Muto Jun, Murakawa Katsuhiko, Yamamoto Hiroyuki, Poudel Saseem, Sato Shoki, Kato Kohei, Senmaru Naoto, Ono Koichi
Department of Surgery, Steel Memorial Muroran Hospital, Muroran, Hokkaido; Department of Surgery, Obihiro Kosei General Hospital, Obihiro, Japan.
Department of Surgery, Obihiro Kosei General Hospital, Obihiro, Japan.
J Minim Access Surg. 2021 Jan-Mar;17(1):116-119. doi: 10.4103/jmas.JMAS_285_19.
The ProGrip™ laparoscopic self-fixating mesh provides advantages such as low cost and reduced pain following tack-free fixation in laparoscopic hernia repair through a transabdominal preperitoneal approach. Obturator hernia repair needs adequate fixation around the hernial orifice without the use of tacking, and ProGrip™ mesh provides options for secure fixation. However, it is often difficult to adequately adjust the mesh placement to cover the obturator hernia orifice with a ProGrip™ mesh, due to adhesion of the grips to the surrounding tissues. We introduce our technique to avoid unintentional adhesion during ProGrip mesh repair and discuss its utility in the treatment of obturator hernias. We repaired seven obturator hernia lesions in five patients using this technique without any complications. The biggest advantage of our technique is that the position of the mesh can be adjusted after it is expanded, unless the sheet is completely removed, allowing the surgeons to fix the mesh without any unintended adhesion to surrounding tissue.
ProGrip™腹腔镜自固定补片具有诸多优势，例如成本低，且在经腹腹膜前入路的腹腔镜疝修补术中采用无钉固定后疼痛减轻。闭孔疝修补术需要在疝孔周围进行充分固定且不使用钉合，而ProGrip™补片提供了可靠固定的选择。然而，由于补片的固定装置与周围组织粘连，使用ProGrip™补片时往往难以充分调整补片位置以覆盖闭孔疝孔。我们介绍了在ProGrip补片修补过程中避免意外粘连的技术，并讨论了其在闭孔疝治疗中的实用性。我们使用该技术为5例患者修复了7处闭孔疝病变，未出现任何并发症。我们技术的最大优势在于，除非补片完全移除，否则在其展开后可调整补片位置，使外科医生能够固定补片而不会与周围组织发生任何意外粘连。
