BJS-03 DO WE NEED FIXATION OF THE MESH IN LAPAROENDOSCOPIC TECHNIQUES FOR M3 INGUINAL DEFECTS? AN EXPERIMENTAL STUDY

Abstract

Abstract Background Hernia societies strongly recommend fixing the mesh in case of large M3 defects in laparoendoscopic repairs. The purpose is to reduce recurrence, which is alarmingly high for this defect. The authors conducted a research experiment to verify the hypothesis that it is possible to preserve the mesh in the operating field in large direct hernias (M3) without the need to use fixing materials. Method Authors conducted an experiment with scientists from Universities of Technology in a model that reflects the conditions in the groin area. By simulating conditions of the highest possible intra-abdominal pressure, they examined the mesh behavior within the groin and its ability to dislocate under the forces generated by this pressure. The experiment involved six spatial implants and one flat macroporous mesh. Results Heavyweight spatial meshes and lightweight spatial individualized mesh showed no tendency to dislocate or move directly to the gate, which was considered a rapid hernia recurrence. Lightweight Meshes, both spatial and flat, underwent significant migration and shifting towards the hernial gates. Conclusion Based on the results, we believe that mesh fixation is not the only alternative to preventing recurrence in complex defects. Similar effects can be achieved by using a larger, more rigid and anatomically fitted implant. The type of implant (rather than its fixation) seems to be a key factor from the point of view of mechanics and biophysics. Clinical trials confirming the results in vivo, will allow to supplement or amend the guidelines for the treatment of large inguinal hernias.