Groin hernias are a common surgical problem, and the search for a perfect surgical repair is ongoing. It is now widely accepted that the use of a tension-free mesh is superior to sutured repair in reducing hernia recurrence. The development of key-hole approaches to groin hernia repair has been an area of great interest in research over the last decade. In 2003 a large research study comparing key-hole versus open repair and found that the key-hole approaches were superior in terms of postoperative pain, numbness, hematoma, infection, reduced surgery time, faster recovery, and return to work. Recurrence rates were found to be similar and very low.
After years of studying this important research Dr Ozmen recommends a laparoscopic (key-hole) approach for the following: first time groin hernias; recurrent hernias (if the primary repair was open); any groin hernia in a woman; and hernias in men who are young and active or who have pain as a predominant symptom of their hernia. Although using a laparoscopic approach has been shown to significantly reduce the risk of persistent postoperative pain and numbness, recent studies have shown that these symptoms can occur in up to 10% of patients. The reason for this is thought to be due to the use of tacks, staples, or stitches to secure the mesh or repair the hernia. Glue is an alternative which has shown a reduction in postoperative pain rates, however, glue is very expensive and its regular use by surgeons is likely to lead to higher costs for health funds and higher premiums for patients.
In an effort to reduce postoperative discomfort, reduce costs, and maintain a low recurrence rate Dr Ozmen uses a self-gripping mesh called Parietex Progrip for his patients’ hernia repairs. This lightweight polyester mesh is self-gripping and partially reabsorbed. It consists of two components: a hydrophilic, monofilament polyester, which provides rapid and effective tissue in-growth, and an absorbable polylactic acid gripping system. The monofilament composition and the large pore size of the mesh are thought to reduce inflammation caused by the mesh and helps the mesh integrate better into the patient’s body. The gripping system consists of over 4000 very small grips giving the mesh self-adhesive properties. The grips are biodegradable and when the tissue grows into the mesh the grips break down leading to a reduction in inflammation.
In the past, Dr Ozmen has had extensive experience using Progrip mesh in open hernia repairs, producing excellent results comparable to traditional mesh with a low pain and recurrence profile. Since November 2011, Dr Ozmen began using the self-gripping Progrip mesh for keyhole groin hernia repairs with excellent results and patient satisfaction.
He has co-authored two research papers on the use of Progrip mesh in laparoscopic groin hernia repair which can be downloaded below:
Left groin dissection showing a direct inguinal hernia.
Following repair with Progrip mesh.