[Repair of inguinal hernia by properitoneal positioning of an ePTFE soft patch (112 patches--75 patients)]

Abstract

From January 1987 to December 1991, 112 ePTFE patches were inserted in properitoneal sites in 75 patients by median (61 patients) or inguinal (14 patients) approach to cure inguinal hernias. The hernia was direct or combined in 60 patients, bilateral in 37 patients and recurrent in 37 patients. These 75 patients accounted for 19.7% of the 380 patients treated for hernia during the same period. Complications occurred in 5 patients, 3 of whom needed a second operation: 2 periprosthetic seromas, 2 femoral nerve irritations and one periprosthetic infection which resolved after treatment without patch removal. No patch was removed. Ninety three percent of the patients had an uneventful postoperative recovery. All patients were followed (range: 4 months-5 years) for an average of 28 months; 88% for one year or more. There were 3 recurrences which healed after reoperation. No late infection of sinus occurred. One patient complained of severe pain without any attributable cause. One patient had femoral hypoesthesia, 7 others suffered slight intermittent pain without any local complication. Discomfort in these 8 cases was very mild. Sixty-eight patients (91%) rated the result of their surgery as good or excellent. This clinical study confirms the biomechanical properties of ePTFE and demonstrates that, in comparison with mesh of equal strength, the infection rate and its severity would be decreased with ePTFE soft tissue patch.