First use in the UK of the Gore®
bioabsorbable inguinal hernia plug
D.A. Raptis and S.G.E. Barker
Corresponding address:
Mr S.G.E. Barker,
St Luke's Hospital for the Clergy,
14 Fitzroy Square,
London W1T 6AH.
E-mail: information@uhc-herniaclinic.co.uk
'Plug and patch' hernia repair techniques have been developed to minimise tissue dissection and
suturing, minimise post-operative pain, to return the patient to ‘normal’ levels of activity
promptly, as well as to help decrease recurrence rates. As an extension to this concept of repair, a
new collagen-based bioabsorbable plug has been developed in an attempt to eliminate
those remaining few complications still deemed to be associated with non-absorbable material
systems. Recent animal studies appear promising. However, there are as yet few case reports and
certainly no randomised controlled trials to support either short-term, or long-term clinical
efficacy. Three patients were the first to receive the new Gore® bioabsorbable hernia plug (GBHP)
in the UK. The operating technique was that for a standard, open, tension-free ‘plug and patch’
hernia repair. Patient A was a 27-year-old male with a direct inguinal hernia. Patient B was a 67-
year-old male with an indirect inguinal hernia. Patient C was a 73-year-old male with bilateral,
direct inguinal herniae. The new GBHP is composed entirely of the co-polymer polyglycolic acid:
trimethylene carbonate and studies have shown that it is bioabsorbed entirely in approximately
6 months. This allows the once hernia ‘defect’ to become filled with collagenous scar tissue, that
helps maintain the architecture of the posterior abdominal wall. The insertion of the new
(and currently single-sized) GBHP was straightforward for the direct hernias. It was more difficult
to insert in to the indirect hernia defect, which necessitated that the product be cut down to a
more appropriate size.
Keywords
Inguinal hernia; hernia plug; plug and patch; bioabsorbable plug.
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