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Comparing fibrin sealant with staples for mesh fixation in laparoscopic transabdominal hernia repair: a case control-study

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Abstract

Background

Laparoscopic hernia repair is not as popular as cholecystectomy. We have performed more than 3,000 laparoscopic herniorrhaphies using the trans-abdominal (TAPP) technique. To prevent recurrences we fix the polypropylene mesh with staples. The use of fibrin glue for graft fixation is a possible alternative.

Methods

We have performed 3,130 laparoscopic hernia repairs over 14 years. For mesh fixation we used titanium clips and observed a small number of complications. In July 2003 we started using fibrin glue (Tissucol®). The purpose of this retrospective longitudinal study was to evaluate if the use of fibrin sealant was as safe and effective as conventional stapling and if there were differences in post-operative pain, complications and recurrences.

Results

From July 2003 to June 2006 we performed 823 laparoscopic herniorrhaphies. Fibrin glue (Tissucol®) was used in 88 cases. Two homogeneous groups of 68 patients (83 cases) treated with fibrin glue and 68 patients (87 cases) where the mesh was fixed with staples, were compared. Patients with relevant associated diseases or large inguino-scrotal hernias were excluded. Operative times were longer in the group treated with fibrin glue with a mean of 35 minutes (range 22–65 mins) compared to the group treated with staples (25 minutes, range 14–50 mins). The time of hospital stay was the same (24 hours). Post-operative complications, that were more frequent in the stapled group, included trocar site pain, hematomas, intra-operative bleedings and incisional hernias. No significant difference was observed concerning seromas, chronic pain and recurrence rate.

Conclusions

Less post-operative pain, and a faster return to usual activities are the main advantages of laparoscopic repair compared to the traditional approach. The use of fibrin sealant reduces in our experience the risk of post- and intra-operative complications such as bleeding and incisional hernia; recurrence rates are similar, but the operative time is longer.

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References

  1. Corbitt JD (1991) Laparoscopic herniorrhaphy. Surg Laparosc Endosc 1:23–25

    PubMed  Google Scholar 

  2. Ger R (1991) The laparoscopic management of groin hernias. Contemp Surg 63:15–19

    Google Scholar 

  3. Arregui ME, Davis CJ, Yucel O, Nagan RF (1992) Laparoscopic mesh repair of inguinal hernia using a preperitoneal approach: a preliminary report. Surg Laparosc Endosc 2:53–58

    PubMed  CAS  Google Scholar 

  4. Filipi CJ, Fitzgibbon RJ, Salerno GM, Hart RO (1992) Laparoscopic herniorrhaphy. Surg Clin North Am 72:1109–1123

    PubMed  CAS  Google Scholar 

  5. Barkun JS, Wexler MJ, Hinchey EJ, Thibeault D, Meakins JL (1995) Laparoscopic versus open inguinal herniorrhaphy: preliminary results of a randomized controlled trial. Surgery 118:703–710

    Article  PubMed  CAS  Google Scholar 

  6. Tanphiphat C, Tanprayoon T, Sangsubhan C, Chatamura K (1998) Laparoscopic versus open inguinal hernia repair. Surg Endosc 12:846–851

    Article  PubMed  CAS  Google Scholar 

  7. Deans GT, Wilson MS, Royston CMS, Brough WA (1995) Recurrent inguinal hernia after laparoscopic repair: a possible cause and prevention. Br J Surg 82:539–541

    Article  PubMed  CAS  Google Scholar 

  8. Felix E, Scott S, Crafton B, Geis P, Duncan T, Sewell R, McKernan B (1998) Causes of recurrence after laparoscopic hernioplasty: a multicenter study. Surg Endosc 9:135–139

    Google Scholar 

  9. Phillips EH, Arregui ME, Carroll BJ, Corbitt J, Crafton WB, Fallas MJ, Filipi C, Fitzgibbons J, Franklin MJ, McKernan B, et al. (1995) Incidence of complications following laparoscopic hernioplasty. Surg Endosc 9:16–21

    PubMed  CAS  Google Scholar 

  10. Sayad P, Hallak A, Ferzli G (1998) Laparoscopic herniorrhaphy: review of complications and recurrence. J Laparoendosc Adv Surg Tech 8:3–10

    Article  CAS  Google Scholar 

  11. Andrew DR, Gregory RP, Richardson DR (1994) Meralgia paraesthetica following laparoscopic inguinal herniorrhaphy. Br J Surg 81(5):715

    Article  PubMed  CAS  Google Scholar 

  12. Chevallier JM, Wind P, Lassau JP (1996) Damage to the inguinofemoral nerves in the treatment of hernias: an anatomical hazard of traditional and laaproscopc techniques. Ann Chir 50:767–775

    PubMed  CAS  Google Scholar 

  13. Stark E, Oestreich K, Wendl K, Rumstradt B, Hagmuller E (1999) Nerve irritation after laparoscopic hernia repair. Surg Endosc 13:878–881

    Article  PubMed  CAS  Google Scholar 

  14. Kraus MA (1993) Nerve injury during laparoscopic inguinal hernia repair. Surg Laparosc Endosc 3:342–345

    PubMed  CAS  Google Scholar 

  15. Rosen A, Halevy A (1997) Anatomical basis for nerve injury during laparoscopic hernia repair. Surg Laparosc Endosc 7:469–471

    Article  PubMed  CAS  Google Scholar 

  16. Khajanchee YS, Urbach DR, Swanstrom LL, Hansen PD (2001) Outcomes of laparoscopic herniorrhaphy without fixation of mesh to the abdominal wall. Surg Endosc 15:1102–1107

    Article  PubMed  CAS  Google Scholar 

  17. Ferzli GS, Frezza EE, Pecoraro AM Jr, Ahern KD (1999) Prospective randomized study of stapled versus unstapled mesh in laparoscopic preperitoneal inguinal hernia repair. J Am Coll Surg 188:461–465

    Article  PubMed  CAS  Google Scholar 

  18. Smith AI, Royston CM, Sedman PC (1999) Stapled and nonstapled laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. A prospective randomized trial. Surg Endosc 13:804–806

    CAS  Google Scholar 

  19. Byrne DJ, Hardy J, Wood RA, McIntosh R, Cuschieri A (1991) Effect of fibrin glues on the mechanical properties of healing wounds. Br J Surg 78:841–843

    Article  PubMed  CAS  Google Scholar 

  20. Spotnitz WD, Falstrom JK, Rodeheaver GT (1997) The role of sutures and fibrin sealant in wound healing. Surg Clin North Am 77:651–699

    Article  PubMed  CAS  Google Scholar 

  21. Fernandez LF, Tejero E, Tieso A (1996) Randomized trial of fibrin glue to seal mechanical oesophagojejunal anastomosis. Br J Surg 83:40–41

    Article  Google Scholar 

  22. Canonico S, Sciaudone G, Pacifico F, Santoriello A (1999) Inguinal hernia repair in patients with coagulation problems: prevention of postoperative bleeding with human fibrin glue. Surgery 125:315–317

    PubMed  CAS  Google Scholar 

  23. Katkhouda N, Mavor E, Friedlander MH, Mason RJ, Kiyabu M, Grant SW, Achanta K, Kirkman EL, Narayan K, Essani R (2001) Use of fibrin sealant for prosthetic mesh fixation in laparoscopic extraperitoneal inguinal hernia repair. Ann Surg 233:18–25

    Article  PubMed  CAS  Google Scholar 

  24. Novik B, Hagedorn S, Mork UB, Dahlin K, Skullman S, Dalenback J (2006) Fibrin glue for securing the mesh in laparoscopic totally extraperitoneal inguinal hernia repair: a study with a 40-month prospective follow-up period. Surg Endosc 20(3):462–467

    Article  PubMed  CAS  Google Scholar 

  25. Olmi S, Erba L, Bertolini A, Scaini A, Mastropasqua E, Conti M, Croce E (2005) Use of fibrin glue (Tissucol) for mesh fixation in laparoscopic transabdominal hernia repair. Chir Ital 57(6):753–759

    PubMed  Google Scholar 

  26. Canonico S, Santoriello A, Campitiello F, Fattopace A, Corte AD, Sordelli I, Benevento R (2005) Mesh fixation with human fibrin glue (Tissucol) in open tension-free inguinal hernia repair: a preliminary report. Hernia 9(4):330–333

    Article  PubMed  CAS  Google Scholar 

  27. Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R Jr, Dunlop D, Gibbs J, Reda D, Henderson W (2004) Veterans Affairs Cooperative Studies Program 456 Investigators: Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 350:1819–1827

    Article  PubMed  CAS  Google Scholar 

  28. Heikkinen TJ, Haukipuro K, Koivukangas P, Hulkko A (1998) A prospective randomized outcome and cost comparison of totally extraperitoneal endoscopic hernioplasty versus Lichtenstein hernia operation among employed patients. Surg Laparosc Endosc 8:338–344

    Article  PubMed  CAS  Google Scholar 

  29. Stylopulos N, Gazzelle GS, Rattner DW (2003) A cost-utility analysis of treatment options for inguinal hernia in 1,513,008 adult patients. Surg Endosc 17:180–189

    Article  Google Scholar 

  30. Kraus MA (1993) Nerve injury during laparoscopic inguinal hernia repair. Surg Laparosc Endosc 3:342–345

    PubMed  CAS  Google Scholar 

  31. Schwab R, Willims A, Kroger A, Becker HP (2006) Less chronic pain following mesh fixation using a fibrin sealant in TEP inguinal hernia repair. Hernia 10:272–277

    Article  PubMed  CAS  Google Scholar 

  32. Felix EL, Harbertson N, Vartanian S (1999) Laparoscopic hernioplasty: significant complications. Surg Endosc 13:328–331

    Article  PubMed  CAS  Google Scholar 

  33. Knook MTT, Weidema WF, Stassen LPS, van Steensel CJ (1999) Endoscopic total extraperitoneal repair of primary and recurrent inguinal hernias. Surg Endosc 13:507–511

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of General, Vascular and Mininvasive Surgery, Spoleto Hospital, Spoleto, PG, Italy

    Graziano Ceccarelli, Luciano Casciola, Alberto Bartoli, Lelio Di zitti, Alessandro Spaziani, Alessia Biancafarina, Massimo Stefanoni & Alberto Patriti

  2. Surgical Department “Pietro Valdoni”, University of Rome “La Sapienza”, Rome, Italy

    Massimo Codacci Pisanelli

Authors
  1. Graziano Ceccarelli
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  2. Luciano Casciola
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  3. Massimo Codacci Pisanelli
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  4. Alberto Bartoli
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  7. Alessia Biancafarina
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  8. Massimo Stefanoni
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  9. Alberto Patriti
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Correspondence to Graziano Ceccarelli.

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Ceccarelli, G., Casciola, L., Pisanelli, M.C. et al. Comparing fibrin sealant with staples for mesh fixation in laparoscopic transabdominal hernia repair: a case control-study. Surg Endosc 22, 668–673 (2008). https://doi.org/10.1007/s00464-007-9458-7

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  • DOI: https://doi.org/10.1007/s00464-007-9458-7

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