Chapters authored
All-in-One Mesh Hernioplasty: A New Procedure for Inguinal Hernia Repair
Since the 1970s, when biocompatible meshes were introduced with the consequent decrease of recurrence, one of the priorities in inguinal hernia surgery was that of minimizing postoperative chronic pain. All technical variations, proposed during the past years in order to improve patient’s comfort, reported a variable incidence of chronic neuralgia. The procedure we describe, applicable to all cases of primary inguinal hernia, employs a smaller pre-cut single mesh that covers all weak areas of the inguinal canal and is enveloped in a fibro-cremasteric sheath, avoiding contact of the prosthesis with neural structures. The new procedure, already performed on 250 patients, aims to improve patients’ comfort and to reduce the incidence of chronic neuralgia.
Part of the book: Hernia Surgery and Recent Developments
Mesh Fixation Methods in Groin Hernia Surgery
No unanimous consent has been reached by surgeons in terms of a method for mesh fixation in laparoscopic and open surgery for inguinal hernia repair. Many different methods of fixation are available, and the choice of which one to use is still based on surgeons’ preferences. At present, tissue glues, sutures, and laparoscopic tacks are the most common fixating methods. In open technique, sutures have been the method of choice for their reduced costs and surgeons’ habits. Nevertheless, tissue glues have been demonstrated to be effective and safe. Similarly, tacks can be considered the most common means of fixation in laparoscopic hernia repair, but they are connected to a higher risk of complication and morbidity. In this chapter, we present these types of mesh fixation, their characteristics and potential risks, and advantages of their use.
Part of the book: Techniques and Innovation in Hernia Surgery