes. 7. 47
