Fixation free laparoscopic obliteration of inguinal hernia defects with the 3D dynamic responsive scaffold ProFlor

Abstract

Laparoscopic TAPP/TEP approaches are well-established options for the cure of inguinal hernias. As in the open approach, mesh fixation and poor-quality biologic response represent controversial questions and are a source of concerns. Furthermore, hernia defect patency represents another problem which seems not well acknowledged among surgeons. These problems are considered the cause of frequent intra and postoperative complications. To overcome these concerns, recently a different concept of cure has emerged. Based on a newly developed dynamic responsive 3D scaffold named ProFlor, a permanent hernia defect obliteration has been finalized. Following its inherent centrifugal expansion due to its dynamic responsivity, this hernia device is positioned fixation free within the defect and induces a probiotic biological response allowing for the re-establishment of the degenerated inguinal barrier. A laparoscopic approach with the 3D scaffold has been tested on 71 patients to demonstrate its effectiveness in reducing intra and postoperative complications. The operated patients presented with bilateral and/or recurrent inguinal hernia. Overall, 122 hernia defects were obliterated with 119 dynamic responsive scaffolds. The procedures were carried out from January 2018 to January 2022 with a defined protocol and detailed procedural steps. The laparoscopic technique with the 3D hernia scaffold allowed for fixation free placement, permanent defect obliteration and dynamically induced regenerative effects. The technique proved effective in reducing intra and postoperative complications. In particular, early postoperative pain and discomfort significantly decreased. No chronic pain and no recurrences were reported during follow up. The results achieved with the described laparoscopic technique seem to embody an innovative concept for inguinal hernia repair. Fixation free, dynamic responsive, permanent defect obliteration, histologically proven regenerative effects are the distinctive features of this 3D scaffold. It seems to embody a more physiological and pathogenetically coherent concept of cure, thus improving treatment results of this widespread disease.

Laparoscopic versus Open Inguinal Hernia Repair in Aging Patients: A Propensity Score Matching-Based Retrospective Study

“…Actually, numerous studies have shown the potential advantages of LIHR, such as faster recovery, reduced pain, and so on. 30,[34][35][36][37] Specifically, LIHR and age were independent risk factors for relieving postoperative pain compared to OIHR, as presented in our study. In fact, patients also need to undergo general anesthesia if performed with LIHR, which may importantly affect the postoperative pain of the patient.…”

Physiologic Cyclical Load on Inguinal Hernia Scaffold ProFlor Turns Biological Response into Tissue Regeneration

“…Aiming to improve such controversial treatment results, a new concept has been conceived for a more physiological and pathogenetic coherent method. It concerns a 3D scaffold, ProFlor, designed with a multilamellar shape, available for open and laparoscopic approaches and made of polypropylene, similar to conventional hernia implants [ 37 , 38 , 39 ]. Compressible on all planes with recoil memory, the 3D core of the scaffold takes advantage of its natural centrifugal expansion to achieve a permanent fixation-free obliteration of the hernia defect.…”

Laparoscopic versus open inguinal hernia repair in aging patients: A propensity score matching-based retrospective study

“…Actually, numerous studies have shown the potential advantages of LIHR, such as faster recovery, reduced pain, and so on [30,[34][35][36][37] . Speci cally, LIHR and age were independent risk factors for relieving postoperative pain compared to OIHR, as presented in our study.…”