Polypropylene suture versus skin staples for securing mesh in lichtenstein inguinal hernioplasty (original) (raw)
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Skin staples: a safe technique for securing mesh in lichtensteins hernioplasty as compared to suture
Surgery research and practice, 2014
Background. Lichtenstein tension free repair is the most commonly used technique due to cost effectiveness, low recurrence rate, and better patient satisfaction. This study was done to compare the duration of surgery and postoperative outcome of securing mesh with skin staples versus polypropylene sutures in Lichtenstein hernia repair. Materials and Methods. A total of 96 patients with inguinal hernia undergoing Lichtenstein mesh repair were randomly assigned into two groups. The mesh was secured either by using skin staples (group I) or polypropylene sutures (group II). Results. The operation time was significantly reduced from mesh insertion to completion of skin closure in group I (mean 20.7 min) as compared to group II (mean 32.7 min) with significant value ( < 0.0001) and less complication rate in group I as compared to group II. Conclusion. Mesh fixation with skin staples is as effective as conventional sutures with added advantage of significant reduction in the operating time and complications or recurrence. The staples can be applied much more quickly than sutures for fixing the mesh, thus saving the operating time. Infection rate is significantly decreased with staples.
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.
Hernia, 2013
Purpose Reduction in operating time has been reported with skin staples instead of original technique of mesh fixation with sutures in Lichtenstein's hernioplasty. Few studies have been conducted, however, with inadequate follow-up and variable results. We have undertaken this study to compare the duration of surgery and incidence of recurrence (beyond 1 year) and chronic pain after mesh fixation with staples versus sutures. Methods In this retrospective cohort study, adult males with primary unilateral inguinal hernia who underwent open Lichtenstein's hernioplasty from January 2009 till October 2010 were included. All patients with recurrent hernia, concomitant surgery, follow-up less than 1 year and missing data were excluded. Data collection was done via questionnaire and telephonic interviews. Outcomes are recurrence, chronic pain and duration of surgery. Results We reviewed 70 patients in each group. At median follow-up of 21 months (range 12-34), there was 0 % recurrence in both the groups and chronic pain was 4.4 % higher in suture versus staple group (11.4 vs. 7 %, p value = 0.7). Median duration of surgery was 30 min higher in suture as compared to staple group (90 vs. 60 min, p value = 0.004). Conclusion Our study confirms that staples are superior to the sutures due to shorter operative time and do not cause any additive risk of recurrence or chronic pain. Prospective trial with long-term follow-up for each patient is required to validate these findings in order to generate definite guidelines.
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.
Use of Tissue Adhesive Versus Staples for Mesh Fixation in Laparoscopic TAPP Inguinal Hernioplasty
Surgery, Gastroenterology and Oncology, 2022
Background: There is a remaining high debate, about mesh fixation involved in laparoscopic inguinal hernia repair (LIHR) that is largely influenced by the individual preferences of each surgeon. In this research study, a comparison is done between mesh fixation in laparoscopic transabdominal preperitoneal (TAPP) using either staples or tissue adhesive (Amcrylate). Methods: This was a prospective randomized controlled study that was applied to 100 patients having an inguinal hernia. Patients included were randomly sorted into two groups based on the closed envelope method; Group I, involved 50 patients previously subjected to laparoscopic TAPP, and tissue adhesive was used for mesh fixation, and GroupII, involved 50 patients subjected to laparoscopic TAPP, and tackers were used for fixation of mesh. Results: We found a difference of statistical significance among the studied groups regarding the assessed VAS score on the 1 st day (P=0.018), 10 th day (P<0.001), and 30 th days (P<0.001), post-operative with a difference that is not statistically significant pre-operative. The statistically analyzed difference among the studied groups was not significant regarding Carolina's Comfort Scale after 6 months, Sensation of mesh, limitation of movement, recurrence, and complications. Conclusion: Mesh fixation using tissue adhesive is preferable to staples because of its association with less post-surgery accompanied pain, earlier return to work, no increase in prompt recurrence rates and complications, better chronic pain experience, and comparable life quality.
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.
International Surgery Journal, 2019
Background: Inguinal hernia repair is one of the most commonly performed procedures by general surgeons. Cyanoacrylate is the generic name for a family of fast acting adhesives. The aim of the present study done in Department of General Surgery, Safdarjung Hospital, New Delhi was to compare the newer emerging technique of mesh fixation.Methods: A total of sixty patients were included in the present study and were allotted in case and control group randomly by sealed envelope technique. In case (study) group, all the patients underwent mesh fixation by cyanoacrylate glue and in control group, by prolene 3-0 sutures.Results: Most frequency in age group 31-40 yrs, males:females ratio >1 and right sided inguinal hernia was more common. Bi-lateral hernia was common in elderly. Indirect: direct ratio 4.5:1. Operating time period for the patients of the case (study) group is less than control group. P value of post-operative pain in immediate post-operative period (day 1 and 2) and POD ...
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
The aim of this study was to assess whether partially absorbable monofilament mesh could influence postoperative pain and recurrence after Lichtenstein hernioplasty over the long term. Patients were randomized into two groups that were treated with lightweight (LW) or heavyweight (HW) mesh in 15 centers in Poland. A modified suture technique was used in the lightweight mesh group. Clinical examination was performed. A pain questionnaire was completed five years after the surgery. Of the 392 patients who underwent surgery, 161 (90.81 %) of 177 in the HW group and 195 (90.69 %) of 215 in the LW group were examined according to protocol, a median of 62 (range 57-66) months after hernia repair. There was no difference in the recurrence rate (1.9 % LW vs. 0.6 % HW; P = 0.493). There were 24 deaths in the follow-up period, but these had no connection to the surgery. The patients treated with LW mesh reported less pain in the early postoperative period. After five years of follow-up, the i...