Pneumatic positioning and mesh fixation in laparoscopic ventral/incisional hernia repair New surgical technique and a new device

AIM: To achieve full-surface contact of a prosthetic mesh with the abdominal wall (avoiding folds and wrinkles) in laparoscopic ventral/ incisional hernia repair (LVHR/LIHR) and to fix the mesh with glue using a new surgical technique and a new device, developed for this specific procedure. MATERIAL OF STUDY: New surgical technique associated with a new surgical pneumatic device allows perfect positioning and extension of the intraperitoneal mesh and facilitates the glue application and mesh fixation. A polyester composite mesh is used for intraperitoneal placement, cyanoacrylate glue is used for mesh fixation. Pigs cadavers were used to test this new technique and the device*. RESULTS: With the help of a pneumatic device the intraperitoneal mesh can be well positioned and perfectly extended without folds, thus allowing an efficient and strong mesh glue fixation. CONCLUSION: Presented pneumatic positioning device is useful to achieve an ideal alignment of mesh with the abdominal wall and supports the fixation task. The proposed technique enables the glue application safely, by avoiding possible spillage over intestinal loops and offering the necessary time for the distribution of such fast polymerizing glue. This technique could also be applied with other types of glue or self-adhesive mesh.