Background: This study's purpose was to examine the outcomes of the laparoscopic repair of large inguinoscrotal hernias with the combined use of a plug and flat mesh and to compare them to laparoscopic repair with the exclusive use of a flat mesh.
Case Series: Fifty male patients with large inguinoscrotal hernias underwent this procedure over two years. Twenty-five patients had a transabdominal preperitoneal (TAPP) hernia repair with the combined use of a plug and flat mesh, and 25 patients had TAPP repair using a flat mesh only. The novelty of this technique lies in the fact that after complete dissection of the hernia sack, a plug mesh is placed reversely, and its top edge is anchored onto the lower edge of the inguinal ligament with a standard fixation device. Next, a flat mesh is fixated, and the two meshes are sutured together with polypropylene sutures to form one combined mesh. One hernia recurrence was recorded during the follow-up period after the combined use of the plug and flat mesh. One patient developed a scrotal hematoma which was treated conservatively.
Conclusions: The laparoscopic repair of large inguinoscrotal hernias with the combined use of a plug and flat mesh is a safe and effective technique with excellent short-term outcomes. It is a simple modification of the standard TAPP procedure. The recurrence rate of large inguinoscrotal hernias is also believed to be reduced. HIPPOKRATIA 2021, 25 (1):38-41.
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