Recurrent Hernia Laparoscopic Repair



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Amit Kumar
1 year ago

Description

Described is a “double mesh” technique for performing laparoscopic re-do repairs of inguinal hernias. When doing this procedure, it is virtually impossible to take down the peritoneum due to incorporation of the old mesh. This technique is therefore done by using a simple onlay of dual Polypropylene/polyurethane mesh, covering the hernia defect and ensuring that sufficient staples are placed into the iliopubic tract. Proper recognition of neuroanatomy is essential. In order to prevent intestinal adhesions, a second patch of gortex is secured to the polypropylene. The Combi Mesh Plus is made of a monofilament polypropylene mesh with a special polyurethane treatment on one of its surfaces, with the effect of a double layer mesh, thinner and more manageable than other double layer meshes. The polyurethane surface, when placed in contact with the peritoneal cavity, has demonstrated a clear advantage in reducing the formation of intestinal adhesions with the prosthesis. Due to its polyurethane surface, the Combi Mesh Plus combines all the qualities of the classical ANGIOLOGICA polypropylene meshes with a unique ability to reduce adhesion formation. The Combi Mesh Plus is especially indicated for all types of ventral hernias or when treating large abdominal wall defects. In addition, it can be particularly useful when a direct closure of the abdomen can be difficult, as in reoperations, or risky, as in obese and chronic obstructive pulmonary disease patients.


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