A novel use of fully absorbable phasixtm mesh for laparoscopic inguinal hernia repair

Abstract

Background and Objectives: An inguinal hernia is usually repaired with synthetic nonabsorbable mesh, resulting in collagen formation, chronic inflammation, and fibrosis, with significantly reduced hernia recurrence. However, chronic pain may affect the quality of life. Poly-4-hydroxybutyrate (P4HB) mesh was introduced to minimize complications, and starts to degrade in 12–18 months. This study assesses the consequences and results of patients undergoing transabdominal pre-peritoneal (TAPP) inguinal hernia repair using P4HB mesh (Phasix™, C.R. Bard Inc., Murray Hill, NJ, USA). Methods: We performed a pilot study of laparoscopic TAPP repair for inguinal hernias using P4HB mesh in 15 patients (14 male and one female) with an average age of 55.8 y, and an average body mass index of 27.4 kg/m2. We assessed the recurrence rate and patients’ chronic pain for 30 months, with institutional review board approval (E-19–3735). The study was conducted from January 2016 to July 2017 in Medical City, King Saud University. We measured postoperative pain, re-actions, mesh sensation, discomfort, and recurrence. Results: In 15 patients, we encountered no recurrence or mesh sensation, except in one patient, who experienced mild chronic inguinal pain for one year, without activity restrictions. Conclusion: Laparoscopic TAPP inguinal hernia repair using P4HB mesh is safe for combined, direct (medial), and indirect (lateral) inguinal hernia, with no recurrence. P4HB absorbable mesh caused less chronic pain and dis-comfort. Longer follow-up, more patients and 15 patients repaired using synthetic mesh are necessary to assess the utility of P4HB for inguinal hernia repair globally.