In a younger/ fit/ active patient needing to have a plug revised for pain is the robotic iliopubic tract repair a good option?
If someone is under 40 and a high level triathlete… Is this repair durable enough for an active person?
When removing mesh, sensitive structures like nerves and cord structures are likely to be affected. Investing facia or other tissues protecting them presumably may be violated. Laying a mesh over this trauma seems riskier than with native tissues.
So while everyone agrees that mesh is going to give you the strongest result, intuitively it seems riskier.
The prospect of the iliopubic tract repair seems like it would minimize the risk of creating new nerve or cord complication. Or if there was such injury, give the body a better chance of healing/ remodeling things it on its own vs a foreign body reaction obliterating the region.
The above concerns may be overblown and I have nothing to base them on other than intuition.
Needless to say after someone has a bad experience with mesh, primary tissue repairs sound great.
Granted what is actually best may depend upon what is found interoperatively…
But for individuals who would otherwise be a good candidate for robotic primary tissue repair, if they are very active should they be discouraged from pursuing it in place of a revisional mesh repair due to higher failure risk?
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