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Preperitoneal Suction Technique to Secure the Proper Mesh Position During Laparoscopic Herniorrhaphy
Nobutoshi Soeta1, Takuro Saito, Fujio Ito
1Departments of *Surgery, Aizu Medical Center ‡Surgery, Fukushima Medical University †Department of Surgery, Iwase General Hospital, Fukushima, Japan.
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|November 22, 2016
Summary
A new preperitoneal cavity suction technique effectively confirms mesh placement during laparoscopic inguinal hernia repair (LIHR), reducing recurrence risk. This method aids in early detection and correction of mesh dislocation, improving patient outcomes.
Area of Science:
- Surgical Innovation
- Minimally Invasive Surgery
- Hernia Repair
Background:
- Mesh dislocation is a significant cause of recurrence in laparoscopic inguinal hernia repair (LIHR).
- Accurate mesh positioning is crucial for successful hernia repair outcomes.
- Current methods may not always guarantee optimal mesh placement visualization.
Purpose of the Study:
- To introduce and evaluate the efficacy of a novel "preperitoneal cavity suction technique" for confirming mesh position during LIHR.
- To assess the technique's ability to detect mesh dislocation during transabdominal preperitoneal approach (TAPP) procedures.
- To determine the potential of this technique in reducing TAPP-related complications.
Main Methods:
- Development of the "preperitoneal cavity suction technique" involving suction of CO2 and effusion via a lateral trocar.
- Application of the technique in adult patients undergoing elective LIHR by TAPP.
- Visualization of mesh placement through the peritoneum using the suction method.
Main Results:
- The technique was applied in 83 of 84 treated lesions, confirming appropriate mesh positioning in 98.8% (82 lesions).
- Mesh dislocation was detected in one case, allowing for intraoperative correction.
- No patient-reported pain or discomfort, no hematomas, and a mean hospitalization of 2.5 days were observed.
- No hernia recurrences were noted during a median follow-up of 15 months.
Conclusions:
- The "preperitoneal suction technique" is a valuable tool for detecting mesh dislocation during LIHR by TAPP.
- This method shows promise in enhancing the safety and effectiveness of laparoscopic inguinal hernia repair.
- The technique has the potential to decrease complications associated with the TAPP procedure.
