Top

Published in:

01-03-2008

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

Authors: Graziano Ceccarelli, Luciano Casciola, Massimo Codacci Pisanelli, Alberto Bartoli, Lelio Di zitti, Alessandro Spaziani, Alessia Biancafarina, Massimo Stefanoni, Alberto Patriti

Published in: Surgical Endoscopy | Issue 3/2008

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.

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

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

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 2:53–58PubMed

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

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

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

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

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

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 9:16–21PubMed

10.

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

11.

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

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 50:767–775PubMed

13.

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

14.

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

15.

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

16.

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

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 188:461–465PubMedCrossRef

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

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 78:841–843PubMedCrossRef

20.

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

21.

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

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 125:315–317PubMed

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 233:18–25PubMedCrossRef

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):462–467PubMedCrossRef

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):753–759PubMed

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):330–333PubMedCrossRef

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 350:1819–1827PubMedCrossRef

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 8:338–344PubMedCrossRef

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 17:180–189CrossRef

30.

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

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 10:272–277PubMedCrossRef

32.

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

33.

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

Title: Comparing fibrin sealant with staples for mesh fixation in laparoscopic transabdominal hernia repair: a case control-study
Authors: Graziano Ceccarelli
Luciano Casciola
Massimo Codacci Pisanelli
Alberto Bartoli
Lelio Di zitti
Alessandro Spaziani
Alessia Biancafarina
Massimo Stefanoni
Alberto Patriti
Publication date: 01-03-2008
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 3/2008
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-007-9458-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2008

A Modified Umbilical Incision for Specimen Extraction After Laparoscopic Abdominal Surgery

Laparoscopic adrenalectomies: A nationwide single-surgeon experience

Endoscopic submucosal dissection used for treating early neoplasia of the foregut using a combination of knives

Safety, feasibility and weight loss after transoral gastroplasty: First human multicenter study

The usefulness of chromoendoscopy with methylene blue in Barrett’s metaplasia and early esophageal carcinoma

News and notices