Modified Implantation of Self-Adhesive Mesh in Laparoscopic Total Extraperitoneal Inguinal Hernia Repair.

Introduction: The self-adhesive mesh has become increasingly popular since its launch and has been proven to be reliable in laparoscopic hernia reparation. However, self-adhesive mesh may encounter unexpected adhesions during operation because one side of the mesh was covered with microgrips. Objective: Performing a modified technique of self-adhesive mesh implantation to avoid unexpected adhesions to the mesh itself and to the surrounding tissues in the operation space. Methods: We carried out a modified self-adhesive mesh implantation during May 2017 and March 2018. The modification was using a plastic membrane to cover the microgrips side of the mesh, and then rolling up the mesh to a cigarette shape. The mesh was inserted into the groin through a 10 mm trocar, and it was opened up with the membrane being removed meanwhile. Results: A total of 21 cases of laparoscopic total extraperitoneal inguinal hernia repair were successfully performed. The mesh could be conveniently put on the right place with no unexpected adhesions and the operation time was greatly shortened by using this modified technique. Conclusion: Putting a plastic membrane on the microgrips side of the self-adhesive mesh could avoid the mesh adhering itself when rolling up and could be easy to spread up the mesh in the operative field without unexpected adhesions, which simplified the surgical process and shortened the surgical duration.