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A new technique to avoid unintentional adhesion while deploying ProGrip mesh and its utility in the laparoscopic repair of obturator hernia


1 Department of Surgery, Steel Memorial Muroran Hospital, Muroran, Hokkaido; Department of Surgery, Obihiro Kosei General Hospital, Obihiro, Japan
2 Department of Surgery, Obihiro Kosei General Hospital, Obihiro, Japan
3 Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Sapporo, Japan
4 Department of Surgery, Steel Memorial Muroran Hospital, Muroran, Hokkaido, Japan

Correspondence Address:
Jun Muto,
1-45, Chiribetsu-Cho, Muroran-Shi, Hokkaido
Japan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmas.JMAS_285_19

The ProGrip™ laparoscopic self-fixating mesh provides advantages such as low cost and reduced pain following tack-free fixation in laparoscopic hernia repair through a transabdominal preperitoneal approach. Obturator hernia repair needs adequate fixation around the hernial orifice without the use of tacking, and ProGrip™ mesh provides options for secure fixation. However, it is often difficult to adequately adjust the mesh placement to cover the obturator hernia orifice with a ProGrip™ mesh, due to adhesion of the grips to the surrounding tissues. We introduce our technique to avoid unintentional adhesion during ProGrip mesh repair and discuss its utility in the treatment of obturator hernias. We repaired seven obturator hernia lesions in five patients using this technique without any complications. The biggest advantage of our technique is that the position of the mesh can be adjusted after it is expanded, unless the sheet is completely removed, allowing the surgeons to fix the mesh without any unintended adhesion to surrounding tissue.


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    -  Muto J
    -  Murakawa K
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2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04