Comparative Study of Fibrin Sealent versus Use of Tackers in Inguinal Hernia Repair

Year 2015, Volume: 40 Issue: 3, 457 - 465, 30.09.2015

Wasim Kar Mela Atri Hanief Dar Azher Mushtaq Sheikh Imran İshfaq Gilkar

https://doi.org/10.17826/cutf.08823

Cited By: 2

Abstract

Purpose: To determine role and benefit of fibrin glue over tackers for mesh fixation in laparoscopic inguinal hernia repair. Backgroud: Mesh fixation by tackers may lead to many complications peroperatively like bleeding, increased hospital stay and overall more cost and later on chronic groin pain. Material and Methods: 60 inguinal hernia with age more than 18 years were taken and were divided in two groups; 30 patient group who underwent TAPP and 30 patient group who underwent TEPP. In 15 patients in both groups tackers were used and in other half fibrin glue was used for fixation of mesh using a 3mm catheter (Duplotip: Baxter Healthcare), which fits the Tisseel syringe. Results: The use of fibrin sealent has a distinct advantage in laparoscopic treatment of inguinal hernias compared with use of tackers as a method of mesh fixation. The use of fibrin sealant reduces the risk of post- and intraoperative complications, such as bleeding, seroma, chronic pain, has a lower incidence of postoperative neuralgia and provides an early faster return to social life. The recurrence rates do not vary much, but the operative time is slightly longer if the preparation time of the fibrin sealant is taken into consideration. In our study, we found a marginal difference in the cost of the two groups, fibrin sealant and stapled tackers.

Keywords

laparoscopy; inguinal hernia; Fibrin sealent; tackers; Mesh fixation

Kasık Fıtığı Onarımında Fibrin Dolgu Maddesi ve Zımba Tabancanın Karşılaştırılması

Abstract

Amaç: Laparoskopik kasık fıtığı onarımında yama fiksasyonunda kullanılan fibrin yapıştırıcısının rolü ve yararının belirlenmesi. Geçmiş: Tabancayla yapılan yama fiksasyonunda peroperatuar kanama gibi bazı komplikasyonların görülmesiyle kronik kasık ağrısı sonrasında hastanede kalma süresinin artışı genel olarak daha fazla maliyete neden olur. Materyal ve Metod: 60 kasık fıtığı olan 18 yaş üzeri hastalar iki gruba ayrıldı bunlar; transabdominal preperitoneal onarımı geçiren 30 hasta ve total extraperitoneal onarımı geçiren 30 hasta. İki gruptaki 15 hastada tabanca kullanılırken geri kalan hastalarda fibrin yapıştırıcı kullanıldı. Ağ fiksasyonu için 3mm katater ve buna uygun Tisseel şırınga kullanıldı (Duplotip: Baxter Sağlık Hizmet). Bulgular: Laparoskopik tedavide kasık fıtığı için kullanılan yama fiksasyon metodlarından tabanca ve fibrin dolgu materyalinin karşılaştırılması yapıldı. Fibrin dolgu materyalinin kullanımı, kanama, seroma, kronik ağrı gibi post ve intraoperatif komplikasyon riskini azalttı. Postoperatif nevralji insidansı düşüktü ve hasta daha erken sosyal hayatına dönebilir. Nüks oranlarında çok farklılık yoktu. Ancak fibrin dolgu materyalinin hazırlık süresi dikkate alınırsa ameliyat süresi biraz daha uzundu. Çalışmamızda, fibrin dolgu materyali ve tabancayla zımbalanmış grupların maliyetinde marjinal bir fark bulundu.

Keywords

Laparoskopi, Kasık Fıtığı, Fibrin Dolgu Materyali, Zımba Tabanca, Ağ Fiksasyonu

References

• Vader VL, Vogt DM, Zucker KA, et al. Adhesion formation in laparoscopic inguinal hernia repair. Surg. Endosc 1997;11:825.
• Nienhuijs SW, Boelens OB, Strobbe LJ. Pain after anterior mesh hernia repair. J Am Coll Surg. 2005;200:885-9.
• Paajanen H. Do absorbable mesh sutures cause less chronic pain than non absorbable sutures after Lichtenstein 2002;6:117-20. herniorraphy? Hernia.
• Pooblan AS, Bruce J, Smith WC, King PM, Krukowski ZH, Chambers WA. A review of chronic pain after inguinal herniorraphy. Clin J Pain. 2003;19:48-54.
• Katkhouda N. A new technique for laparoscopic hernia repair using Fibrin sealant. Surg. Technol Int. 2004;12:120-6.
• Ten Hallers EJ, Jansen JA, Marres HA, Rakhorst G, Verkerke GJ. Histological assessment of titanium and polypropylene Fiber mesh implantation with and without fibrin tissue glue. J Biomed Mater Res A. 2007;80:372-80.
• Lovisetto F, Zonta S, Rota E, Mazzilli M, Berdone M, Bottero L, Faillance G, Longoni M. Use of human fibrin glue(Tissucol) versus staples for mesh fixation in laparoscopic trans abdominal preperitoneal hernio plasty. Ann Surg. 2007;245:222-31.
• Lau H. Fibrin sealant versus mechanical stapling for mesh fixation during endoscopic extraperitoneal inguinal hernioplasty. Ann Surg. 2005;242:670-75.
• Katkhouda N; Mavor E; Friedlander M.H; et al.Use of fibrin sealant for prosthetic mesh fixation in laparoscopic extraperitoneal inguinal hernia repair. Ann Surg. 2001;233:18-25.
• Malangoni MA, Rosen MJ. Hernias. In: Townsend CM, Beauchamp RD, Evers BM. Mattox KL, eds. Sabiston textbook of surgery. Pa: Saunders Elsevier. 2010;1155;1160-1.
• Manthey D, Nicks BA. Hernias. e-medicine website www. e-medicine.com/emerg/topic 251.htm.
• McIntosh A, Hutchinson A, Roberts A, et al. evidence based management of groin hernia in primary care- a systemic review. Fam Pract. 2000;17:442.
• AmFam, Bax T, Sheppard BC, Cross RA. Surgical options in the management of groin hernias. Physician. 1999;59:143-56.
• Wantz G. E. Abdominal wall hernias. In: Schwartz SI, ed. Principles of surgery. 7thed. New York, NY: Mc Graw Hill. 1999;1585-1611.
• Patrick J.Javid, David C. Brooks. Hernias. In :Zinner MJ, Ashley SW, eds. Maingot’s Abdominal Operations. Pa: McGraw Hill; 11th edition; Chap. 5: 104,105,116,117.
• Kingsnorth AN, Wright D, Porter CS, Robertson G. Prolene hernia system compared with Lichtenstein patch: a randomized double blind of short term and medium term outcomes in primary inguinal hernia repair. Hernia. 2002;6:113-9.
• Ferzli G, Sayad P, Huie F, et al. Endoscopic extraperitonealHerniorraphy: A 5-year experience. Surg. Endosc. 1998;12:1