Laparoscopic Inguinal Hernia Repair Using ProGrip™ Self-Fixating Mesh: Technical Learning Curve and Mid-Term Outcomes

Laparoscopic Inguinal Hernia Repair Using ProGrip™ Self-Fixating Mesh: Technical Learning Curve and Mid-Term Outcomes

Mellert Logan T; Cheung Maureen E; Zografakis John G; Dan Adrian G

Surgical Technology International

2019

2019-05

PURPOSE: Self-fixating mesh has been introduced to further improve the quality results already seen with laparoscopic inguinal hernia repair. An observational study was undertaken to evaluate the technical learning curve and mid-term outcomes associated with the use of ProGrip™ (Medtronic, Minneapolis, MN, USA) laparoscopic self-fixating mesh in transabdominal preperitoneal (TAPP) inguinal herniorrhaphy. METHODS: Patients who underwent elective laparoscopic TAPP inguinal herniorrhaphy by a single surgeon using ProGrip™ laparoscopic self-fixating mesh within a one-year period were studied. The primary outcome measures included the time from mesh introduction to the final position (MI-FP), surgical complications, and pain scores. Demographic and other perioperative outcome data were collected and analyzed. RESULTS: Forty hernias were repaired in 29 patients with a laparoscopic TAPP approach. The average MI-FP was 249.4 seconds for the first 20 repairs, and 118.6 seconds (p < 0.001) for the final 20. Minor post-operative surgical complications were reported by 13.8% of patients; there were no major surgical complications. The average pain score on a scale of 0 to 5 was 0.9 (SD = 0.67, range 0-3). CONCLUSIONS: Surgeons with reasonable laparoscopic experience can expect to become fully proficient in the manipulation of self-fixating mesh after 15 to 20 repairs. Use of this product yielded low intraoperative and mid-term postoperative complication rates as well as low postoperative pain.

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