Open tension-free Lichtenstein repair of inguinal hernia: use of fibrin glue versus sutures for mesh fixation.
Summary of "Open tension-free Lichtenstein repair of inguinal hernia: use of fibrin glue versus sutures for mesh fixation."
PURPOSE:
To investigate pain and other complications following inguinal hernioplasty performed by the Lichtenstein technique with mesh fixation by fibrin glue or sutures.
METHODS:
Five hundred and twenty patients were enrolled in this 12-month observational multicenter study and received either sutures or fibrin glue (Tissucol((R))/Tisseel((R))) based on the preference of the surgeon. Pain, numbness, discomfort, recurrence, and other complications were assessed postoperatively and at 1, 3, 6, and 12 months. Pain intensity was assessed by a visual analog scale (VAS; 0 [no pain] to 10 [worst pain]).
RESULTS:
One hundred and seventy-one patients received sutures and 349 received fibrin glue. During the early postoperative phase, 87.4% of patients in the fibrin glue group and 76.6% of patients in the sutures group were complication-free (P = 0.001). Patients who received fibrin glue were also less likely to experience hematoma/ecchymosis than those in the suture group (both P = 0.001). The mean pain score was significantly lower in the fibrin group than the sutures group (2.5 vs. 3.2, P < 0.001). At 1 month, significantly fewer patients in the fibrin glue group reported pain, numbness, and discomfort compared with patients in the sutures group (all P < 0.05). Fibrin glue patients also experienced less intense pain (0.6 vs. 1.2; P = 0.001). By 3 months, the between-group differences had disappeared, except for numbness, which was more prevalent in the sutures group. By 12 months, very few patients reported complications.
CONCLUSIONS:
Tissucol fibrin glue for mesh fixation in the Lichtenstein repair of inguinal hernia shows advantages over sutures, including lower incidence of complications such as pain, numbness, and discomfort, and should be considered as a first-line option for mesh fixation in hernioplasty.
Affiliation
Azienda Ospedaliera Università degli Studi di Roma "La Sapienza", Rome, Italy, pal.negro@libero.it.
Journal Details
This article was published in the following journal.
Name: Hernia : the journal of hernias and abdominal wall surgery
ISSN: 1248-9204
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20676711
- DOI: http://dx.doi.org/10.1007/s10029-010-0706-8
Medical and Biotech [MESH] Definitions
Hernia, Inguinal
An abdominal hernia with an external bulge in the GROIN region. It can be classified by the location of herniation. Indirect inguinal hernias occur through the internal inguinal ring. Direct inguinal hernias occur through defects in the ABDOMINAL WALL (transversalis fascia) in Hesselbach's triangle. The former type is commonly seen in children and young adults; the latter in adults.
Hernia, Abdominal
A protrusion of abdominal structures through the retaining ABDOMINAL WALL. It involves two parts: an opening in the abdominal wall, and a hernia sac consisting of PERITONEUM and abdominal contents. Abdominal hernias include groin hernia (HERNIA, FEMORAL; HERNIA, INGUINAL) and VENTRAL HERNIA.
Hernia, Femoral
A groin hernia occurring inferior to the inguinal ligament and medial to the FEMORAL VEIN and FEMORAL ARTERY. The femoral hernia sac has a small neck but may enlarge considerably when it enters the subcutaneous tissue of the thigh. It is caused by defects in the ABDOMINAL WALL.
Inguinal Canal
The tunnel in the lower anterior ABDOMINAL WALL through which the SPERMATIC CORD, in the male; ROUND LIGAMENT, in the female; nerves; and vessels pass. Its internal end is at the deep inguinal ring and its external end is at the superficial inguinal ring.
Hernia, Obturator
A pelvic hernia through the obturator foramen, a large aperture in the hip bone normally covered by a membrane. Obturator hernia can lead to intestinal incarceration and INTESTINAL OBSTRUCTION.
PubMed Articles
An animal model to train Lichtenstein inguinal hernia repair.
PURPOSE: Inguinal hernia repair is a common surgical procedure, and the majority of operations worldwide are performed ad modum Lichtenstein (open tension-free mesh repair). Until now, no suitable sur...
A new approach for transversalis fascia reinforcement in Lichtenstein's inguinal hernia repair.
Operations undertaken for inguinal hernia repair are the most common elective surgical procedures. According to the current guidelines, Lichtenstein's tension-free method is the gold standard for elec...
PURPOSE: This prospective, randomized, double-blind study compared the analgesic efficacy and safety of parecoxib sodium versus lornoxicam and diclofenac, after Lichtenstein tension-free mesh inguinal...
PURPOSE: The optimal technique for open inguinal hernia repair is yet to be determined. METHODS: Three hundred and nine male patients [median of 60 years (range, 31-75)] undergoing primary open ingui...
Lichtenstein repair has been the gold standard in inguinal hernia surgery. The aim of this study was to investigate the role of mesh fixation in terms of postsurgical chronic pain and recurrence.
Clinical Trials
Study of Surgical Mesh for Inguinal Hernia Repair
The purpose of this study is to assess the early outcomes when using the Biomerix Revive™ as a tension-free onlay patch, Lichtenstein-style, in patients who are candidates for primary, u...
Efficacy Study of Tissucol/Tisseel Fibrin Sealant to Treat Inguinal Hernia
The purpose of the study is to evaluate mid and long term postoperative pain and further disabling complications in open inguinal hernia repair by Lichtenstein technique after mesh fixatio...
Polypropylene Meshes in Hernia Repair
The aim of this study was to analyze the shrinkage of two different screens in the repair of inguinal hernias in men . 32 patients with unilateral inguinal hernia were assigned randomly....
Chronic Pain After Inguinal Hernia Repair
Chronic pain after inguinal hernia repair has become a major concern. Although tension-free Lichtenstein technique is used and new lightweight meshes have been developed, still up to 40 %...
Randomized Multicentre Study Comparing TEP With Lichtenstein Repair for Primary Inguinal Hernia
The purpose of this study was to compare the recurrence rate after TEP (laparoscopic method) and Lichtenstein (open method) repair on primary inguinal hernia.
