Mesh reconstruction of the myopectineal region following wide local excision for inguinofemoral tumors.

Abstract

Introduction: Appropriate reconstruction following radical resection of sarcomas in the inguinofemoral region and the pelvis is essential to prevent the subsequent development of an incisional hernia. Simple soft-tissue coverage may not suffice, as resection often involves the removal of the flat muscles and the inguinal ligament. We propose a technique of extraperitoneal mesh placement to reconstruct the myopectineal orifice (MPO).

Methods: In this paper, we present a technique of extraperitoneal mesh reconstruction of the myopectineal region and inguinal ligament following radical resection for inguinofemoral tumours. The short-term surgical outcome, long-term oncological outcomes, and the development of an incisional hernia were also retrospectively reviewed.

Results: A total of 13 patients were included in the study from May 2017 to February 2025. In 11/13 patients, primary closure of the soft tissue defect was possible. In two patients, a local rotational flap was required for soft tissue coverage. In 11/13 patients, a polypropylene mesh was used. In two patients, a titanium-coated polypropylene mesh was used. For all patients, the mesh was placed in the extra-peritoneal plane. Regarding short-term complications, 4 patients developed a surgical site infection, and 2 developed a seroma. In terms of long term outcomes, only one patient was confirmed to have developed an incisional hernia.

Conclusion: This technique offers a simple, safe, cost-effective, and reproducible method for reconstructing the myopectineal orifice in patients undergoing radical resection of soft tissue tumors involving the inguinofemoral region, with the sacrifice of the inguinal ligament.