Laparoscopic repair of boundary incisional hernia in a kidney transplanted patient. A safe tacks-fibrin glue combined mesh fixation technique

Maffongelli, A.

Research output: Contribution to journalArticle

Abstract

Introduction Incisional hernia in renal transplant patients is a complication that affects negatively the global outcome of transplant and the quality of life. The repair of this condition was classically made by open repair with mesh. Increasing evidences suggest that laparoscopic repair could be advocated as the technique of choice in these patients with optimal results. However the fixation of mesh should be performed by a mixed combination of fibrin sealant (lateral margin of wall defect) and tacks (medial margin). The tacks fixation of the mesh along the lateral margin of the wall defect, close to the graft, is generally difficult for the small size of the remaining aponeurotic plane, and dangerous for the underlying presence of the graft. Materials and Methods a case of incisional hernia in a kidney transplant recipient was repaired by laparoscopic mesh technique. The polypropylene-polyglycolic acid (PGA) composite mesh was fastened with a mixed technique of absorbable tacks for medial margin of the defect and fibrin sealant for the lateral side in contiguity with graft surface. Results The patient was discharged after 4 days. The 6 months follow-up did not show mesh displacement or recurrence of hernia. Conclusions The laparoscopic mesh repair may become the gold standard for kidney transplant patients affected by incisional hernia. The difficulties of mesh fixation close to the graft can be overcome by the combination of fibrin sealant glue and absorbable tacks at different margins of the wall defect. This technique may offer advantages for this population of patients.
Original languageEnglish
Pages (from-to)215-219
Number of pages5
JournalTransplantation Proceedings
Volume51
Publication statusPublished - 2018

Cite this

@article{3527ff8d60bd4d2886206cd0e8240280,
title = "Laparoscopic repair of boundary incisional hernia in a kidney transplanted patient. A safe tacks-fibrin glue combined mesh fixation technique",
abstract = "Introduction Incisional hernia in renal transplant patients is a complication that affects negatively the global outcome of transplant and the quality of life. The repair of this condition was classically made by open repair with mesh. Increasing evidences suggest that laparoscopic repair could be advocated as the technique of choice in these patients with optimal results. However the fixation of mesh should be performed by a mixed combination of fibrin sealant (lateral margin of wall defect) and tacks (medial margin). The tacks fixation of the mesh along the lateral margin of the wall defect, close to the graft, is generally difficult for the small size of the remaining aponeurotic plane, and dangerous for the underlying presence of the graft. Materials and Methods a case of incisional hernia in a kidney transplant recipient was repaired by laparoscopic mesh technique. The polypropylene-polyglycolic acid (PGA) composite mesh was fastened with a mixed technique of absorbable tacks for medial margin of the defect and fibrin sealant for the lateral side in contiguity with graft surface. Results The patient was discharged after 4 days. The 6 months follow-up did not show mesh displacement or recurrence of hernia. Conclusions The laparoscopic mesh repair may become the gold standard for kidney transplant patients affected by incisional hernia. The difficulties of mesh fixation close to the graft can be overcome by the combination of fibrin sealant glue and absorbable tacks at different margins of the wall defect. This technique may offer advantages for this population of patients.",
author = "{Maffongelli, A.} and {Lo Monte}, {Attilio Ignazio} and Giuseppe Buscemi and Giuseppe Damiano and Palumbo, {Vincenzo Davide} and Silvia Ficarella and Salvatore Buscemi and Salvatore Fazzotta",
year = "2018",
language = "English",
volume = "51",
pages = "215--219",
journal = "Transplantation Proceedings",
issn = "0041-1345",
publisher = "Elsevier USA",

}

TY - JOUR

T1 - Laparoscopic repair of boundary incisional hernia in a kidney transplanted patient. A safe tacks-fibrin glue combined mesh fixation technique

AU - Maffongelli, A.

AU - Lo Monte, Attilio Ignazio

AU - Buscemi, Giuseppe

AU - Damiano, Giuseppe

AU - Palumbo, Vincenzo Davide

AU - Ficarella, Silvia

AU - Buscemi, Salvatore

AU - Fazzotta, Salvatore

PY - 2018

Y1 - 2018

N2 - Introduction Incisional hernia in renal transplant patients is a complication that affects negatively the global outcome of transplant and the quality of life. The repair of this condition was classically made by open repair with mesh. Increasing evidences suggest that laparoscopic repair could be advocated as the technique of choice in these patients with optimal results. However the fixation of mesh should be performed by a mixed combination of fibrin sealant (lateral margin of wall defect) and tacks (medial margin). The tacks fixation of the mesh along the lateral margin of the wall defect, close to the graft, is generally difficult for the small size of the remaining aponeurotic plane, and dangerous for the underlying presence of the graft. Materials and Methods a case of incisional hernia in a kidney transplant recipient was repaired by laparoscopic mesh technique. The polypropylene-polyglycolic acid (PGA) composite mesh was fastened with a mixed technique of absorbable tacks for medial margin of the defect and fibrin sealant for the lateral side in contiguity with graft surface. Results The patient was discharged after 4 days. The 6 months follow-up did not show mesh displacement or recurrence of hernia. Conclusions The laparoscopic mesh repair may become the gold standard for kidney transplant patients affected by incisional hernia. The difficulties of mesh fixation close to the graft can be overcome by the combination of fibrin sealant glue and absorbable tacks at different margins of the wall defect. This technique may offer advantages for this population of patients.

AB - Introduction Incisional hernia in renal transplant patients is a complication that affects negatively the global outcome of transplant and the quality of life. The repair of this condition was classically made by open repair with mesh. Increasing evidences suggest that laparoscopic repair could be advocated as the technique of choice in these patients with optimal results. However the fixation of mesh should be performed by a mixed combination of fibrin sealant (lateral margin of wall defect) and tacks (medial margin). The tacks fixation of the mesh along the lateral margin of the wall defect, close to the graft, is generally difficult for the small size of the remaining aponeurotic plane, and dangerous for the underlying presence of the graft. Materials and Methods a case of incisional hernia in a kidney transplant recipient was repaired by laparoscopic mesh technique. The polypropylene-polyglycolic acid (PGA) composite mesh was fastened with a mixed technique of absorbable tacks for medial margin of the defect and fibrin sealant for the lateral side in contiguity with graft surface. Results The patient was discharged after 4 days. The 6 months follow-up did not show mesh displacement or recurrence of hernia. Conclusions The laparoscopic mesh repair may become the gold standard for kidney transplant patients affected by incisional hernia. The difficulties of mesh fixation close to the graft can be overcome by the combination of fibrin sealant glue and absorbable tacks at different margins of the wall defect. This technique may offer advantages for this population of patients.

UR - http://hdl.handle.net/10447/355276

M3 - Article

VL - 51

SP - 215

EP - 219

JO - Transplantation Proceedings

JF - Transplantation Proceedings

SN - 0041-1345

ER -