Mesh reconstruction of the myopectineal region following wide local excision for inguinofemoral tumors.

INTRODUCTION

Appropriate reconstruction following radical resection of sarcomas in the inguinofemoral region and the pelvis is essential to prevent the subsequent development of an incisional hernia. Simple soft-tissue coverage may not suffice, as resection often involves the removal of the flat muscles and the inguinal ligament. We propose a technique of extraperitoneal mesh placement to reconstruct the myopectineal orifice (MPO).

METHODS

In this paper, we present a technique of extraperitoneal mesh reconstruction of the myopectineal region and inguinal ligament following radical resection for inguinofemoral tumours. The short-term surgical outcome, long-term oncological outcomes, and the development of an incisional hernia were also retrospectively reviewed.

RESULTS

A total of 13 patients were included in the study from May 2017 to February 2025. In 11/13 patients, primary closure of the soft tissue defect was possible. In two patients, a local rotational flap was required for soft tissue coverage. In 11/13 patients, a polypropylene mesh was used. In two patients, a titanium-coated polypropylene mesh was used. For all patients, the mesh was placed in the extra-peritoneal plane. Regarding short-term complications, 4 patients developed a surgical site infection, and 2 developed a seroma. In terms of long term outcomes, only one patient was confirmed to have developed an incisional hernia.

CONCLUSION

This technique offers a simple, safe, cost-effective, and reproducible method for reconstructing the myopectineal orifice in patients undergoing radical resection of soft tissue tumors involving the inguinofemoral region, with the sacrifice of the inguinal ligament.