Chronic pain after laparoscopic and open mesh repair of groin hernia

Kumar, Subodh; Wilson, R. G.; Nixon, S. J.; Macintyre, I. M. C.

doi:10.1046/j.1365-2168.2002.02260.x

Cited by 245 publications

(202 citation statements)

References 21 publications

Supporting

Mentioning

171

Contrasting

Unclassified

Order By: Relevance

“…42 Besides nerve damage during dissection, thermal injury due to electrocautery, and inflammatory and/or mechanical reaction to the mesh, stapling of the mesh is the most frequent evocated mechanism. 34,45,48 Among other potential factors causing postoperative pain is the repair of recurrent hernias. There is a great variation in the rate of postoperative chronic pain, ranging from 0.1 to 0.4% and 22.5% 41,45,49 in laparoscopic repairs for which staples are used to attach the mesh.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Fibrin Sealant versus Use of Tackers for Fixation of Mesh in Laparoscopic Inguinal Hernia Repair

Shinde¹

2009

WJOLS

View full text Add to dashboard Cite

Background: Laparoscopic fixation of meshes prior to their fibrous incorporation should be reliable to minimize recurrences following transabdominal preperitoneal hernia repair (TAPP) and totally extraperitoneal repair (TEP) repair of inguinal hernias. However, suture, tack and staple-based fixation systems are associated with postoperative chronic inguinal pain. Initial fixation with fibrin sealant offers an atraumatic alternative, but there is little data showing that fibrin-based mesh adhesion provides adequate biomechanical stability for repair of inguinal hernia by TAPP and TEP.Methods: A literature search was performed using medline and the search Google, Springer link and Highwire press. The following search terms were used: Laparoscopic hernia mesh, Fibrin glue, and Tackers. 2293 citations were found in total.Selected papers were screened for further references. Criteria for selection of literature were the number of cases (excluded if less than 80), methods of analysis (statistical or nonstatistical), operative procedure (only universally accepted procedures were selected) and the institution where the study was done (specialized institution for laparoscopic surgery).Results: Mesh fixation has always invited lots of interest amongst surgeons and instrument companies due to the wide range of postoperative complications each of them caused. TAPP and TEP usually involves fixation of mesh, however many studies challenging the mesh fixation in TEP are being published. There are two most common methods of fixing mesh using fibrin glue (Tissucol) and tackers. Fibrin sealant possesses both mechanical strength and elasticity. Overall, data from previous studies, shows that mesh stability with fibrin sealant fixation is at least equivalent to suture fixation, indicating that fibrin sealant could be considered the fixation method of choice in inguinal hernia repair. This new method of mesh fixation is obviously potentially less harmful than stapling the mesh and can help reduce the risk of chronic postoperative pain at a comparative or even lower cost than a stapling device. Conclusions:Fibrin glue gives an adequate mesh fixation with a less chance of chronic postoperative pain. It appears to be an alternative to staples and may help reduce the postoperative pain problems after hernia repair. All methods give the same results in terms of recurrence rate, hospital stay, and costs; but with better results in terms of postoperative pain, seromas, and trocar-related trauma. However the use of fibrin glue needs extensive study, as the anatomical dissection and inguinal region preparation have to be carefully performed, and the mesh size has to be adequate; peritoneum closure with a running suture is more time consuming. Large randomized trials and longer follow-up are required to demonstrate the advantages of either technique.

show abstract

Section: Discussionmentioning

confidence: 99%

“…45 Fibrin glue is reported to have hemostatic properties,thus reducing seroma and hematoma formation. 44 In other study, the incidence of postoperative seromas was1.8% (6/320), whereas the incidence reported in the literature varies from 3.8 to 10.5%.…”

Section: Fibrin Glue Use Staples Usementioning

confidence: 99%

Fibrin Sealant versus Use of Tackers for Fixation of Mesh in Laparoscopic Inguinal Hernia Repair

Shinde¹

2009

WJOLS

View full text Add to dashboard Cite

show abstract

“…A restrição das atividades, física ou esportiva pode chegar a 18% dos casos 50,51 . A inguinodinia parece ocorrer numa freqüência um pouco menor nas operações por via laparoscópica, estimada em 2% a 2,5% dos reparos [52][53][54] , do que naquelas realizadas por via anterior, de 2,1 a 37% 49,[55][56][57] . Pelo fato desta síndrome ser potencialmente incapacitante e de difícil tratamento, a sua prevenção merece cuidado especial 58 .…”

Section: Inguinodiniaunclassified

O uso da prótese na correção das hérnias da parede abdominal é um avanço, mas o seu uso indiscriminado, um abuso

Minossi¹,

Silva

Spadella³

2008

Rev. Col. Bras. Cir.

View full text Add to dashboard Cite

A hérnia da parede abdominal é uma entidade clínica de elevada prevalência, tanto na população adulta como infantil 1 , estimada entre 3% a 8%, sendo cinco a seis vezes mais comum no sexo masculino. Cerca de 75% de todas as hérnias ocorrem na região inguinal. As hérnias incisionais e ventrais representam aproximadamente 10% de todas as hér-nias e as femorais, apenas 3%. As hérnias incomuns são responsáveis por 5% a 10% dos casos restantes.A hérnia e seu reparo cirúrgico são um capítulo extensamente estudado e de profundo interesse por parte dos cirurgiões 2 . As correções estão muito distantes de um consenso entre os cirurgiões, havendo muitas divergências mesmo entre as grandes escolas médicas.O marco na correção das hérnias deve ser atribuído a Edoardo Bassini (1844 -1924) : aproximação e sutura, em tripla camada, do músculo oblíquo interno, transverso e fáscia transversal ao ligamento inguinal. Bassini já realizava abertura ampla da fáscia transversal em toda sua extensão, antes de se efetuar a sutura do assoalho inguinal 6 . Shouldice apenas disciplinou a técnica original de Bassini, ao realizar a sutura estratificada em vários planos.Mais recentemente, se popularizou a abordagem posterior pré-peritoneal das hérnias inguinais, revivida e preconizada por Nyhus (epônimo: operação de Nyhus 7 ). Na década de 90, houve modificações revolucionári-as no tratamento das hérnias inguinais. A introdução do conceito de herniorrafia com livre tensão deu espaço aos reparos baseados na colocação de telas (Lichtenstein, "Mesh Plug", Nyhus e reparo laparoscópico).A partir de 1946, após estudos experimentais, foi introduzido na prática médica o uso de próteses metálicas, como o tântalo e, posteriormente, o aço inoxidável. A fragmentação destes materiais, no entanto, com risco de penetração em vasos e nervos, e a eventual migração destes para outras partes do organismo, limitou o uso desta técnica, encorajando pesquisas com outros materiais, como o náilon, o polietileno, o polivinil, o dácron e o téflon. Esses materiais, todavia, associaram-se a um maior índice de infecção e rejeição. O polipropileno monofilamentar, material inerte com baixo índi-ce de infecção e fistulização, é o material preferido pela maioria dos cirurgiões.As próteses, tanto biológicas como artificiais, foram inicialmente utilizadas para apoiar um reforço realizado pela técnica convencional. O cirurgião, ao não se convencer da resistência do reforço, optava por complementá-lo usando uma prótese. Esta conduta, portanto, era excepcional 8 . Na década de 60, chamava-se à atenção para o risco de recidiva da hérnia, caso a sutura fosse feita sob muita tensão, mesmo com o uso de prótese. Para eliminar a tensão local, Usher et al., 1960, preconizaram a utilização da prótese,

show abstract

“…The main points of most disputes focus on postoperative chronic pain, recurrence, and foreign body feeling [5][6][7] . Currently, the Modified Kugel hernia repair through the pre-peritoneal space for inguinal hernias has become widespread.…”

Section: Introductionmentioning

confidence: 99%

Swing mesh versus Modified Kugel mesh for primary inguinal hernia repair. A prospective randomized clinical trial

Zhou¹,

Zhang³

et al. 2016

Acta Cir. Bras.

View full text Add to dashboard Cite

PURPOSE:To evaluate the safety and efficacy of a new mesh in the pre-peritoneal repair of inguinal hernia. METHODS:We randomly divided 120 patients undergoing pre-peritoneal repair into 2 groups between March 2012 and December 2013. The patients were randomized to receive the Swing mesh (n=60; study group) or the Modified Kugel mesh (n=60; control group).The primary end point of this study was to compare postoperative groin pain of the two groups. Complications, recurrence and analgesic use were also recorded. RESULTS:There were no recurrent cases in either group throughout the study period. There was no significant difference between the groups with respect to postoperative complications. The VAS of early postoperative pain was 1.32±1.69 in study group and 1.52±1.93 in control group, with the difference being not statistically significant (p = 0.547). Concerning chronic pain, no remarkable statistically significant difference was observed between the two groups at 3-month, 6-month, 12-and 18-month follow-up period. CONCLUSION:Swing mesh can be safely and effectively used in inguinal hernia repair with the same advantage compared to the Modified Kugel mesh.Key words: Hernia, Inguinal. Surgical Mesh. Swing mesh versus Modified Kugel mesh for primary inguinal hernia repair. A prospective randomized clinical trial

show abstract

Chronic pain after laparoscopic and open mesh repair of groin hernia

Cited by 245 publications

References 21 publications

Fibrin Sealant versus Use of Tackers for Fixation of Mesh in Laparoscopic Inguinal Hernia Repair

Fibrin Sealant versus Use of Tackers for Fixation of Mesh in Laparoscopic Inguinal Hernia Repair

O uso da prótese na correção das hérnias da parede abdominal é um avanço, mas o seu uso indiscriminado, um abuso

Swing mesh versus Modified Kugel mesh for primary inguinal hernia repair. A prospective randomized clinical trial

Contact Info

Product

Resources

About