V-Loc, a new wound closure device for peritoneal closure--is it safe? A comparative study of different peritoneal closure systems.

Background: Transabdominal laparoscopic hernia repair is a safe and commonly used procedure for groin hernias. Failure of peritoneal closure is rare but can lead to herniation and bowel obstruction. A new wound closure device named V-Loc was tested in this study.

Tensile strength and adhesion formation of mesh fixation systems used in laparoscopic incisional hernia repair.

Background: Mesh tearoff from the tissue is the most common reason for hernia recurrence after hernia surgery involving the use of a synthetic mesh. Various fixation systems were critically compared in terms of their retention strength and the formation of adhesions.

Methods: In a prospective study with 25 Sprague-Dawley rats, two pieces of Parietex composite meshes measuring 2 x 3 cm were fixed intraperitoneally in a paramedian location.

Clinically diagnosed groin hernias without a peritoneal sac at laparoscopy--what to do?

Background: Groin or femoral hernias may be concealed behind intact peritonea when the laparoscopic transabdominal preperitoneal (TAPP) mesh technique is used. The aim of this study was to determine the causes, frequency, and surgical procedures in cases of clinically diagnosed hernias without peritoneal defects.

Methods: A prospective controlled study comprising 1795 consecutive patients undergoing 2190 laparoscopic TAPP herniorraphies was conducted.

Anatomical changes after inguinal hernia treatment: a reason for chronic pain and recurrent hernia?

Background: Chronic pain and hernia recurrence are the most frequent long-term complications of treating inguinal hernia. One reason may be postsurgical changes in the anatomy of the groin.

Methods: In a retrospective investigation from 1994 to 2008, 1,194 patients undergoing 1,421 laparoscopic transabdominal preperitoneal (TAPP) herniorrhaphies were studied.

Comparison of a new self-gripping mesh with other fixation methods for laparoscopic hernia repair in a rat model.

Background: Microhooks are small structures on the surface of the Progrip (PG; Sofradim Corp) mesh to ensure its anchorage in tissue. Additional fixation is not required. The aim of this animal study was to compare the strength of incorporation, foreign body reaction, and changes in material after implantation of this novel mesh with the current fixation alternatives, namely the hernia stapler (HS) and fibrin glue (FG).

Biomechanical properties of lightweight versus heavyweight meshes for laparoscopic inguinal hernia repair and their impact on recurrence rates.

Background: Laparoscopic inguinal hernia repair can be performed using light- or heavyweight meshes. Apart from the size of the mesh, its friction coefficient (mu(0)) and flexural stiffness are of crucial importance to avoidance of hernia recurrence.

Methods: In the current biomechanical study, tensile tests were performed to determine the ultimate tensile strength and modulus of elasticity of six lightweight meshes and six heavyweight meshes for laparoscopic inguinal hernia repair.

Preliminary results with the reinforced tension line: a new technique for patients with ventral abdominal wall hernias.

Background: After median laparotomy, excessive horizontal tensile forces on the suture base or scar tissue lead to incisional hernias or recurrent hernias. Our new suture technique, known as reinforced tension line (RTL), allows peak tensile forces to be distributed from the suture base to the surrounding tissue through a longitudinal suture, thereby preventing the suture from cutting through the tissue.

Methods: From April 2002 to April 2005, the RTL technique was used to treat 103 patients with ventral abdominal wall hernias > or = 3 cm in size.