Bilateral Inguinal Hernioplasty Using the Hernia Sac for Posterior Wall Reinforcement
DOI:
https://doi.org/10.34635/rpc.1107Keywords:
Hernia, Inguinal/surgery, Herniorrhaphy, Polypropylenes, Surgical MeshAbstract
Inguinal hernioplasty is among the most frequently performed surgical procedures. The recurrence and complication rates have prompted continuous investigation into alternative techniques and materials. We aimed to report the case of a 67-year-old male patient who underwent bilateral inguinal hernioplasty utilizing a flap from the hernia sac for posterior wall reinforcement. The use of synthetic meshes, particularly polypropylene mesh introduced in the 1950s, has become widespread, especially in laparoscopic and complex hernia repairs. Despite advances, complications related to mesh use persist. An alternative for repairing indirect inguinal hernias is to use the peritoneal tissue from the hernia sac. Being autologous, it minimizes the risks of rejection or other adverse reactions. Peritoneal tissue can be effectively used to reinforce the posterior wall in inguinal hernia repairs, including cases involving large hernias.Downloads
References
Amaral DO, Silva JE, Silva LM, Carnesi FL, Penhavel FA, Melo RM. Emergency admissions for inguinal hernia in Brazil from 2010 to 2019: mortality and costs in the public health system. ABCD Arch Bras Dig Surg. 2023;36:e1738. doi:10.1590/0102-672020230020e1738.
Hidalgo NJ, Guillaumes S, Bacherol, Butori E, Expert JJ, Ginestà C, et al. Bilateral inguinal hernia repair by laparoscopic totally extrapentioned (TEP) vs. laparoscopic transabdominal preperitoneal (TAPP). BMC Surg. 2023;23:270. doi:10.1186/s12893-023-02177-2.
Chibataki, Daronch OT. Postoperative risk assessment of complications in inguinal hernioplasty and their association with risk factors. Rev Assoc Med Bras. 2020;66:623-9. doi:10.1590/1806-9282.66.5.623.
Messias BA, Almeida PL, Ichinose TMS, Mocchetti ER, Barbosa CA, Waisberg J, et al. Is the Lichtenstein technique properly used in inguinal hernia repair? National analysis and surgical technique review. Rev Col Bras Cir. 2023;50:e20233655. doi:10.1590/0100-6991e-20233655.
Cunha-e-Silva JA, Oliveira PG, Oliveira L, Silva J, Silva R, Silva A, et al. Conventional inguinal herniorrhaphy with self-fixating mesh versus totally extrapentional laparoscopic repair with polypropylene mesh: early postoperative results. Rev Col Bras Cir. 2017;44:238-44. doi:10.1590/0100-69912017003003.
Kumar HR. The current status of open inguinal hernia repair in adults: a narrative review. Asian J Med Health. 2024;22:142-5.
Rasador AC, da Silveira CA, Lima DL, Nogueira R, Malcher F, Sreearanaju P, et al. Mesh versus future for elective primary umbilical hernia open repair: a systematic review and meta-analysis. Hernia. 2024;28:2069-78. doi:10.1007/s10029-024-03106-9.
Sester E, Wilgaard T, Ware H, Holtedahl KH, Glomasker T, Johannessen HO, et al. Mesh versus non-mesh for emergency groin hernia repair. Cochrane Database Syst Rev. 2023;12:CDOI5160. doi:10.1002/14651858.CDOI5160.pub2.
Sanderson R, De-Marchi DD, Cesario JC, Sanderson LG, Zilberstein B. Quality of life using EURAHS-QoL scores after surgical treatment of inguinal hernia: transabdominal preperitoneal (TAPP) and Lichtenstein laparoscopic techniques. ABCD Arch Bras Dig Surg. 2024;37:e1798. doi:10.1590/0102-672020240005e1798.
Laizo A, Silva Neto JG, Silva Júnior JG. Histology of hernia sacs in inguinal hernia in adults and children: presence of smooth muscle fibers and their relation to blood vessels. Rev Col Bras Cir. 2009;36:323-6. doi:10.1590/S0100-69912009000400009.
Tian XJ, Wang XM, Lei YH, Wang DC, Wei J, Fu ZJ, et al. The role of prophylactic antibiotics in elective inguinal tension-free hernia repair: A systematic review and meta-analysis. Int Wound J. 2023;20:1191-204. doi:10.1111/iwj.13978.
Laizo A, Terzella MR, Rinco EA, Lázaro da Silva A. Surgical technique for inguinal hernia repair using the hernia sac as posterior wall reinforcement. Rev Port Cir. 2015;33:21-24.
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