ObjectiveInvestigate the shape of plug mesh and patch after plug-mesh hernia repair and discuss the necessity of improving the operative procedures. MethodsUse B ultrasound to investigate the shape of plug-mesh and patch after mesh plug hernia repair and review the patients medical record,evaluate how operative procedures affect the shape of patch and the results. ResultsIn 4 of the 16 cases,the distant end of patches overlapped the pubic margin,in the remaining 12cases the distant end of patches didn't reach the pubic margin. When changing the cut-in direction of B ultrasound probe,a wide and dense shadow was discovered in 8 cases whose patches didn't reach the pubic margin. Between the pubic margin and dense shadow there was a space showing low dense shadow. These photocopies showed that the patches had folded up or crimped. In 11 of 12 cases,the patches didn't fix on pubic margin or cut shorter during operation. Conclusion It is suggested to fix the distant end of patch on the aponeurosis tissue of pubic in the procedure of mesh plug hernia repair,and combine the plug-mesh repair with Lichtenstein repair.

Objective To find a ideal method for inguinal herniorrhaphy. Methods One hundred patients with inguinal hernia were randomized to receive respectively PHS and Mesh Plug & Patch tension-free herniorrhaphy. Results In PHS group, the average operative time was 35 min. The postoperative complication rate was 2% (1/50), the average hospital stay was 2 days. Follow-up of 6～10 months has found no recurrence. In Plug group, the average operative time was 40 min,complication rate was 8% (4/50), the average hospital stay were 3 days. Postoperatively, 6 patients complained of temporary foreign body feeling. Follow-up of 6～10 months has found no recurrence in either group. Conclusions Both PHS and Mesh Plug & Patch are ideal materials for herniorrhaphy. PHS is especially suitable for lean inguinal hernia patients with large defect on transversalis fascia. Plug & Patch has an advantage in fat patients with small defect on transversalis fascia.

Objective To evaluate methods of OP mesh spreading in preperitoneal tension-free repair of inguinal hernia via open anterior approach.Methods The clinical data of 1 528 cases underwent preperitoneal tension-free repair of inguinal hernia via open anterior approach from March 2012 to April 2015 was analyzed retrospectively.The methods of mesh crimp spreading, pectineal ligament suture fixation, pubic tubercle suture fixation and auxiliary support were used.Results The mesh crimp spreading method was used in 1 021 cases, pectineal ligament suture fixation method was used in 64 cases, pubic tubercle suture fixation method was used in 48 cases, auxiliary support method was used in 395 cases.Meshes were all well spreaded.Conclusions The four methods of mesh spreading are effective, simple, convenient and easy to use in preperitoneal tension-free repair of inguinal hernia via open anterior approach.