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Simplified preperitoneal Marlex hernia repair

M D Horton1, M G Florence

  • 1Department of Surgery, Swedish Medical Center/Seattle, Washington.

American Journal of Surgery
|May 1, 1993
PubMed
Summary
This summary is machine-generated.

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This study introduces a simplified preperitoneal mesh repair for inguinal hernias under local anesthesia. The technique offers a tension-free closure, quick recovery, and shows promising results with no recurrences in early follow-up.

Area of Science:

  • Surgical Innovation
  • Hernia Repair Techniques
  • Minimally Invasive Surgery

Background:

  • The Lichtenstein technique popularized mesh for inguinal hernia repair.
  • Preperitoneal mesh placement is appealing but traditional methods can be challenging under local anesthesia.
  • Laparoscopic approaches are increasing, suggesting preperitoneal mesh may become a standard.

Purpose of the Study:

  • To describe a simplified preperitoneal mesh repair for inguinal hernias performed under local anesthesia.
  • To evaluate the feasibility, safety, and early outcomes of this novel surgical approach.

Main Methods:

  • A simplified preperitoneal approach was used for the first 100 inguinal hernia repairs under local anesthesia.
  • The preperitoneal space was accessed directly through the posterior floor, ensuring coverage of direct, indirect, and femoral spaces.

Related Experiment Videos

  • Marlex mesh was placed, followed by a tension-free closure of the posterior floor.

    • Main Results:

    • Patients were discharged within 1-2 hours post-operation.
    • The average follow-up was 15 months, with no reported recurrences or infections.
    • One patient required reoperation for an arterial bleeder, but had no further issues; another experienced neuralgia, likely unrelated to the mesh.

    Conclusions:

    • This simplified preperitoneal mesh repair is a feasible and effective technique for inguinal hernias under local anesthesia.
    • The approach allows for tension-free repair, rapid recovery, and a potentially brief learning curve compared to laparoscopic methods.
    • Early results indicate a low complication rate and no recurrences, supporting its potential as a standard procedure.