Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Osaka University, 2-2 C11 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan.
Hernia. 2014 Aug;18(4):587-90. doi: 10.1007/s10029-013-1152-1. Epub 2013 Aug 10.
Surgical repair of symptomatic perineal hernia is challenging, especially via a perineal approach with limited exposure of the hernia sac. Furthermore, insecure fixation of autologous or synthetic materials to bony structures often results in recurrence. Here, we describe the application of a titanium mesh for perineal hernia repair.
We performed hernia repair with a thin titanium mesh via a perineal approach in three patients who developed secondary perineal hernia following abdominoperineal resection. After the hernia sac was isolated and dissected, the titanium mesh was molded and placed over the ischium and coccyx to support the pelvic floor.
No major complications occurred, and all three patients were free of recurrence at follow-up after 73, 109, and 6 months, respectively. The patients experienced slight pain in the perineal region when sitting, which resolved within 6 months.
Our successful preliminary results indicate that a titanium mesh is useful for perineal hernia repair by the perineal approach, as it can provide rigid support for the pelvic floor by its entire surface while ensuring stability without any fixation.
有症状的会阴疝的手术修复具有挑战性，特别是通过会阴入路进行修复时，疝囊的显露有限。此外，自体或合成材料与骨结构的不牢固固定通常会导致复发。在此，我们介绍了一种用于会阴疝修补的钛网的应用。
我们在 3 名接受腹会阴切除术后发生继发性会阴疝的患者中，通过会阴入路使用薄型钛网进行了疝修补。在分离和解剖疝囊后，将钛网成型并放置在坐骨和尾骨上，以支撑盆底。
无重大并发症发生，3 名患者分别随访 73、109 和 6 个月后均无复发。患者在坐位时会阴部有轻微疼痛，6 个月内缓解。
我们初步成功的结果表明，钛网通过会阴入路用于会阴疝修补是有用的，因为它可以通过整个表面为盆底提供刚性支撑，同时确保稳定性而无需任何固定。
