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Ann R Coll Surg Engl. 2009 April; 91(3): 270.
PMCID: PMC2765029
Technical Notes and Tips
Bruce Campbell, Section Editor

A Simple ‘Parachute’ Technique for Placement of Extraperitoneal Mesh in Abdominal Wall Hernia Repair

The satisfactory placement of extraperitoneal sub-lay meshes in abdominal wall hernia repair can be technically challenging. Achieving adequate 5-cm sub-lay margins beyond the edges of the fascial defect without crumpling of the mesh can be problematic, resulting in sub-optimal mesh positioning. We describe pictorially a simple method of mesh ‘parachuting’ into the extraperitoneal space with accurate 4-point peripheral mesh fixation without the need for extension of the fascial defect or compromise of sub-lay distances, both of which can contribute to hernia recurrence.

Figure 1

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Diagrammatic representation of the ‘parachute’ technique for placement of extraperitoneal mesh.

Articles from Annals of The Royal College of Surgeons of England are provided here courtesy of The Royal College of Surgeons of England