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Mesh Plug Repair

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The Art of Hernia Surgery

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Abstract

Besides the Lichtenstein technique, the mesh plug repair (MPR) has demonstrated excellent results over the years, with recurrence, chronic pain, and quality of life rates comparable to Lichtenstein’s in most of the reported outcomes. MPR is a deep repair with the device laying in the pre-peritoneal space. The technique was originally proposed in the late 1980s by Gilbert and Trabucco and finally standardized by Rutkow, who introduced the first preformed plug (PerFix™). Since then, many 3D devices have been offered on the market, made with new materials and new profiles, to meet the current requirements of the hernia surgery and overcome criticisms addressed to this technique, such as the excessive use of foreign material and the risk of plug migration. In fact, choosing the proper plug besides paying attention to technical details can reduce migration that seems anyway very rare. Originally proposed for all groin hernias, MPR today should be indicated for the treatment of lateral, recurrent “internal,” and femoral hernias, according to a tailored management of inguinal hernia. MPR offers the fastest learning curve, the shortest operative time, and the lowest perceived difficulty among all the procedures for groin hernia repair. It should remain in the toolbox of all general surgeons.

To Davide Fieschi (1869–1953), the pioneer of open plug repair [1].

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Authors and Affiliations

  1. Abdominal Wall Surgery Unit, Department of Surgery, Sapienza University of Rome, Rome, Italy

    Francesco Gossetti, Linda D’Amore, Maria Romana Grimaldi, Francesca Ceci & Paolo Negro

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  1. Francesco Gossetti
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  2. Linda D’Amore
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  3. Maria Romana Grimaldi
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  4. Francesca Ceci
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  5. Paolo Negro
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Correspondence to Francesco Gossetti .

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  1. University of Insubria, Istituto Clinico, Sant’Ambrogio General Surgery Day Surgery, Milan, Italy

    Giampiero Campanelli

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Gossetti, F., D’Amore, L., Grimaldi, M.R., Ceci, F., Negro, P. (2018). Mesh Plug Repair. In: Campanelli, G. (eds) The Art of Hernia Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-72626-7_27

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