PMC7876838_01
Preperitoneal view of recurrent indirect hernia defect left.
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After parietalization of the spermatic vessels the hernia sac was fully dissected and the previously assessed defect diameter of ca 30 mm was confirmed (Fig. 1).
Preparing ProFlor-E  for the delivery into the abdominal cavity. A: The implant core is squeezed along its longitudinal axis. B: The connected flat mesh is rolled upon the squeezed core. C: The compressed and rolled ProFlor-E  is being approached to the 12 mm trocar. D: ProFlor-E  has been introduced into the trocar with screwing maneuver and is being funneled through the channel with a forceps.
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To allow the 40 mm wide, 15 mm thick prosthesis to be funneled across the 12 mm trocar channel, the implant core was squeezed with the fingers along its longitudinal axis reaching a thickness of ca 9 mm (Fig. 2A), then the connected flat mesh was rolled upon the squeezed core (Fig. 2B). The compressed, rolled ProFlor-E  configuration was brought close to the 12 mm trocar and introduced in screwing mode into the trocar to be finally funneled through the channel with a forceps (Fig. 2C, D).
A: ProFlor E is approached to the hernia defect. - B: the outline of 40 mm ProFlor prosthesis.
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Once delivered into the abdominal cavity, the procedure continued by introducing the 3D prosthesis into the hernia defect (Fig. 3).
ProFlor-E  core fully obliterated the whole hernia defect. The connected flat mesh lies folded partially close to the inferior epigastric vessels.
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A final adjustment of ProFlor-E  core to face the edges to the defect border was made (Fig. 4).
The placement of ProFlor-E  has been accomplished: the implant core occupies the hernial gap while its connected flat mesh fully covers the posterior inguinal backwall.
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To complete the procedure, the connected flat mesh was deployed to cover the remaining surface of the inguinal backwall (Fig. 5).