Suture versus staple for fixation of mesh in incisional hernia repair

Abstract

The incidence of incisional hernia has been reported to be between 11 and 20% in patients post laparotomy and carries the risk of pain, incarceration and strangulation. Prosthetic mesh for incisional hernia repair has been shown to be superior to suture repair. The recurrence rate of primary mesh repair of incisional hernias has been reported to be as high as 38%. This experimental study in euthanised rats aims to compare the fixation strength of mesh using sutures and surgical staples. Forty euthanised adult male Sprague-Dawley rats were used for midline laparotomy incisions and repair of the abdominal wall carried out using polypropylene mesh anchored using either skin staples or Prolene sutures. An intra-abdominal expander device was inserted into the abdomen and inflated to measure 'burst pressure'. Pressure changes and surgical time were recorded. There was no statistically significant difference (P = 0.83) in the pressure required to disrupt the mesh fixation between the two groups, 101 Ϯ 12 mmHg in the suture group versus 102 Ϯ 14 mmHg in the staple group. Staple fixation was 9.7 times faster compared with suture fixation, 291 Ϯ 42 s for suture versus 30 Ϯ 8 s for staples (P < 0.001) (power = 94%). The immediate strength of fixation is equal using both sutures and staples, however staple fixation is faster. Mesh migration due to inadequate fixation using either method is unlikely to cause early failure, however suture and staple 'cut out' during early movement may explain this.

Is there difference in chronic pain after Suture and Stapler fixation method of mesh in Ventral Hernia? Is stapler fixation method quicker? A randomized controlled trial

“…This finding was consistent with three other studies of Dhillon RS et al, Khan AA et al and Sheikh FA et al done in 2008, 2014 and 2013 respectively. 5 , 12 , 13 …”

The Development of Equipment to Measure Mesh Erosion of Soft Tissue

“…Some meshes use different polymers, including degradable materials and those derived from biological sources, and some are made using other methods, such a weaving. They are widely used to make implantable devices for the repair and support of soft tissues and organs, such as hernia repair [ 3 , 4 ] and restraint of prolapsed organs in the pelvic area such as the vagina and rectum [ 5 , 6 ]. Another application, which became very popular over the last twenty years, is the use of mesh in the form of a tape of width approximately 10 mm to apply pressure to the urethra to prevent urinary incontinence [ 7 , 8 ].…”