Laparoscopic Repair of Inguinal Hernia with Biomimetic Matrix

Background and Objectives: Materials utilized for the repair of hernias fall into 2 broad categories, synthetics and biologics. Each has its merits and drawbacks. The synthetics have a permanent, inherent strength but are associated with some incidence of chronic pain. The bio-logics rely on variable tissue regeneration to give strength to the repair, limiting their use to specific situations. How-ever, thanks to their transient presence and tissue in-growth, the biologics do not result in a significant inci-dence of chronic pain. We studied the use of a biomimetic (REVIVE, Biomerix Corporation, Fremont, CA) in this set-ting in an attempt to obviate the disadvantages of each material. Methods: Fourteen patients underwent laparoscopic re-pair by totally extraperitoneal and transabdominal pre-peritoneal techniques of 16 inguinal hernias. Follow-up was as long as 19 mo, and 8 patients were followed for 12 mo. There were no recurrences and a 5 % incidence of functionally insignificant discomfort. Results: REVIVE is shown in histology and in vivo to demonstrate regeneration and tissue ingrowth into the polycarbonate/polyuria matrix similar to that in the bio-logics rather than scarring or encapsulation. There were no recurrences, indicating its strength and resilience as a permanent repair similar to that in the synthetics. Conclusion: This is proof of the concept that a biomi-metic may bridge the gap between the biologics and synthetics and may be able to be utilized on a regular basis with the benefits of both materials and without their drawbacks