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Surgical Endoscopy
Published in: Surgical Endoscopy 3/2011

01-03-2011

Mesh shrinkage and pain in laparoscopic ventral hernia repair: a randomized clinical trial comparing suture versus tack mesh fixation

Authors: Guido Beldi, Markus Wagner, Lukas E. Bruegger, Anita Kurmann, Daniel Candinas

Published in: Surgical Endoscopy | Issue 3/2011

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Abstract

Background

Mesh fixation during laparoscopic ventral hernia repair can be performed using transfascial sutures or metal tacks. The aim of the present study is to compare mesh shrinkage and pain between two different techniques of mesh fixation in a prospective randomized trial.

Methods

A randomized trial was performed. Patients with ventral hernia of maximal diameter 8 cm were assigned to mesh fixation using either transfascial nonabsorbable sutures or metal tacks for fixation of a parietene composite mesh. The borders of the mesh were marked using clips, and radiological images in prone position were used for assessment of mesh size and location. The primary endpoint was mesh shrinkage; secondary endpoints included postoperative pain, mesh dislocation, and surgical morbidity.

Results

Demographic parameters were similar in both groups. A total of 40 patients were randomized, and 36 patients were available for follow-up. There was one hernia recurrence in each group. Pain was significantly higher following suture fixation after 6 weeks, but no difference was found after 6 months. Mesh shrinkage after 6 months was significantly higher using tacks for mesh fixation.

Conclusions

Transfascial sutures are associated with more pain within the first 6 postoperative weeks and less mesh shrinkage after 6 months compared with mesh fixation using metal tacks.
Literature
1.
Beldi G, Ipaktchi R, Wagner M, Gloor B, Candinas D (2006) Laparoscopic ventral hernia repair is safe and cost effective. Surg Endosc 20:92–95PubMedCrossRef
2.
Bingener J, Buck L, Richards M, Michalek J, Schwesinger W, Sirinek K (2007) Long-term outcomes in laparoscopic vs open ventral hernia repair. Arch Surg 142:562–567PubMedCrossRef
3.
Chelala E, Thoma M, Tatete B, Lemye AC, Dessily M, Alle JL (2007) The suturing concept for laparoscopic mesh fixation in ventral and incisional hernia repair: mid-term analysis of 400 cases. Surg Endosc 21:391–395PubMedCrossRef
4.
Heniford BT, Park A, Ramshaw BJ, Voeller G (2003) Laparoscopic repair of ventral hernias: nine years’ experience with 850 consecutive hernias. Ann Surg 238:391–399; discussion 399–400
5.
Olmi S, Scaini A, Cesana GC, Erba L, Croce E (2007) Laparoscopic versus open incisional hernia repair: an open randomized controlled study. Surg Endosc 21:555–559PubMedCrossRef
6.
Kapischke M, Schulz T, Schipper T, Tensfeldt J, Caliebe A (2008) Open versus laparoscopic incisional hernia repair: something different from a meta-analysis. Surg Endosc 22:2251–2260PubMedCrossRef
7.
Asencio F, Aguilo J, Peiro S, Carbo J, Ferri R, Caro F, Ahmad M (2009) Open randomized clinical trial of laparoscopic versus open incisional hernia repair. Surg Endosc 23:1441–1448PubMedCrossRef
8.
Sajid MS, Bokhari SA, Mallick AS, Cheek E, Baig MK (2009) Laparoscopic versus open repair of incisional/ventral hernia: a meta-analysis. Am J Surg 197:64–72PubMedCrossRef
9.
Wassenaar E, Schoenmaeckers E, Raymakers J, van der Palen J, Rakic S (2010) Mesh-fixation method and pain and quality of life after laparoscopic ventral or incisional hernia repair: a randomized trial of three fixation techniques. Surg Endosc 24:1296–1302PubMedCrossRef
10.
Carbonell AM, Matthews BD, Kercher KW, Heniford BT (2003) Technique for introducing large composite mesh while performing laparoscopic incisional hernioplasty. Surg Endosc 17:1506; author reply 1507
11.
van’t Riet M, de Vos van Steenwijk PJ, Kleinrensink GJ, Steyerberg EW, Bonjer HJ (2002) Tensile strength of mesh fixation methods in laparoscopic incisional hernia repair. Surg Endosc 16:1713–1716PubMedCrossRef
12.
Winslow ER, Diaz S, Desai K, Meininger T, Soper NJ, Klingensmith ME (2004) Laparoscopic incisional hernia repair in a porcine model: what do transfixion sutures add? Surg Endosc 18:529–35
13.
Karakousis CP, Volpe C, Tanski J, Colby ED, Winston J, Driscoll DL (1995) Use of a mesh for musculoaponeurotic defects of the abdominal wall in cancer surgery and the risk of bowel fistulas. J Am Coll Surg 181:11–16PubMed
14.
Kaufman Z, Engelberg M, Zager M (1981) Fecal fistula: a late complication of Marlex mesh repair. Dis Colon Rectum 24:543–544PubMedCrossRef
15.
Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, Pitkin R, Rennie D, Schulz KF, Simel D, Stroup DF (1996) Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA 276:637–639PubMedCrossRef
16.
McGinty JJ, Hogle NJ, McCarthy H, Fowler DL (2005) A comparative study of adhesion formation and abdominal wall ingrowth after laparoscopic ventral hernia repair in a porcine model using multiple types of mesh. Surg Endosc 19:786–790PubMedCrossRef
17.
Jacob BP, Hogle NJ, Durak E, Kim T, Fowler DL (2007) Tissue ingrowth and bowel adhesion formation in an animal comparative study: polypropylene versus proceed versus parietex composite. Surg Endosc 21:629–633PubMedCrossRef
18.
Sickle KR, Baghai M, Mattar SG, Bowers SP, Ramaswamy A, Swafford V, Smith CD, Ramshaw BJ (2005) What happens to the rectus abdominus fascia after laparoscopic ventral hernia repair? Hernia 9:358–362
19.
Hollinsky C, Kolbe T, Walter I, Joachim A, Sandberg S, Koch T, Rülicke T, Tuchmann A (2010) Tensile strength and adhesion formation of mesh fixation systems used in laparoscopic incisional hernia repair. Surg Endosc 24:1318–1324PubMedCrossRef
20.
Schoenmaeckers EJ, van der Valk SB, van den Hout HW, Raymakers JF, Rakic S (2009) Computed tomographic measurements of mesh shrinkage after laparoscopic ventral incisional hernia repair with an expanded polytetrafluoroethylene mesh. Surg Endosc 23:1620–1623PubMedCrossRef
Metadata
Title
Mesh shrinkage and pain in laparoscopic ventral hernia repair: a randomized clinical trial comparing suture versus tack mesh fixation
Authors
Guido Beldi
Markus Wagner
Lukas E. Bruegger
Anita Kurmann
Daniel Candinas
Publication date
01-03-2011
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 3/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-010-1246-0

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