PAHA POLYPROPYLENE MESH

Hernia repair is a common surgical procedure where polypropylene mesh is extensively used to reinforce and support weakened or damaged tissue. The mesh provides a scaffold that allows tissue to grow into it, strengthening the repair. Here's a detailed overview of its use in hernia repair:

Open Hernia Repair

1. Tension-Free Repair:

• Procedure:
  • The surgeon makes an incision directly over the hernia site.
  • The herniated tissue is pushed back into the abdominal cavity.
  • A flat piece of polypropylene mesh is placed over the defect in the abdominal wall.
  • The mesh is then secured with sutures, staples, or tacks to the surrounding healthy tissue, without pulling the tissue together under tension.
• Advantages:
  • Reduced tension on the tissues, leading to less postoperative pain.
  • Lower risk of hernia recurrence compared to tension-based repairs.
  • Often performed under local or regional anesthesia.

2. Plug and Patch Technique:

• Procedure:
  • The surgeon makes an incision over the hernia site.
  • The herniated tissue is repositioned into the abdominal cavity.
  • A cone-shaped piece of mesh, known as a plug, is inserted into the hernia defect.
  • A flat piece of mesh, known as a patch, is then placed over the defect and secured.
• Advantages:
  • Provides robust support by addressing both the hernia defect and the surrounding area.
  • Suitable for various types of hernias, including inguinal and femoral hernias.

Laparoscopic Hernia Repair

1. Transabdominal Preperitoneal (TAPP):

• Procedure:
  • Performed under general anesthesia.
  • The surgeon makes small incisions in the abdominal wall and inserts a laparoscope (a thin tube with a camera).
  • The abdominal cavity is inflated with carbon dioxide gas to create space.
  • The hernia sac is identified, and the herniated tissue is pushed back into the abdominal cavity.
  • A piece of polypropylene mesh is placed over the hernia defect from inside the abdominal cavity.
  • The mesh is secured using tacks, sutures, or adhesive.
  • The peritoneum (the lining of the abdominal cavity) is then closed over the mesh.
• Advantages:
  • Minimally invasive, leading to smaller incisions and reduced postoperative pain.
  • Shorter recovery time and quicker return to normal activities.
  • Allows for the repair of bilateral hernias in the same procedure.

2. Totally Extraperitoneal (TEP):

• Procedure:
  • Performed under general anesthesia.
  • The surgeon makes small incisions near the hernia site and inserts a laparoscope.
  • The space between the abdominal wall and the peritoneum is inflated with carbon dioxide gas.
  • The hernia sac is identified, and the herniated tissue is repositioned.
  • A piece of polypropylene mesh is placed between the abdominal wall and the peritoneum, covering the hernia defect.
  • The mesh is secured in place using tacks or sutures.
  • The peritoneum remains intact, and no entry into the abdominal cavity occurs.
• Advantages:
  • Minimally invasive with a lower risk of injury to intra-abdominal organs.
  • Reduced postoperative pain and quicker recovery.
  • Decreased risk of adhesion formation and bowel obstruction compared to TAPP.