Prior to the Kugel Mesh Hernia Patch, other inventors led the way in creating tension-free surgical repairs of hernias using synthetic mesh materials to bridge and patch hernia defects. These types of repairs offered both a decrease in recurrence rate as well as a decrease in the patient’s post-operative discomfort. Patients undergoing these more advanced procedures of the day were able to resume their normal activities sooner.
In practice, however, some of these early techniques were somewhat complicated. Several used a type of plug or locating device inside the hernia defect itself. Also many of these earlier inventions were designed specifically for use in laparoscopic procedures. Moreover, many of the prior patches had to be sutured or stapled to the patient’s body tissue.
Although these medical advances were acknowledged for their usefulness and success, there remained a need for more improvements in the surgical repair of hernias.
A New Kind of Hernia Patch
The hernia patch designed by Dr. Robert D. Kugel in the early 1990s was a breakthrough because it can be implanted through a small incision slightly away from the hernia itself, and requires no sutures to hold it in place once positioned behind the hernia. His most innovative concept is what later came to be called the “memory recoil ring” – a thin, flexible plastic loop inside the mesh material that allows the patch to be folded and inserted through a small incision. Then when the patch is released, the plastic loop springs back into its normal shape causing the patch to unfold back into a flat format.
Patent Application Drawing, U.S.P.T.O
In his first patent application filed September 29, 1994, Dr. Kugel describes how the patch is implanted:
“Then without the need for general anesthesia, nor expensive laparoscopic instrumentation, a surgeon, when repairing an inguinal hernia, makes a small incision in the patient, approximately three centimeters long, arranged obliquely, approximately two to three centimeters above the internal ring location of the inguinal hernia. Through this small incision, using the muscle splitting technique, the surgeon performs a dissection deep into the patient’s preperitoneal space, creating a pocket in this space into which this hernia mesh patch is to be inserted.
“Thereafter, the surgeon, using his or her fingers, readily folds and compacts this hernia mesh patch and directs it through the incision and into the patient’s preperitoneal space, where it unfolds and expands into its planar configuration, creating a trampoline effect. Then the surgeon, using just one of his or her fingers, placed partially through a slit in the top layer of mesh and into the pocket or pouch between the top and bottom layers of this hernia mesh patch, conveniently and accurately moves the hernia mesh patch to cover the defect in the thick reinforcing lining of the patient’s abdominal cavity. Thereafter the surgeon withdraws his or her finger and then secures the incision with stitches.
“The patient’s post-operative discomfort is decreased, and risk of any recurrence is likewise decreased. The patient’s body, soon after surgery, reacts to the mesh of the hernia mesh patch, and in a short time, the mesh becomes stuck, thereby keeping the hernia mesh patch in place. Thereafter the patient’s scar tissue grows into the mesh over a period of time, between thirty and sixty days, to permanently fix the hernia mesh patch in its intended position over the repaired area, where the hernia was located.”
Between 1996 and 1999, Dr. Kugel filed additional utility patents on eight improvements in the patch’s design making it even easier to implant and hold itself in place.
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