Femoral hernia repair with Bard Mesh Dart Plug

Several tension-free femoral hernia repair techniques are currently available with different approaches and prosthetic devices, all of which, however, largely yielding excellent results. The aim of this report was to describe the technical aspects of femoral hernia repair via an infrainguinal approach using the Bard Mesh Dart Plug, and to evaluate the short- and medium-term results in our experience. From May 2000 to December 2003, 25 patients (F/M ratio 2.1:1; mean age 66.4 years) underwent femoral hernia repair with the Bard Mesh Dart Plug. Fourteen patients (56%) were operated on as emergency cases for irreducible hernias and in 3 cases a bowel resection under general anaesthesia was necessary. The other 11 patients underwent surgery on an outpatient day surgery basis under local or spinal anaesthesia. Topical antibiotic prophylaxis was administered in all cases, while short-term prophylaxis with ceftazidime was limited to emergency patients. The main phases of the operation are described. The mean operative time was 40 minutes and the patients were mostly discharged within 2 hours of surgical treatment. No general or local intraoperative complications were registered. Postoperative mortality occurred in a single case (a 98-year-old woman, ASA IV, affected by strangulated hernia). Postoperative morbidity included 4 seromas and 1 haematoma. No recurrences were observed over a mean follow-up period of 24 months (range: 5-46 months). The femoral hernia repair with the Bard Mesh Dart Plug is a simple, safe, fast and effective procedure which can often be carried out in the day surgery setting. It can therefore be regarded as a valid alternative to other tension-free techniques.