MANAGEMENT OF RECURRENT AND PERIVASCULAR FEMORAL HERNIAS BY GIANT PROSTHETIC REINFORCEMENT OF THE VISCERAL SAC

BACKGROUND: Classical hernioplasties have been used to manage primary femoral hernias for over a century. In women, infrainguinal repair of the parietal defect is simple and successful. In men, femoral hernias are frequently associated with inguinal hernias and, therefore, a Coop er's ligament repair is indicated, For recurrent femoral hernias, howe ver, the classical hernioplasties are often inadequate just as they ar e for the repair of recurrent inguinal hernias and a prosthetic repair is indicated. Giant prosthetic reinforcement of the visceral sac (GPR VS) is the descriptive name of a properitoneal groin hernioplasty with a large piece of Mersilene(TM) The repair focuses on retaining the pe ritoneum rather than repairing the parietal defect and is efficient, a natomic, sutureless, and tension-free. It is the only repair that reli ably eliminates all hernias of the groin, including perivascular femor al hernias. STUDY DESIGN: In this study, GPRVS by way of an abdominal incision was used to treat recurrent and perivascular femoral hernias. Also included are a description of and experiences with a new techniq ue of unilateral GPRVS performed through an infrainguinal approach. RE SULTS: The data reveal no recurrences in 69 problem femoral hernias of which 15 were primary (two perivascular) and 54 recurrent (four periv ascular). CONCLUSIONS: Giant prosthetic reinforcement of the visceral sac performed transabdominally or by way of the newly described infrai nguinal method is a useful and reliable method to treat primary, recur rent and perivascular femoral hernias.