Amato Giuseppe, Romano Giorgio, Goetze Thorsten, Gordini Luca, Erdas Enrico, Medas Fabio, Calò Piergiorgio
Postgraduate School of General Surgery, University of Cagliari Cagliari, Italy.
Department of General Surgery and Emergency, University of Palermo, Palermo, Italy.
Surg Technol Int. 2017 Jul 25;30:175-181.
The fixation and the overlap of the mesh represent an open issue in incisional hernia repair. An exclusively designed prosthesis has been developed to assure a suture-free repair and a broader coverage of the abdominal wall. This study describes the long-term results of incisional hernia procedures carried out positioning a tentacle-shaped implant through a specifically developed surgical technique.
A proprietary symmetrically-shaped flat mesh constituted by a large central body with integrated radiating arms was used to repair incisional hernias in 68 patients. The prosthesis was placed in preperitoneal/retromuscular sublay. The friction of the straps passing through myotendineal structures of the abdomen was intended to assure an adequate grip to firmly hold the device in place with a broad overlap of the hernia defect in a fixation-free fashion. All tentacle straps were positioned through a special needle passer crossing the abdominal wall laterally from the defect borders then cut short in the subcutaneous layer.
In a long-term follow-up of 12 to 96 months (mean 58 months), 11 seromas occurred. No infections, hematomas, chronic pain, mesh dislocation, or recurrence have been reported.
The tentacle strap system of the prosthesis effectively ensured reduced skin incision and an easier implant placement avoiding the need for suturing the mesh. Regularly performed computed tomography (CT) and ultrasound (US) investigations proved that the arms of the implant ensured a proper orientation and stabilization of the mesh in association with a broad defect overlap. The specifically developed surgical procedure showed a quick postoperative recovery, a very low complication rate, and no recurrences, even in the long-term.
补片的固定和重叠是切口疝修补术中一个尚未解决的问题。已研发出一种专门设计的假体，以确保无缝合修补和更广泛地覆盖腹壁。本研究描述了通过一种专门开发的手术技术植入触手状植入物进行切口疝手术的长期结果。
使用一种专利的对称扁平补片，其由一个带有集成辐射臂的大中央主体构成，用于修复68例患者的切口疝。假体置于腹膜前/肌后间隙。穿过腹部肌腱结构的束带的摩擦力旨在确保充分的抓地力，以无固定方式通过疝缺损的广泛重叠将装置牢固地固定到位。所有触手束带均通过一种特殊的穿针器从缺损边缘横向穿过腹壁，然后在皮下层剪短。
在12至96个月（平均58个月）的长期随访中，发生了11例血清肿。未报告感染、血肿、慢性疼痛、补片移位或复发情况。
假体的触手束带系统有效地减少了皮肤切口，使植入更容易，无需缝合补片。定期进行的计算机断层扫描（CT）和超声（US）检查证明，植入物的臂确保了补片在与广泛的缺损重叠相关的情况下正确定向和稳定。专门开发的手术方法显示术后恢复快、并发症发生率极低，即使长期来看也无复发情况。
