[Self-fixating Progrip implant used in the laparoscopic totally extraperitoneal technique for inguinal hernia repair]

Modern tension-free techniques have become standard for inguinal hernia repair. The most highly regarded minimally invasive technique is laparoscopic totally extraperitoneal hernioplasty (TEP) which results in shorter recovery, earlier return to normal activities and better quality of life as compared to open repair techniques. The aim of the study was to evaluate the effects of inguinal hernia management in a von Willebrand (type 2a) patient. For the first time in Poland a partially absorbant mesh with a self-fixating system was implanted in a completely extraperitoneal approach using laparoscopy (TEP technique).

The procedure used was typical for the method; two 5 mm ports and a 10 mm port for the camera were applied below the umbilical line. A 15 x 9 cm synthetic mesh was inserted through the 10 mm port and positioned preperitonealy to close the hernia ring. Substitution therapy was administered for 7 days to control factor VIII activity in plasma at a level of approximately 100% for the first 3 days and 70% until healing of the postoperative wound.

Surgery was uneventful with no postoperative complications. The patient was discharged from hospital within 7 days of suture removal. No hernia recurrence nor persisting pain were reported at follow-up examination 6 months after the procedure.

Synthetic mesh with a self-fixating system used in the TEP technique for inguinal hernia repair has been proved safe and fully effective.