Publication:

Two mesh technique in lieu of single mesh in giant prosthetic reinforcement of the visceral sac for bilateral inguinal hernias

Background Posterior wall strengthening is the essential aim of Bilateral Inguinal hernia repair. The two methods for it are tissue repair and tension free repair. Tension free repair have become the gold standard. The preperitoneal repair for Bilateral Inguinal hernia is performed by wrapping the lower part of the parietal peritoneum with a large chevron shape polypropylene mesh.

Methods This study presents a modification of stoppas repair using a polypropylene mesh of size 15×9 cm to cover the myopectineal ostium of fruchaud on each side. The direct hernia sac was inverted with a purse string suture. Indirect hernia was opened and margins approximated with a 2-0 polyglycolic acid suture. No drainage was used.

Results Post-operative period was uneventful in all the patients. This new technique uses less post-operative time and the cost of surgery is reduced. There was one post-operative recurrence on one side only on follow up at one week, three weeks and three months.

Conclusions The use of two small size mesh covering both Fruchaud’s myopectineal orifices for bilateral inguinal hernia repair instead of a large size mesh is a promising technique. It saves the operative time and shortens the hospitalization time.