Prospective randomized study of stapled versus unstapled mesh in a laparoscopic preperitoneal inguinal hernia repair

Ferzli, George; Frezza, E; Pecoraro, A.M.; Ahern, Kathleen

doi:10.1016/s1072-7515(99)00039-3

Cited by 129 publications

(134 citation statements)

References 15 publications

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“…However, the largest of these two series did not specify the length of follow-up and the other one was a rather small series (n = 89). Although two randomized studies with a short follow-up of nonfixed mesh in laparoscopic repairs (one in TEP and the other in TAPP) did show promising results in terms of recurrence, 40,51 justification for routine nonstapling of the mesh in TEP is not yet substantiated. 13 The low rate of chronic pain complications was similarly observed in many studies by avoiding stapling.This confirms that mesh stapling does play a key role in generating postoperative pain after laparoscopic hernia repair.…”

Section: Discussionmentioning

confidence: 99%

“…41,47,48 However, these studies have been criticized as having too few patients, too short a follow-up period (range, 1-32 months), or too great a loss to follow-up evaluation(8-12% of patients). 5,6 The size of the prosthesis is an important factor. In few experience, fixation of a 14.13 cm mesh ensures better prosthesis stability, and consequently less dislocation and recurrence.…”

Section: Fibrin Glue Use Staples Usementioning

confidence: 99%

“…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%. 40,41,47 Tissucol also is cheaper than any other means of mesh fixation. For example, 1 ml of Tissucol costs e80, as compared with e300 for Endoanchor (Ethicon Endo-Surgery) and e250 for Protak (Tyco, Norwalk, CT, USA).…”

Section: Fibrin Glue Use Staples Usementioning

confidence: 99%

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

Shinde¹

2009

WJOLS

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Fibrin Glue Use Staples Usementioning

confidence: 99%

Section: Fibrin Glue Use Staples Usementioning

confidence: 99%

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

Shinde¹

2009

WJOLS

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“…In both the above mentioned techniques, the hernia sac is reduced, and a large piece of mesh is used to cover the entire inguinal region. Metal staples can be used to hold the mesh in place, however some surgeons believe this is an unnecessary step because it increases costs and also risks due to the possibility of nerve entrapment (31,32). As an alternative to stapling or suturing, the use of fibrin glue can also be explored as a potential option (8,33).…”

Section: Group 4: Laparoscopic Proceduresmentioning

confidence: 99%

“…By searching for secondary hernias during primary repair, Shouldice hospital states that they are able to provide better patient care. Most patients at Shouldice are middle aged, with 32 roughly a quarter being older than 65. This in turn influences the type of hernias seen, as sliding hernias, for example, are more frequent in the older age group.…”

Section: Surgical Specialty Hospitals (Shouldice)mentioning

confidence: 99%

Recurrence of inguinal hernia in general and hernia specialty hospitals in Ontario, Canada

Malik

Bell

Stukel

et al. 2012

Journal of the American College of Surgeons

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Selective Non-Stapling of Mesh During Unilateral Endoscopic Total Extraperitoneal Inguinal Hernioplasty

Lau

Patil²

2003

Arch Surg

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Prospective randomized study of stapled versus unstapled mesh in a laparoscopic preperitoneal inguinal hernia repair

Cited by 129 publications

References 15 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

Recurrence of inguinal hernia in general and hernia specialty hospitals in Ontario, Canada

Selective Non-Stapling of Mesh During Unilateral Endoscopic Total Extraperitoneal Inguinal Hernioplasty

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