Gender-specific mesh implant with barrier for inguinal hernia repair

Abstract

Disclosed herein are gender-specific implantable mesh for inguinal hernia repair in a patient, comprising: a fabric layer comprising a side defining a surface area wherein the fabric layer is configured to enable tissue adhesion to said mesh; an anti-adhesive barrier comprising a shape configured to prevent direct contact between the fabric layer and both a spermatic cord and a genital nerve upon implantation, wherein the shape covers a part of the surface area on the side of the fabric layer, the part being less than 25%, and wherein the shape is oblique to a horizontally-oriented centerline and a vertically-oriented centerline; and a keyhole configured to fit the genital nerve and the spermatic cord of the patient therethrough without constriction, wherein the keyhole is oblique and inferior to a horizontally-oriented centerline and medial to a vertically-oriented centerline.

What is claimed is: 
     
         1 . A mesh for sublay inguinal hernia repair in a subject wherein upon implantation the mesh is located posterior to an inguinal hernia defect and posterior or deep to a genital nerve in the subject, the mesh comprising:
 (a) a fabric layer comprising a plurality of pores configured to enable tissue adhesion to the mesh upon implantation of the mesh in the subject; and   (b) a fin extending inferiorly from an inguinal ligament level of the fabric layer and extending substantially medially from a vertically-oriented centerline of the fabric layer such that the fin is inferior to an iliopubic tract and does not obstruct a femoral artery or a femoral vein in the subject upon implantation of the mesh.   
     
     
         2 . The mesh of  claim 1 , wherein the fin is inferior to a horizontally-oriented centerline of the fabric layer. 
     
     
         3 . The mesh of  claim 1 , wherein a portion of a medial edge is substantially flat. 
     
     
         4 . The mesh of  claim 1 , wherein a portion of a medial edge of the mesh is substantially straight. 
     
     
         5 . The mesh of  claim 1 , wherein a portion of one or more edges of the mesh are substantially curved. 
     
     
         6 . The mesh of  claim 1 , wherein the mesh has a three-dimensional shape. 
     
     
         7 . The mesh of  claim 1 , wherein mesh comprises an inferior edge having
 (a) a first portion that is substantially medial to the vertical-oriented centerline, and   (b) a second portion that is substantially lateral to the vertical-oriented centerline the fin, wherein the first portion of the inferior edge is inferior to the second portion of the inferior edge.   
     
     
         8 . The mesh of  claim 1 , wherein at least a portion of the fabric layer comprises a weave, a braid, an interlaced structure, or any combination thereof that define the plurality of pores and that enable tailoring of the mesh without unravelling of a portion of the mesh. 
     
     
         9 . The mesh of  claim 1 , wherein a width of the fabric layer laterally is greater than a height of the fabric layer, wherein the height of the mesh, measured from a superior edge to an inferior edge of the mesh, is from about 0.5 inches to about 15 inches, and wherein the width of the mesh, measured from a lateral edge to a medial edge of the mesh, is from about 0.1 inches to about 15 inches. 
     
     
         10 . The mesh of  claim 1 , wherein the fabric layer has a density of no greater than about 40 grams per square meter (g/m 2 ). 
     
     
         11 . The mesh of  claim 1 , wherein the mesh comprises a synthetic material comprising polypropylene, polyester, expanded Polytetrafluoroethylene (ePTFE), or any combination thereof. 
     
     
         12 . The mesh of  claim 1 , wherein the fin comprises a curved inferior tip. 
     
     
         13 . A mesh for inguinal hernia repair in a subject, the mesh comprising:
 (a) a fabric layer comprising a plurality of pores configured to enable tissue adhesion to the mesh upon implantation of the mesh in the subject; and   (b) a fin extending substantially medially from a vertically-oriented centerline of the fabric layer and extending inferiorly from a horizontally-oriented centerline of the fabric layer, the fin including a first inferior edge that extends inferiorly to a second inferior edge of the mesh.   
     
     
         14 . The mesh of  claim 13 , wherein a portion of one or more edges of the mesh are substantially flat. 
     
     
         15 . The mesh of  claim 13 , wherein a portion of a medial edge of the mesh is substantially straight. 
     
     
         16 . The mesh of  claim 13 , wherein the fin comprises a curved inferior tip. 
     
     
         17 . An method for sublay inguinal hernia repair in a subject comprising:
 (a) obtaining a mesh comprising (i) a fabric layer comprising a plurality of pores configured to enable tissue adhesion to the mesh upon implantation of the mesh in the subject, and (ii) a fin extending substantially medially from a vertically-oriented centerline of the fabric layer and extending inferiorly from a horizontally-oriented centerline of the fabric layer; and   (b) positioning the mesh posterior to an inguinal hernia defect and posterior or deep to a genital nerve in the subject such that the fin is inferior to an iliopubic tract and the mesh lateral to the vertically-oriented centerline of the fabric layer does not obstruct a femoral artery or a femoral vein in the subject.   
     
     
         18 . The method of  claim 17 , comprising positioning the vertically-oriented centerline of the fabric layer lateral to the femoral artery and femoral vein in the subject. 
     
     
         19 . The method of  claim 17 , comprising positioning the fin medial to the femoral artery and femoral vein in the subject. 
     
     
         20 . The method of  claim 17 , comprising positioning the fin in proximity to Cooper's ligament to enable attachment of the fin thereto.