A bilayer patch device for inguinal hernia repair

A new bilayer device was used in 759 patients to repair inguinal hernias at the Hernia Institute of Florida. All but three procedures were done under local or regional anesthesia, and all patients were ambulatory. Results are encouraging, though the time these patients have been followed is short. There has not been a failure noted or reported. Minor postoperative complications, consistent with rates of other open hernia repair procedures, have occurred. The unique feature of this polypropylene mesh device is that it has three attached components. Its underlay patch provides a posterior mesh repair. Its connector has the desirable attributes of a plug repair. Its onlay patch covers the posterior wall, well lateral to the internal inguinal ring. A few sutures in the onlay patch assure the stability of the entire three-part, one-piece device. A description of the myopectineal orifice and commentary of its significance is presented. One purpose of publishing this early report is to share with other surgeons some personal observations that can help to simplify technique of dissection of the posterior space, and the deployment of the underlay patch.