Suitable Mesh for Adult Groin Hernia Tep Repair Based on Pelvic 3d-Ct Scan Measurements

Background The totally extraperitoneal (TEP) repair for groin hernia, performed at Yuki Hospital between 2006 and Dec 2023 on 542 patients, could avoid complications associated with entering the peritoneal cavity. Recurrence occurred in seven patients due to the use of small-sized mesh. The purpose of this study is to identify suitable mesh sizes for TEP repair. Method 206 consecutive patients (104 males, 102 females) who underwent abdominal CT scans were included. The Pelvic bone structures were reconstructed using 3DCT scanning, and the curved length from the pubic tubercle to the anterior iliac spine was measured by a radiologist. This length corresponds to the actual length covered by the mesh during laparoscopic TEP groin hernia repair. Results Patient ages ranged from 18–86 years, median 70. The curved length from the pubic tubercle to the anterior iliac spine averaged 163.6 ± 10.9 mm for male and 160.0 ± 7.7 mm for female, demonstrating a correlation with height (male: 167.2 ± 7.6 cm, correlation coefficient (r) = 0.68, female: 153.2 ± 7.2 cm, r = 0.50). We usually utilize a standard 10.8 × 16 cm 3D large size mesh in TEP repair, which covers 98% of the average curved length for male. Conclusion The curved length from the pubic tubercle to the anterior superior iliac spine can be preoperatively estimated using 3D CT scans. The large size 3D mesh (10.8 × 16 cm) appears to be suitable for most Japanese adults undergoing TEP repair for groin hernia.