Surgical Results With the ONSTEP Technique Using OnFlex Mesh for Inguinal Hernias: Case Series With Treating 986 Lesions.

Abstract

The ONSTEP technique is a surgical repair method that uses an anterior approach for inguinal hernias. It is a new surgical technique that spans layers in which the medial side of the mesh is inserted into the peritoneal cavity, and the lateral side is positioned over the internal oblique muscle. Previous reports on this technique have mentioned the use of PolySoft Hernia Patch mesh; however, there have been no reports of surgical outcomes using OnFlex Mesh with absorbent rings. The authors evaluate the results of the ONSTEP technique using OnFlex Mesh. In 2017, this technique was introduced as an outpatient surgical procedure at our institution. In the past 3 years, it has been performed in 941 patients to repair 986 lesions. Recurrences were observed in only 1 patient (0.10%), and complications included subcutaneous hemorrhage in 21 patients, hematoma in 10, seroma in 9, wound infection in 4, and mesh infection in 1. No serious events, such as postoperative ileus, chronic pain, or bladder injury, were observed. Because this technique does not require a procedure to detach the lateral preperitoneal space, the duration of surgery was 27±8 min, which was shorter than other transinguinal preperitoneal repair techniques. The ONSTEP technique using OnFlex Mesh is a simple and safe repair method that can be performed as an outpatient surgical procedure. Although there is still a need to wait for long-term results, favorable short-term to medium-term results have been obtained.