Appropriate mesh size in the totally extraperitoneal repair of groin hernias based on the intraoperative measurement of the myopectineal orifice.
Groin hernia
Mesh size
Myopectineal orifice
Totally extraperitoneal approach
Journal
Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
received:
10
02
2020
accepted:
30
04
2020
pubmed:
13
5
2020
medline:
29
7
2021
entrez:
13
5
2020
Statut:
ppublish
Résumé
Insufficient coverage of the area of a possible groin hernia is an important risk factor in hernia recurrence. To prevent recurrence, it is important to use the appropriate mesh size based on the size of the myopectineal orifice (MPO), which is the weak area of the abdominal wall where inguinal hernias occur. We aimed to estimate the appropriate mesh size for groin hernias by investigating MPO size. Four hundred and six patients underwent groin hernia repair using a totally extraperitoneal (TEP) approach at the Zeze Hospital between July 2009 and December 2017. We investigated patients' backgrounds, MPO components dimensions, and hernia recurrence, and evaluated the appropriate mesh size. The 359 male and 47 female patients had an average age of 63 ± 15 years. In 171, 147, and 88 cases, hernias were localized to the right, left, and bilaterally, respectively. The number of lateral, medial, femoral, and combined hernias was 317, 124, 11, and 42, respectively. The 95th percentile for the horizontal and vertical lengths in cases of hernia orifice ≥ 3 cm were 9.6 cm and 7.0 cm, respectively, while it was 9.2 cm and 6.4 cm in cases of hernia orifice < 3 cm. We added 2 cm and 3 cm to the 95th percentile for the length and width of the MPO, resulting in 13.2 × 10.4 cm and 15.6 × 13.0 cm in cases with hernia orifice < 3 cm and ≥ 3 cm, respectively. Relapse after TEP occurred in 1 patient (0.2%). The appropriate mesh size for TEP repair, derived from intraoperative MPO measurements, was estimated as 13.2 × 10.4 cm and 15.6 × 13.0 cm when the hernia orifice was < 3 cm and ≥ 3 cm, respectively. Using appropriate mesh sizes based on MPO measurement may reduce groin hernia recurrence after TEP.
Sections du résumé
BACKGROUND
Insufficient coverage of the area of a possible groin hernia is an important risk factor in hernia recurrence. To prevent recurrence, it is important to use the appropriate mesh size based on the size of the myopectineal orifice (MPO), which is the weak area of the abdominal wall where inguinal hernias occur. We aimed to estimate the appropriate mesh size for groin hernias by investigating MPO size.
METHODS
Four hundred and six patients underwent groin hernia repair using a totally extraperitoneal (TEP) approach at the Zeze Hospital between July 2009 and December 2017. We investigated patients' backgrounds, MPO components dimensions, and hernia recurrence, and evaluated the appropriate mesh size.
RESULTS
The 359 male and 47 female patients had an average age of 63 ± 15 years. In 171, 147, and 88 cases, hernias were localized to the right, left, and bilaterally, respectively. The number of lateral, medial, femoral, and combined hernias was 317, 124, 11, and 42, respectively. The 95th percentile for the horizontal and vertical lengths in cases of hernia orifice ≥ 3 cm were 9.6 cm and 7.0 cm, respectively, while it was 9.2 cm and 6.4 cm in cases of hernia orifice < 3 cm. We added 2 cm and 3 cm to the 95th percentile for the length and width of the MPO, resulting in 13.2 × 10.4 cm and 15.6 × 13.0 cm in cases with hernia orifice < 3 cm and ≥ 3 cm, respectively. Relapse after TEP occurred in 1 patient (0.2%).
CONCLUSION
The appropriate mesh size for TEP repair, derived from intraoperative MPO measurements, was estimated as 13.2 × 10.4 cm and 15.6 × 13.0 cm when the hernia orifice was < 3 cm and ≥ 3 cm, respectively. Using appropriate mesh sizes based on MPO measurement may reduce groin hernia recurrence after TEP.
Identifiants
pubmed: 32394174
doi: 10.1007/s00464-020-07616-2
pii: 10.1007/s00464-020-07616-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2126-2133Références
Lowham AS, Filipi CJ, Fitzgibbons RJ Jr, Stoppa R, Wantz GE, Felix EL, Crafton WB (1997) Mechanisms of hernia recurrence after preperitoneal mesh repair. Traditional and laparoscopic Ann Surg 225:422–431
pubmed: 9114802
Fruchaud H (1956) Anatomie chirurgicale des hernies de l’aine. G. Doin, Paris
Rath A, Bhatia P, Kalhan S, John S, Khetan M, Bindal V, Ali A, Singh R (2014) Endoscopic TEP inguinal hernia repair in the management of occult obturator and femoral hernias. Surg Laparosc Endosc Percutan Tech 24:375–377
doi: 10.1097/SLE.0b013e3182901509
Knook MT, van Rosmalen AC, Yoder BE, Kleinrensink GJ, Snijders CJ, Looman CW, van Steensel CJ (2001) Optimal mesh size for endoscopic inguinal hernia repair: a study in a porcine model. Surg Endosc 15:1471–1477
doi: 10.1007/s00464-001-0048-9
Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, de Lange D, Fortelny R, Heikkinen T, Kingsnorth A, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Miserez M (2009) European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 13:343–403
doi: 10.1007/s10029-009-0529-7
Bittner R, Montgomery MA, Arregui E, Bansal V, Bingener J, Bisgaard T, Buhck H, Dudai M, Ferzli GS, Fitzgibbons RJ, Fortelny RH, Grimes KL, Klinge U, Kockerling F, Kumar S, Kukleta J, Lomanto D, Misra MC, Morales-Conde S, Reinpold W, Rosenberg J, Singh K, Timoney M, Weyhe D, Chowbey P (2015) Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society). Surg Endosc 29:289–321
doi: 10.1007/s00464-014-3917-8
HerniaSurge G (2018) International guidelines for groin hernia management. Hernia 22:1–165
doi: 10.1007/s10029-017-1668-x
Fitzgibbons RJ Jr, Forse RA (2015) Clinical practice. Groin hernias in adults. N Engl J Med 19:756–763
doi: 10.1056/NEJMcp1404068
Ghariani W, Dougaz MW, Jerraya H, Khalfallah M, Bouasker I, Dziri C (2019) Recurrence Factors of Groin Hernia: a systematic Review. Tunis Med 97:619–625
pubmed: 31729732
Bandoh T, Shiraishi N, Yamashita Y, Terachi T, Hashizume M, Akira S, Morikawa T, Kitagawa Y, Yanaga K, Endo S, Onishi K, Takiguchi S, Tamaki Y, Hasegawa T, Mimata H, Tabata M, Yozu R, Inomata M, Matsumoto S, Kitano S, Watanabe M (2017) Endoscopic surgery in Japan: The 12th national survey(2012–2013) by the Japan Society for Endoscopic Surgery. Asian J Endosc Surg 10:345–353
doi: 10.1111/ases.12428
Bittner R, Arregui ME, Bisgaard T, Dudai M, Ferzli GS, Fitzgibbons RJ, Fortelny RH, Klinge U, Kockerling F, Kuhry E, Kukleta J, Lomanto D, Misra MC, Montgomery A, Morales-Conde S, Reinpold W, Rosenberg J, Sauerland S, Schug-Pass C, Singh K, Timoney M, Weyhe D, Chowbey P (2011) Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia [International Endohernia Society (IEHS)]. Surg Endosc 25:2773–2843
doi: 10.1007/s00464-011-1799-6
Wolloscheck T, Konerding MA (2009) Dimensions of the myopectineal orifice: a human cadaver study. Hernia 13:639–642
doi: 10.1007/s10029-009-0559-1
Miserez M, Alexandre JH, Campanelli G, Corcione F, Cuccurullo D, Pascual MH, Hoeferlin A, Kingsnorth AN, Mandala V, Palot JP, Schumpelick V, Simmermacher RK, Stoppa R, Flament JB (2007) The European hernia society groin hernia classification: simple and easy to remember. Hernia 11:113–116
doi: 10.1007/s10029-007-0198-3
Anitha B, Aravindhan K, Sureshkumar S, Ali MS, Vijayakumar C, Palanivel C (2018) The Ideal Size of Mesh for Open Inguinal Hernia Repair: A Morphometric Study in Patients with Inguinal Hernia. Cureus 10:e2573
pubmed: 29974028
pmcid: 6029728
Li J, Gong W, Liu Q (2019) Intraoperative adjunctive techniques to reduce seroma formation in laparoscopic inguinal hernioplasty: a systematic review. Hernia 23:723–731
doi: 10.1007/s10029-019-01903-1
Reddy VM, Sutton CD, Bloxham L, Garcea G, Ubhi SS, Robertson GS (2007) Laparoscopic repair of direct inguinal hernia: a new technique that reduces the development of postoperative seroma. Hernia 11:393–396
doi: 10.1007/s10029-007-0233-4