Self-gripping mesh in laparoscopic obturator hernia repair: clinical experience in a single institution

Abstract

Abstract Purpose: We propose a treatment strategy for obturator hernia repair using a self-fixating mesh. An obturator hernia is a relatively rare type of abdominal hernia with a high mortality rate, with surgery being the only treatment option. Various approaches to repairing obturator hernia using meshes and tackers have been proposed. Nonetheless, postoperative complications such as chronic inguinal pain and hemorrhage have been reported with tacker-fixated mesh approaches. Although the self-adhesive property of a self-fixating mesh enables tacker-less hernia repair, it is rarely used in inguinal hernia repair. Tacker-less repair reduces the likelihood of chronic pain development; however, the difficulty in handling the mesh in the abdominal cavity must be overcome. Methods: We have been using a self-fixating mesh (PG mesh; ProGrip™ laparoscopic self-fixating mesh) for obturator hernia repair since April 2020. In two cases preceding the introduction of the PG mesh for obturator hernia repair, we experienced difficulty attaching the PG mesh; nevertheless, we successfully performed obturator hernia repair by simplifying the method, using three steps, to attach the PG mesh. Results: Between April 2020 and October 2022, we encountered seven cases of obturator hernia. Of these cases, five were repaired using the PG mesh. Postoperatively, one patient had a small subcutaneous hematoma with no postoperative complications, including chronic pain and hemorrhage. The postoperative recovery time was not prolonged, and there was no recurrence of symptoms during the observation period. Conclusion: PG mesh appears to be suitable for obturator hernia repair.