Skip to main content
Top
Published in: Hernia 6/2019

01-12-2019 | Inguinal Hernia | Original Article

Individual mesh size for open anterior inguinal hernia repair: an anthropometric study in Turkish male patients

Authors: H. Kulacoglu, H. Celasin, D. Oztuna

Published in: Hernia | Issue 6/2019

Login to get access

Abstract

Purpose

To conduct a study to determine the measurements of the inguinal region in male patients with inguinal hernias to reveal the proper mesh size for each patient.

Methods

In this prospective study, the anthropometric measurements were obtained from 100 consecutive adult male patients with unilateral primary inguinal hernias. First, the distance between the pubic tubercle and the medial border of the deep inguinal ring was measured (x). Second, the distance between the inner edge of the inguinal ligament and the uppermost level of the internal oblique aponeurosis at the midpoint of the inguinal ligament corresponding to the Hesselbach triangle was measured (y). Individual mesh sizes were calculated according to the original recommendations for mesh overlap.

Results

The mean x value was 41.6 mm (22–55 mm), the mean y value was 45.2 mm (30–68 mm). The mean dimensions of the mesh were 126.6 mm × 65.2 mm. The largest mesh was 140 mm × 88 mm, and the smallest one was 107 mm × 62 mm. The mean mesh area was 8320 mm2. It was larger than the index mesh area recommended by the Lichtenstein Hernia Institute in 45 patients and smaller in 55 patients.

Conclusions

The intraoperative measurements for ideal mesh size in Lichtenstein repair of inguinal hernias may present somewhat different mesh dimensions in many patients. Individualization of mesh size may be of importance in surgical outcomes.
Literature
1.
go back to reference Montgomery J, Dimick JB, Telem DA (2018) Management of groin hernias in adults-2018. JAMA 320:1029–1030CrossRef Montgomery J, Dimick JB, Telem DA (2018) Management of groin hernias in adults-2018. JAMA 320:1029–1030CrossRef
2.
go back to reference Gong W, Li J (2018) Operation versus watchful waiting in asymptomatic or minimally symptomatic inguinal hernias: the meta-analysis results of randomized controlled trials. Int J Surg 52:120–125CrossRef Gong W, Li J (2018) Operation versus watchful waiting in asymptomatic or minimally symptomatic inguinal hernias: the meta-analysis results of randomized controlled trials. Int J Surg 52:120–125CrossRef
3.
go back to reference HerniaSurge Group (2018) International guidelines for groin hernia management. Hernia 22:1–165CrossRef HerniaSurge Group (2018) International guidelines for groin hernia management. Hernia 22:1–165CrossRef
5.
go back to reference Amato B, Moja L, Panico S, Persico G, Rispoli C, Rocco N et al (2012) Shouldice technique versus other open techniques for inguinal hernia repair. Cochrane Database Syst Rev 18:CD001543 Amato B, Moja L, Panico S, Persico G, Rispoli C, Rocco N et al (2012) Shouldice technique versus other open techniques for inguinal hernia repair. Cochrane Database Syst Rev 18:CD001543
6.
go back to reference Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hernioplasty. Am J Surg 157:188–193CrossRef Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hernioplasty. Am J Surg 157:188–193CrossRef
7.
go back to reference Amid PK (2003) The Lichtenstein repair in 2002: an overview of causes of recurrence after Lichtenstein tension-free hernioplasty. Hernia 7:13–16CrossRef Amid PK (2003) The Lichtenstein repair in 2002: an overview of causes of recurrence after Lichtenstein tension-free hernioplasty. Hernia 7:13–16CrossRef
8.
go back to reference Amid PK (2004) Lichtenstein tension-free hernioplasty: its inception, evolution, and principles. Hernia 8:1–7CrossRef Amid PK (2004) Lichtenstein tension-free hernioplasty: its inception, evolution, and principles. Hernia 8:1–7CrossRef
9.
go back to reference Hounnou G, Destrieux C, Desmé J, Bertrand P, Velut S (2002) Anatomical study of the length of the human intestine. Surg Radiol Anat 24:290–294CrossRef Hounnou G, Destrieux C, Desmé J, Bertrand P, Velut S (2002) Anatomical study of the length of the human intestine. Surg Radiol Anat 24:290–294CrossRef
10.
go back to reference NCD Risk Factor Collaboration (2016) Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet 387:1377–1396CrossRef NCD Risk Factor Collaboration (2016) Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet 387:1377–1396CrossRef
11.
go back to reference NCD Risk Factor Collaboration (2017) Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet 390:2627–2642CrossRef NCD Risk Factor Collaboration (2017) Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet 390:2627–2642CrossRef
12.
go back to reference Amid PK, Shulman AG, Lichtenstein IL (1994) Local anesthesia for inguinal hernia repair step-by-step procedure. Ann Surg 220:735–737CrossRef Amid PK, Shulman AG, Lichtenstein IL (1994) Local anesthesia for inguinal hernia repair step-by-step procedure. Ann Surg 220:735–737CrossRef
13.
go back to reference Kulacoglu H (2012) Step-by-step local anesthetic infiltration technique in repair of groin hernias “technical note”. Turk J Surg 28:164–168CrossRef Kulacoglu H (2012) Step-by-step local anesthetic infiltration technique in repair of groin hernias “technical note”. Turk J Surg 28:164–168CrossRef
14.
go back to reference Campanelli G, Bruni PG, Morlacchi A, Lombardo F, Cavalli M (2017) Primary inguinal hernia: the open repair today pros and cons. Asian J Endosc Surg 10:236–243CrossRef Campanelli G, Bruni PG, Morlacchi A, Lombardo F, Cavalli M (2017) Primary inguinal hernia: the open repair today pros and cons. Asian J Endosc Surg 10:236–243CrossRef
15.
go back to reference Miserez M, Alexandre JH, Campanelli G, Corcione F, Cuccurullo D, Pascual MH et al (2007) The European hernia society groin hernia classification: simple and easy to remember. Hernia 11:113–116CrossRef Miserez M, Alexandre JH, Campanelli G, Corcione F, Cuccurullo D, Pascual MH et al (2007) The European hernia society groin hernia classification: simple and easy to remember. Hernia 11:113–116CrossRef
16.
go back to reference Seker D, Oztuna D, Kulacoglu H, Genc Y, Akcil M (2013) Mesh size in Lichtenstein repair: a systematic review and meta-analysis to determine the importance of mesh size. Hernia 17:167–175CrossRef Seker D, Oztuna D, Kulacoglu H, Genc Y, Akcil M (2013) Mesh size in Lichtenstein repair: a systematic review and meta-analysis to determine the importance of mesh size. Hernia 17:167–175CrossRef
17.
go back to reference Trabucco EE, Trabucco AF (1998) Flat plug and mesh hernioplasty in the “Inguinal box”: description of the surgical technique. Hernia 2:133–138CrossRef Trabucco EE, Trabucco AF (1998) Flat plug and mesh hernioplasty in the “Inguinal box”: description of the surgical technique. Hernia 2:133–138CrossRef
18.
go back to reference Pélissier EP (2001) Inguinal hernia: the size of the mesh. Hernia 5:169–171CrossRef Pélissier EP (2001) Inguinal hernia: the size of the mesh. Hernia 5:169–171CrossRef
19.
go back to reference Amid PK, Shulman AG, Lichtenstein IL (1993) Critical scrutiny of the open “tension-free” hernioplasty. Am J Surg 165:369–371CrossRef Amid PK, Shulman AG, Lichtenstein IL (1993) Critical scrutiny of the open “tension-free” hernioplasty. Am J Surg 165:369–371CrossRef
20.
go back to reference Celdrán A, Frieyro O, Souto JL, Villar S (2000) Study of recurrences after anterior open tension-free hernioplasty. Hernia 4:85–87CrossRef Celdrán A, Frieyro O, Souto JL, Villar S (2000) Study of recurrences after anterior open tension-free hernioplasty. Hernia 4:85–87CrossRef
21.
go back to reference DeBord JR (1998) The historical development of prosthetics in hernia surgery. Surg Clin North Am 78:973–1006CrossRef DeBord JR (1998) The historical development of prosthetics in hernia surgery. Surg Clin North Am 78:973–1006CrossRef
22.
go back to reference Klinge U, Klosterhalfen B, Müller M, Ottinger AP, Schumpelick V (1998) Shrinking of polypropylene mesh in vivo: an experimental study in dogs. Eur J Surg 164:965–969CrossRef Klinge U, Klosterhalfen B, Müller M, Ottinger AP, Schumpelick V (1998) Shrinking of polypropylene mesh in vivo: an experimental study in dogs. Eur J Surg 164:965–969CrossRef
23.
go back to reference Nakanishi Y, Nethery V (1999) Anthropometric comparison between Japanese and Caucasian American male university students. Appl Human Sci 18:9–11CrossRef Nakanishi Y, Nethery V (1999) Anthropometric comparison between Japanese and Caucasian American male university students. Appl Human Sci 18:9–11CrossRef
24.
go back to reference Haftenberger M, Lahmann PH, Panico S, Gonzalez CA, Seidell JC, Boeing H et al (2002) Overweight, obesity and fat distribution in 50- to 64-year-old participants in the European Prospective Investigation into Cancer and Nutrition (EPIC). Public Health Nutr 5:1147–1162CrossRef Haftenberger M, Lahmann PH, Panico S, Gonzalez CA, Seidell JC, Boeing H et al (2002) Overweight, obesity and fat distribution in 50- to 64-year-old participants in the European Prospective Investigation into Cancer and Nutrition (EPIC). Public Health Nutr 5:1147–1162CrossRef
25.
go back to reference Kagawa M, Binns CB, Hills AP (2007) Body composition and anthropometry in Japanese and Australian Caucasian males and Japanese females. Asia Pac J Clin Nutr 16(Suppl 1):31–36PubMed Kagawa M, Binns CB, Hills AP (2007) Body composition and anthropometry in Japanese and Australian Caucasian males and Japanese females. Asia Pac J Clin Nutr 16(Suppl 1):31–36PubMed
26.
go back to reference Novotny R, Going S, Teegarden D, Van Loan M, McCabe G, McCabe L, Daida YG, Boushey CJ, ACT Research Team (2007) Hispanic and Asian pubertal girls have higher android/gynoid fat ratio than whites. Obesity (Silver Spring) 15:1565–1570CrossRef Novotny R, Going S, Teegarden D, Van Loan M, McCabe G, McCabe L, Daida YG, Boushey CJ, ACT Research Team (2007) Hispanic and Asian pubertal girls have higher android/gynoid fat ratio than whites. Obesity (Silver Spring) 15:1565–1570CrossRef
27.
go back to reference Frisancho AR (2007) Relative leg length as a biological marker to trace the developmental history of individuals and populations: growth delay and increased body fat. Am J Hum Biol 19:703–710CrossRef Frisancho AR (2007) Relative leg length as a biological marker to trace the developmental history of individuals and populations: growth delay and increased body fat. Am J Hum Biol 19:703–710CrossRef
28.
go back to reference Harris FI, White AS (1937) The length of the inguinal ligament in the differentiation between direct and indirect inguinal hernia. JAMA 109:1900–1903CrossRef Harris FI, White AS (1937) The length of the inguinal ligament in the differentiation between direct and indirect inguinal hernia. JAMA 109:1900–1903CrossRef
29.
go back to reference Rebustelo E (1938) La conformazione del bacino e la predisposizione alle ernie inguinali. Riv di Chir 4:390–404 Rebustelo E (1938) La conformazione del bacino e la predisposizione alle ernie inguinali. Riv di Chir 4:390–404
30.
go back to reference Piana C (1947) L’importanza della conformazione del bacino nella genesi dell’ernia inguinale. Arch Ital di Chir 69:209–222 Piana C (1947) L’importanza della conformazione del bacino nella genesi dell’ernia inguinale. Arch Ital di Chir 69:209–222
31.
go back to reference Goffi FS, Leite GM, Pinto PEL (1953) Alguns aspectos da etiopatogenia das hérnias inguinais. Rev Paul Med 43:29–45 Goffi FS, Leite GM, Pinto PEL (1953) Alguns aspectos da etiopatogenia das hérnias inguinais. Rev Paul Med 43:29–45
32.
go back to reference de Carvalho CA, de Souza RR, Fernandes PM, Waksman H, Fernandes VC (1987) The relationship between anthropometric parameters and measurements of the human inguinal region. Surg Radiol Anat 9:281–285CrossRef de Carvalho CA, de Souza RR, Fernandes PM, Waksman H, Fernandes VC (1987) The relationship between anthropometric parameters and measurements of the human inguinal region. Surg Radiol Anat 9:281–285CrossRef
33.
go back to reference Harissis HV, Georgiou GK (2014) The role of pelvic bone anatomy in the pathogenesis of inguinal hernia. Chirurgia (Bucur) 109:783–787 Harissis HV, Georgiou GK (2014) The role of pelvic bone anatomy in the pathogenesis of inguinal hernia. Chirurgia (Bucur) 109:783–787
34.
go back to reference Trabucco EE (1993) The office hernioplasty and the Trabucco repair. Ann It Chir 64:127–149 Trabucco EE (1993) The office hernioplasty and the Trabucco repair. Ann It Chir 64:127–149
35.
go back to reference Sanjay P, Reid TD, Bowrey DJ, Woodward A (2006) Defining the position of deep inguinal ring in patients with indirect inguinal hernias. Surg Radiol Anat 28:121–124CrossRef Sanjay P, Reid TD, Bowrey DJ, Woodward A (2006) Defining the position of deep inguinal ring in patients with indirect inguinal hernias. Surg Radiol Anat 28:121–124CrossRef
36.
go back to reference Wolloscheck T, Konerding MA (2009) Dimensions of the myopectineal orifice: a human cadaver study. Hernia 13:639–642CrossRef Wolloscheck T, Konerding MA (2009) Dimensions of the myopectineal orifice: a human cadaver study. Hernia 13:639–642CrossRef
37.
go back to reference Rabe R, Yacapin CP, Buckley BS, Faylona JM (2012) Repeated in vivo inguinal measurements to estimate a single optimal mesh size for inguinal herniorrhaphy. BMC Surg 12:19CrossRef Rabe R, Yacapin CP, Buckley BS, Faylona JM (2012) Repeated in vivo inguinal measurements to estimate a single optimal mesh size for inguinal herniorrhaphy. BMC Surg 12:19CrossRef
38.
go back to reference Anitha B, Aravindhan K, Sureshkumar S, Ali MS, Vijayakumar C, Palanivel C (2018) The ideal size of mesh for open inguinal hernia repair: a morphometric study in patients with inguinal hernia. Cureus 10:e2573PubMedPubMedCentral Anitha B, Aravindhan K, Sureshkumar S, Ali MS, Vijayakumar C, Palanivel C (2018) The ideal size of mesh for open inguinal hernia repair: a morphometric study in patients with inguinal hernia. Cureus 10:e2573PubMedPubMedCentral
Metadata
Title
Individual mesh size for open anterior inguinal hernia repair: an anthropometric study in Turkish male patients
Authors
H. Kulacoglu
H. Celasin
D. Oztuna
Publication date
01-12-2019
Publisher
Springer Paris
Keyword
Inguinal Hernia
Published in
Hernia / Issue 6/2019
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-019-01993-x

Other articles of this Issue 6/2019

Hernia 6/2019 Go to the issue