PPP technique (plane polypropylene prosthesis): quick and safe procedure to repair recurrent inguinal hernia in high-risk patients

We present a repair technique for recurrent inguinal hernia that is based on closing the hernial ring with a folded flat prosthesis. It is a fast technique that was designed to be applied especially to the high-risk patients. It is a prospective observational study over 51 cases planned for elective surgery to repair a recurrent inguinal hernia. The patients presented one or more of these characteristics: pluripathology, of at least 80 years of age, anesthetic risk equal or more than ASA-III and size of the hernial orifice equal or less than 3 cm. The technique consists in reducing the sac, preparing a preperitoneal pocket and placing the prosthesis in that space, repairing the defect over it. The average total time of the surgical procedure was 29 minutes; the actual hernial ring repair lasted 8 minutes on average. General anesthesia was applied to 41 patients and spinal anesthesia for the other 10. The mean hospital stay was 1.2 days. The technique is a simple, fast and safe procedure. With low postoperative morbidity and no recurrences in follow-up. The short stay limits operative morbidity. The multidisciplinary involvement of specialists in the concomitant pathologies facilitated the non-appearance of general complications. The patients reviewed were highly satisfied with the results of the operation. We consider that this technique can be performed by any general surgeon without special training in abdominal wall. The cost of this modality of hernia repair is lower than other repairs. We believe that this technique can be included in the therapeutic guides for recurrent inguinal hernia.