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Review
. 2022 Apr 22;8(5):e09320.
doi: 10.1016/j.heliyon.2022.e09320. eCollection 2022 May.

Avoiding migration at open mesh plug inguinal hernioplasty

Affiliations
Review

Avoiding migration at open mesh plug inguinal hernioplasty

Charlotte Brown et al. Heliyon. .

Abstract

The open repair of groin hernias is often augmented with prosthetic biomaterials (mesh) as this favours a lower recurrence rate. The use of such prostheses may be associated with various complications including migration the frequency of which is unclear. A 29-year review of this complication after mesh plug hernioplasty is undertaken and technical advice described to avoid this.

Keywords: Mesh complications; Open mesh plug inguinal hernioplasty; Plug migration.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A moist sponge is pressed into the perperitoneal plane of the hernial defect (left indirect). The key point is recognition of the glistening darker yellow preperitoneal fat. The ‘cavity’ for the MP may be enlarged, if necessary, by further blunt dissection to accommodate the flattened prosthesis.
Figure 2
Figure 2
Gentle stretching flattens the outer petals of the MP to increase the cross-sectional area of the sublay component before placement in the ‘cavity’ in the perperitoneal plane. [Reprinted with permission from SpringerNature: Hernia. Groin symptoms 5-7 years after a ‘modified’ plug and patch inguinal hernioplasty. Bhattacharjee A, Jayamanne H, Evans MD, Stephenson BM. 2010].
Figure 3
Figure 3
The stretched and flattened sublay component now augments a greater area of the defect (lower panel). [Reprinted with permission from SpringerNature: Hernia. Groin symptoms 5-7 years after a ‘modified’ plug and patch inguinal hernioplasty. Bhattacharjee A, Jayamanne H, Evans MD, Stephenson BM. 2010].
Figure 4
Figure 4
The inner petals (coloured here) are anchored circumferentially to the well defined defect.

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