Skin staples: a safe technique for securing mesh in lichtensteins hernioplasty as compared to suture (original) (raw)
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journal of medical science and clinical research, 2017
Background: Fixation of the mesh in Lichtenstein's inguinal hernioplasty is traditionally performed with polypropylene sutures. A modification of this technique uses skin staples for securing of the mesh. This study compared two methods of mesh fixation. Material and Methods: Forty six patients undergoing fifty repairs were randomized into two groups. In control group polypropylene mesh was secured with 2/0 polypropylene sutures and skin closed with 2/0 ethilon. In study group polypropylene mesh was secured with skin staples and skin was closed with staples from the same stapler. Duration of surgery, post-operative complications, recurrence and costs were compared. Results: The operation was significantly shorter when staples were used (mean 36 minute versus 52 minute, P < 0.001). There was no significant difference in the incidence of postoperative complications. There were no recurrences in either group in the follow up period (median 3 months). Conclusion: The use of skin staples to secure mesh in Lichtenstein inguinal hernioplasty significantly reduced the duration of surgery and was as effective as conventional mesh fixation with polypropylene in the short term One more advantage of using skin stapler for mesh fixation in HIV and hepatitis B positive patients is to reduces the operating time thus reduces the duration of exposure to infected blood as well as it reduces the chances of needle prick injury.
Background: The tension-free hernioplasty as introduced by Lichtenstein has gained increasing acceptance during the last decade. This study compared two methods of mesh fixation. Material and Methods: Fifty-four patients undergoing sixty repairs were randomized into two groups. In control group polypropylene mesh was secured with 2/0 polypropylene sutures and skin closed with 2/0 polyamide black. In study group polypropylene mesh was secured with skin staples and skin was closed with staples from the same stapler. Duration of the surgery was recorded. Results: The operation was significantly shorter when staples were used (median 42 min 30 s versus 54 min 30 s, P < 0.001). There was no significant difference in the incidence of postoperative complications or pain. There were no recurrences in either group in the follow up period (median 12 months). Conclusion: This technique of mesh fixation is as effective as conventional fixation with polypropylene sutures with an important added advantage; significant reduction in the operative time.
Journal of Medical Science And clinical Research
Background: Since time immemorial, inguinal herniorrhaphy is one of the oldest and commonest operations in the surgeon's technical armamentarium. Since the first true herniorrhaphy was performed by Bassini as early as 1887 AD, modifications and surgical techniques have shared a common disadvantage: suture line tension. To use this already defective tissue particularly under tension is counter-productive and total reinforcement with a sheet of mesh securing the areas much beyond the boundary of Hasselbach's triangle is much more effective procedure 3. With the use of modern mesh prosthetics, it is now possible to repair all adult inguinal hernias without distortion of normal anatomy and with no suture line tension. Aims and Objectives: To compare the use of skin staples versus polypropylene sutures to fix the mesh. Settings and design: This is a prospective study carried out in SSG Hospital from July 2002 to April 2005. Materials and Methods: This study comprised of 54 patients undergoing 60 repairs randomized into stapler group and polypropylene group. Results: The duration of surgery and length of hospital stay in the group wit mesh fixation by staples was less as compared to mesh fixed by polypropylene sutures. Also the complication rate was less as compared to the other group. Conclusion: It can be concluded that in a set up like ours, catering to poor and rural patients, this technique of mesh fixation is as effective as conventional fixation with polypropylene sutures with an important added advantage, which was significant, and that is reducing the operative time, being less painful and providing good fixation of mesh and the most important, early return to work.
Polypropylene suture versus skin staples for securing mesh in lichtenstein inguinal hernioplasty
Objective: To compare polypropylene suture and skin staples for securing mesh in Lichtenstein inguinal hernioplasty in terms of mean operating time and postoperative pain. Study Design: Randomized clinical trial. Place and Duration of Study: Surgical Ward, Combined Military Hospital, Kharian, from August 2011 to February 2012. Methodology: All individuals fulfilling inclusion criteria underwent elective Lichtenstein inguinal hernioplasty as admitted patients, under spinal anaesthesia and with aseptic measures. In group 1, during the operation, mesh fixation was done with 2/0 polypropylene suture and skin was closed with subcuticular 2/0 polypropylene suture whereas in group 2, the anchorage of mesh was done with skin staples and skin was closed with staples from the same stapler. Mean operative time and postoperative pain, assessed on a visual analog score, were compared between the groups. Results: The overall postoperative pain was lower (p = 0.026) when staples were used to ancho...
A comparative study of skin staples versus sutures for fixing mesh in tension-free mesh hernioplasty
Archives of Clinical and Experimental Surgery (ACES), 2017
Introduction Hernia repair is the most common elective procedure in general surgery [1]. Annually over 700,000 inguinal herniorrhaphies are performed in the United States [2], 100,000 in France [1], and 800,000 in UK [3]. The techniques include open suture, open mesh, and laparoscopic techniques. Traditionally, the most important measure of success of a hernia repair proce
Hernia : the journal of hernias and abdominal wall surgery, 2012
Following Lichtenstein hernia repair, up to 25% of patients experience prolonged postoperative and chronic pain as well as discomfort in the groin. One of the underlying causes of these complaints are the compression or irritation of nerves by the sutures used to fixate the mesh. We compared the level and rate of chronic pain in patients operated with the classical Lichtenstein technique fixated by sutures to patients with sutureless mesh fixation technique. A two-armed randomized trial with 264 male patients was performed. After consent, patients were randomized preoperatively. For the fixation of the mesh we used either sutures with slow-absorbing material (PDS 2.0) (group I, n = 133) or tissue glue (Histoacryl) (group II, n = 131). Follow-up examinations were performed after 3, 12 months and after 5 years. Patient characteristics in the two groups were similar. No cross-over between groups was observed. After 5 years, long-term follow-up could be completed for 59% of subjects. Af...
Randomized clinical trial of self-gripping mesh versus sutured mesh for Lichtenstein hernia repair
British Journal of Surgery, 2012
Background Many patients develop discomfort after open repair of a groin hernia. It was hypothesized that suture fixation of the mesh is a cause of these symptoms. Methods This patient- and assessor-blinded randomized multicentre clinical trial compared a self-gripping mesh (Parietene Progrip®) and sutured mesh for open primary repair of uncomplicated inguinal hernia by the Lichtenstein technique. Patients were assessed before surgery, on the day of operation, and at 1 and 12 months after surgery. The primary endpoint was moderate or severe symptoms after 12 months, including a combination of chronic pain, numbness and discomfort. Results The intention-to-treat population comprised 163 patients with self-gripping mesh and 171 with sutured mesh. The 12-month prevalence of moderate or severe symptoms was 17·4 and 20·2 per cent respectively (P = 0·573). There were no significant differences between the groups in postoperative complications (33·7 versus 40·4 per cent; P = 0·215), rate o...
The Egyptian Journal of Hospital Medicine, 2018
Background: inguinal hernia repair is one of the most common operations in general surgery. The Lichtenstein tension-free operation has become gold standard in open inguinal hernia repair. Despite the low recurrence rates; postoperative pain and discomfort remain a problem for a large number of patients. Aim of the work: the aim of this study is to compare between cyanoacrylate, sutureless and polypropylene sutures in mesh fixation on lichtenstein tension free in repair of open inguinal hernia regard as postoperative pain, infection, recurrence,& cost benefit. Methods: a total of thirty patients with primary unilateral uncomplicated inguinal hernia were randomized to undergo lichtenstein tension free hernioplasty, and were randomized using close envelope into three groups: Group A: Inguinal hernioplasty with mesh fixation using polypropylene sutures (10 patients), Group B: Inguinal hernioplasty with mesh fixation using cyanoacrylate glue (10 patients) and Group C: Inguinal herniopla...
International Surgery Journal, 2018
The Lichtenstein technique is a standard procedure for open tension-free inguinal hernia repair performed using meshes to strengthen the posterior wall of inguinal canal. Tension free repair using mesh in Lichtenstein inguinal hernia surgery has led to a substantial decrease in hernia recurrence. The prevalence of postoperative pain after open and laparoscopic procedures has been reported to be as high as 30%. Estimate is that 12% of patients feel themselves to be restricted in their daily activities because of pain. 1,2 Conventionally, the mesh is secured by either sutures or staples. Despite the ''tension-free'' nature of these hernioplasties, sutures and staples may strangulate muscle fibers, compress regional nerves, or give rise to incapacitating pain or dysesthesia. 3 Complications associated with sutured mesh fixation following open groin hernia repair have prompted surgeons to evaluate methods of atraumatic fixation, such as the use of human fibrin glue. Fibrin glue is a biodegradable adhesive combining human-derived fibrinogen and thrombin that replicates the last step of the ABSTRACT Background: Tension free repair using mesh in open hernia repair has become more popular in recent years. Chronic pain remains a frequent complication after Lichtenstein inguinal hernia repair. The use of sutures to fix the mesh has been implicated. Fixing the mesh using cynoacrylate glue could avoid this complication. The purpose of the present study is to study the incidence of pain and other complications following inguinal hernia repair performed by the Lichtenstein technique with mesh fixation by cyanoacrylate surgical glue. Methods: T This study was conducted at tertiary care hospital. Inclusion criteria were all patients coming to the hospital with inguinal or inguinoscrotal hernias diagnosed clinically. Exclusion criteria were all complicated inguinal hernia namely obstructed, strangulated, and large hernias with scrotal abdomen, recurrent hernia. Patient not fit for surgery or not consenting to join the study. The patients will be informed about the surgery and thereafter requested to sign an informed consent. Primary outcome was postoperative pain. Secondary endpoints were operating time, surgical site infection and recurrence rate. Results: Total number of 31 cases enrolled in the study of which twenty-two had unilateral and seven had bilateral inguinal hernias. Average pain score on POD 1, 3, 7 was 5.75; 4.53; 3.32 respectively. One patient developed seroma which was managed conservatively. No evidence of recurrence during study period. Conclusions: Cyanoacrylate surgical glue is a reliable method and can be used as an alternative for conventional Lichtenstein hernia repair.