Page 66 - World Journal of Laparoscopic Surgery

A Novel Technique Using Mesh to Repair a Recurrent Large Indirect Inguinoscrotal Hernia
and to avoid superior leverage of mesh by the cord structures, thus references
reducing the risk of recurrence.
Currently, evidence for a reduction in recurrence by the slit 1. Belyansky I, Tsirline VB, Klima DA, et al. Prospective, comparative
study of postoperative quality of life in TEP, TAPP, and modified
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mesh placement technique is inconclusive. There are only three Lichtenstein repairs. Ann Surg 2011;254(5):709–715. DOI: 10.1097/
studies comparing the outcomes of slit vs non-slit mesh during a SLA.0b013e3182359d07.
laparoscopic TAPP repair. 11,12,14 Although these studies failed to prove 2. Pawlak M, Tulloh B, de Beaux A. Current trends in hernia surgery in
an advantageous difference with slit mesh in terms of recurrence NHS England. AnnR Coll Surg Engl 2020;102(1):25–27. DOI: 10.1308/
rate, none of them are well designed randomised controlled trials. rcsann.2019.0118.
Leibl et al. suggested that some recurrences are associated 3. Saber A, Hokkam EN, Ellabban GM. Laparoscopic transabdominal
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with insufficient closure of the mesh slit. This may be due to two preperitoneal approach for recurrent inguinal hernia: A randomized
reasons. First, it has been well documented that mesh shrinkage is a trial. J Minim Access Surg 2015;11(2):123–128. DOI: 10.4103/0972-
9941.153809.
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major issue in laparoscopic hernia repair. It is generally recognized 4. Bracale U, Melillo P, Pignata G, et al. Which is the best laparoscopic
that intraperitoneally placed mesh will shrink up to 40% and lose its approach for inguinal hernia repair: TEP or TAPP? A systematic
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flexibility considerably, after five years. Second, gas insufflation of review of the literature with a network meta-analysis. Surg Endosc
the abdominal cavity is a crucial element in laparoscopic surgery 2012;26(12):3355–3366. DOI: 10.1007/s00464-012-2382-5.
which significantly expands the abdominal surface volume. The 5. Saber A, Ellabban GM, Gad MA, et al. Open preperitoneal versus
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shrinkage over time may therefore result in dislodgment of the cord BMC Surg 2012;12(1):22. DOI: 10.1186/1471-2482-12-22.
structure from the slit. Therefore, by anchoring the two trouser flaps 6. Campanelli G, Pettinari D, Nicolosi FM, et al. Inguinal hernia
recurrence: classification and approach. Hernia 2006;10(2):159–161.
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point is created. This fixation point anchors the mesh in a consistent 7. Simons MP, Aufenacker T, Bay-Nielsen M, et al. European Hernia
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despite the effects of mesh shrinkage. Moreover, this also refashions patients. Hernia 2009;13(4):343–403. DOI: 10.1007/s10029-009-
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evidence of spermatic cord injury caused by slit mesh reported. 18 inguinal hernia repair (TAPP): a single-center, case-matched study.
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Ho L Chong: https://orcid.org/0000-0001-8313-1791 mesh technique on testicular perfusion and volume in the early
Andrew N Wilson: https://orcid.org/0000-0003-0269-159X and late postoperative period of the totally extraperitoneal
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World Journal of Laparoscopic Surgery, Volume 14 Issue 1 (January–April 2021) 67