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Mesh Fixation in Laparoscopic Repair of Ventral Hernia: A New MethodDepartment of Surgery, Vanderbilt University School of Medicine, Nashville, and NorthCrest Medical Center, Springfield, TN; 322 NorthCrest Drive, Springfield, TN 37172 sskmd{at}aol.com During laparoscopic repair of ventral hernia, optimal fixation of the prosthetic mesh to the abdominal wall includes transfascial fixation with sutures in addition to fixation with a stapling, clipping, or tacking device. With the current methods, intracorporeal passage grasping and retrieval of sutures from the abdominal cavity are technically difficult. The reason for this difficulty is the lack of three-dimensional visual feedback during conventional laparoscopy. An easier method is needed. A new method using T-shaped anchors (T-anchors) is described. A T-anchor is a horizontal bar made of rigid titanium that is attached to a vertical limb made of monofilament suture. T-anchors are deployed in pairs, through a needle, and are tied over a musculofascial bridge to achieve transfascial fixation of the mesh to the abdominal wall. This method eliminates the need for intracorporeal grasping and retrieval of the sutures.
Key Words: ventral hernia repair • laparoscopy • visual feedback • T-anchor
Surgical Innovation, Vol. 12, No. 2,
151-154 (2005) |
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