Top

Surgical Endoscopy

Published in:

01-10-2016

Review of 1000 fibrin glue mesh fixation during endoscopic totally extraperitoneal (TEP) inguinal hernia repair

Authors: Christophe R. Berney, Joseph Descallar

Published in: Surgical Endoscopy | Issue 10/2016

Abstract

Background

Chronic pain is a common complication arising after conventional open herniorrhaphy and to a lesser extent postlaparoscopic inguinal hernia repairs as groin incision is avoided. Although published studies support elimination of mesh fixation during endoscopic procedures, the vast majority of surgeons will still recommend it by fear of encountering increased recurrence rates, if omitted. Regrettably, penetrating staple or tack fixation devices are the preferred methods to secure the mesh and cannot be applied at the level of the triangles of ‘doom’ and ‘pain’ where hernia tends to reoccur the most. This ongoing prospective cohort study aimed to confirm the safety and advantages of fibrin glue, as a substitute to staple mesh fixation during totally extraperitoneal (TEP) inguinal hernia repair.

Methods

Over a 10-year period, 703 patients underwent 1000 elective TEP inguinal hernia repairs. Mesh fixation was achieved using exclusively fibrin sealant. Patients were reviewed at 2, 6 weeks and thereafter on an ad hoc basis if judged necessary until complete resolution of their symptoms. Quality of life (QoL) was assessed in a subgroup of 320 patients using the Carolina Comfort Scale (CCS).

Results

No conversion to open surgery was observed. There were three cases of major morbidities and no mortality. Three months after surgery, only seven patients (1 %) experienced chronic groin or testicular discomfort and none of them required prescription painkillers. When using the CCS, at 2 weeks 93.1 % of the patients were either satisfied or very satisfied with their outcome. This satisfaction index increased up to 99.2 % at 6 weeks post surgery. Finally, only eight hernia recurrences (1.1 %) were reported, of which five occurred during the first month of the study.

Conclusion

Fibrin glue mesh fixation of inguinal hernia during TEP repair is extremely safe and reliable, with a very high satisfaction index for the patients and limited risk of developing chronic pain.

Langeveld HR, van’t Riet M, Weidema WF, Stassen LP, Steyerberg EW, Lange J, Bonjer HJ, Jeekel J (2010) Total extraperitoneal inguinal hernia repair compared with Lichtenstein (the LEVEL-Trial): a randomized controlled trial. Ann Surg 251(5):819–824CrossRefPubMed

Gong K, Zhang N, Lu Y, Zhu B, Zhang Z, Du D, Zhao X, Jiang H (2011) Comparison of the open tension-free mesh-plug, transabdominal preperitoneal (TAPP), and totally extraperitoneal (TEP) laparoscopic techniques for primary unilateral inguinal hernia repair: a prospective randomized controlled trial. Surg Endosc 25(1):234–239CrossRefPubMed

Dulucq JL, Wintringer P, Mahajna A (2011) Occult hernias detected by laparoscopic totally extra-peritoneal inguinal hernia repair: a prospective study. Hernia 15(4):399–402CrossRefPubMed

Aasvang E, Kehlet H (2005) Chronic postoperative pain: the case of inguinal herniorrhaphy. Br J Anaesth 95(1):69–76CrossRefPubMed

Wong J, Anvari M (2001) Treatment of inguinodynia after laparoscopic herniorrhaphy: a combined laparoscopic and fluoroscopic approach to the removal of helical tackers. Surg Lap Endosc Percutan Tech 11(2):148–151

Lowham AS, Filipi CJ, Fitzgibbons RJ Jr, Stoppa R, Wantz GE, Felix EL, Crafton WB (1997) Mechanisms of hernia recurrence after preperitoneal mesh repair. Traditional and laparoscopic. Ann Surg 225(4):422–431CrossRefPubMedPubMedCentral

Teng YJ, Pan SM, Liu YL, Yang KH, Zhang YC, Tian JH, Han JX (2011) A meta-analysis of randomized controlled trials of fixation versus nonfixation of mesh in laparoscopic total extraperitoneal inguinal hernia repair. Surg Endosc 25(9):2849–2858CrossRefPubMed

Amid PK (2004) Radiologic images of meshoma: a new phenomenon causing chronic pain after prosthetic repair of abdominal wall hernias. Arch Surg 139(12):1297–1298CrossRefPubMed

Fortelny RH, Petter-Puchner AH, Glaser KS, Redl H (2012) Use of fibrin sealant (Tisseel/Tissucol) in hernia repair: a systematic review. Surg Endosc 26(7):1803–1812CrossRefPubMed

10.

Berney CR, Yeo AE (2013) Mesh fixation with fibrin sealant during endoscopic totally extraperitoneal inguinal hernia approach: a review of 640 repairs. Hernia 17(6):709–717CrossRefPubMed

11.

Putnis S, Berney CR (2012) Totally extraperitoneal repair of inguinal hernia: techniques and pitfalls of a challenging procedure. Langenbecks Arch Surg 397(8):1343–1351CrossRefPubMed

12.

Miserez M, Alexandre JH, Campanelli G, Corcione F, Cuccurullo D, Pascual MH, Hoeferlin A, Kingsnorth AN, Mandala V, Palot JP, Schumpelick V, Simmermacher RK, Stoppa R, Flament JB (2007) The European hernia society groin hernia classification: simple and easy to remember. Hernia 11(2):113–116CrossRefPubMed

13.

Berney CR (2012) The Endoloop technique for the primary closure of direct inguinal hernia defect during the endoscopic totally extraperitoneal approach. Hernia 16(3):301–305CrossRefPubMed

14.

Heniford BT, Walters AL, Lincourt AE, Novitsky YW, Hope WW, Kercher KW (2008) Comparison of generic versus specific quality-of-life scales for mesh hernia repairs. J Am Coll Surg 206(4):638–644CrossRefPubMed

15.

Knox RD, Berney CR (2015) A preoperative hernia symptom score predicts inguinal hernia anatomy and outcomes after TEP repair. Surg Endosc 29(2):481–486CrossRefPubMed

16.

Berney CR (2012) Unusual clinical presentation of a preperitoneal hernia following endoscopic totally extraperitoneal inguinoscrotal hernia repair. Hernia 16(5):585–587CrossRefPubMed

17.

Bittner R, Montgomery MA, Arregui E, Bansal N, Bingener J, Bisgaard T, Buhck H, Dudai M, Ferzli GS, Fitzgibbons RJ, Fortelny RH, Grimes KL, Klinge U, Kockerling F, Kumar S, Kukleta J, Lomanto D, Misra MC, Morales-Conde S, Reinpold W, Rosenberg J, Singh K, Timoney M, Weyhe D, Chowbey P (2015) Update of guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal Hernia (International Endohernia Society). Surg Endosc 29(9):289–321CrossRefPubMed

18.

Griffin KJ, Harris S, Tang TY, Skelton N, Reed JB, Harris AM (2010) Incidence of contralateral occult inguina hernia found at the time of laparoscopic trans-abdominal pre-peritoneal (TAPP) repair. Hernia 14(4):345–349CrossRefPubMed

19.

Putnis S, Wong A, Berney C (2011) Synchronous femoral hernias diagnosed during endoscopic inguinal hernia repair. Surg Endosc 25(12):3752–3754CrossRefPubMed

20.

Old OJ, Kulkarni SR, Hardy TJ, Slim FJ, Emerson LG, Bulbulia RA, Whyman MR, Poskitt KR (2015) Incidental non-inguinals hernias in totally extra-peritoneal hernia repair. Ann R Coll Surg Engl 97(2):120–124CrossRefPubMed

21.

Köckerling F, Schug-Pass C, Adolf D, Keller T, Kuthe A (2015) Bilateral and unilateral total extraperitoneal inguinal hernia repair (TEP) have equivalent early outcomes: analysis of 9395 cases. World J Surg 39(8):1887–1894CrossRefPubMedPubMedCentral

22.

Tamme C, Scheidbach H, Hampe C, Schneider C, Köckerling F (2003) Totally extraperitoneal endoscopic inguinal hernia repair (TEP). Surg Endosc 17(2):190–195CrossRefPubMed

23.

Bochkarev V, Ringley C, Vitamvas M, Oleynikov D (2007) Bilateral laparoscopic inguinal hernia repair in patients with occult contralateral inguinal defects. Surg Endosc 21(5):734–736CrossRefPubMed

24.

Berney CR (2012) Mastering the totally extraperitoneal technique is a prerequisite for successful inguinal hernia repair. ANZ J Surg 82(4):196–197CrossRefPubMed

25.

Olmi S, Erba L, Bertolini A, Scaini A, Croce E (2006) Fibrin glue for mesh fixation in laparoscopic transabdominal preperitoneal (TAPP) hernia repair: indications, technique, and outcomes. Surg Endosc 20(12):1846–1850CrossRefPubMed

26.

Katkhouda N, Mavor E, Friedlander MH, Mason RJ, Kiyabu M, Grant SW, Achanta K, Kirkman EL, Narayanan K, Essani R (2001) Use of fibrin sealant for prosthetic mesh fixation in laparoscopic extraperitoneal inguinal hernia repair. Ann Surg 233(1):18–25CrossRefPubMedPubMedCentral

27.

Gonzalez R, Fugate K, McClusky D 3rd, Ritter EM, Lederman A, Dillehay D, Smith CD, Ramshaw BJ (2005) Relationship between tissue ingrowth and mesh contraction. World J Surg 29(8):1038–1043CrossRefPubMed

28.

Schwab R, Schumacher O, Junge K, Binnebosel M, Klinge U, Becker HP, Schumpelick V (2008) Biomechanical analyses of mesh fixation in TAPP and TEP hernia repair. Surg Endosc 22(3):731–738CrossRefPubMed

29.

Kukleta JF, Freytag C, Weber M (2012) Efficiency and safety of mesh fixation in laparoscopic inguinal hernia repair using n-butyl cyanoacrylate: long-term biocompatibility in over 1300 mesh fixations. Hernia 16(2):153–162CrossRefPubMed

Title: Review of 1000 fibrin glue mesh fixation during endoscopic totally extraperitoneal (TEP) inguinal hernia repair
Authors: Christophe R. Berney
Joseph Descallar
Publication date: 01-10-2016
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 10/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-016-4791-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Review of 1000 fibrin glue mesh fixation during endoscopic totally extraperitoneal (TEP) inguinal hernia repair

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 10/2016

Robotic complete mesocolic excision for right-sided colon cancer

Systematic review on the effectiveness of augmented reality applications in medical training

Erratum to: Laparoscopic splenectomy is a better surgical approach for spleen-relevant disorders: a comprehensive meta-analysis based on 15-year literatures

Total laparoscopic living donor right hemihepatectomy: first case in China mainland and literature review

Body composition changes after totally laparoscopic distal gastrectomy with delta-shaped anastomosis: a comparison with conventional Billroth I anastomosis

New device for transrectal trocar placement and rectal sealing for NOTES: a porcine in vivo and human cadaver study