Abstract
Background
Anchoring the mesh in laparoscopic totally extraperitoneal groin hernia repair (TEP) with human fibrin glue has theoretical advantages. However, these have been supported and reported previously only in animal studies. Before the initiation of large patient trials, the authors wanted to confirm the feasibility, assess the costs, and rule out any flagrant short- and long-term adverse effects of fibrin glue usage in a small series of patients.
Methods
Nine consecutive TEP repairs with fibrin glue mesh fixation were performed. The perioperative and postoperative outcomes at 1, 16, and 40 months were compared with those for a control group of 96 stapled repairs.
Results
Gluing was easy and is less expensive than stapling. No fibrin glue–related adverse effects were found. The overall outcome was similar to that for stapled repairs, with no indication that the glued repairs were inferior.
Conclusions
Fibrin glue seems to be a reasonable, feasible, and maybe even competitive alternative to the standard tissue-penetrating mesh fixation. The results of this study justify launching larger trials.
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Change history
21 March 2022
A Correction to this paper has been published: https://doi.org/10.1007/s00464-022-09196-9
References
Amid PK (2004) Radiologic images of meshoma: a new phenomenon causing chronic pain after prosthetic repair of abdominal wall hernias. Arch Surg 139: 1297–1298
Amid PK, Shulman AG, Lichtenstein IL (1992) Selecting synthetic mesh for the repair of groin hernia. Postgrad Gen Surg 4: 150–155
Beattie GC, Kumar S, Nixon SJ (2000) Laparoscopic total extraperitoneal hernia repair: mesh fixation is unnecessary. J Laparoendosc Adv Surg Techn 10: 71–73
Busuttil RW (2003) A comparison of antifibrinolytic agents used in hemostatic fibrin sealants. J Am Coll Surg 197: 1021–1028
Dulucq JL (1991) Traitement des hernies de l’aine par mise en place d’un patch prothétique sous-péritonéal en rétro-péritonéoscopie. Cahiers de Chirurgie 79: 15–16
Farouk R, Drew PJ, Qureshi A, Roberts AC, Duthie GS, Monson JR (1996) Preliminary experience with butyl-2-cyanoacrylate adhesive in tension-free inguinal hernia repair. Br J Surg. 8: 1100
Ferzli GS, Frezza EE, Pecoraro Jr AM, Ahern KD (1999) Prospective randomized study of stapled versus unstapled mesh in laparoscopic preperitoneal inguinal hernia repair. J Am Coll Surg 188: 461–465
Hollinsky C, Hollinsky KH (1999) Static calculations for mesh fixation by intraabdominal pressure in laparoscopic extraperitoneal herniorrhaphy. Surg Laparosc Endosc Percutan Tech. 9: 106–109
Joch C (2003) The safety of fibrin sealants. Cardiovasc Surg 11(Suppl 1): 23–28
Jourdan IC, Bailey ME (1998) Initial experience with the use of N-butyl 2-cyanoacrylate glue for the fixation of polypropylene mesh in laparoscopic hernia repair. Surg Laparosc Endosc 4: 291–293
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: 18–25
Khajanchee YS, Urbach DR, Swanstrom LL, Hansen PD (2001) Outcomes of laparoscopic herniorrhaphy without fixation of mesh to the abdominal wall. Surg Endosc 15: 1102–1107
Lynen Janson P, Mertens P, Klinge U, Schumpelick V (2004) The biology of hernia formation. Surgery 136: 1–4
Mobley SR, Hilinski J, Toriumi DM (2002) Surgical tissue adhesives. Facial Plast Surg Clin North Am 10: 147–154
Moreno-Egea A, Torralba Martinez JA, Morales Cuenca G, Aguayo Albasini JL (2004) Randomized trial of fixation vs nonfixation of mesh in total extraperitoneal hernioplasty. Arch Surg 139: 1376–1379
National Institute for Clinical Excellence (2004) Laparoscopic surgery for inguinal hernia repair. National Health Service (United Kingdom) NICE Technology Appraisal 83. Accessed March 17, 2005 at http://www.nice.org.uk/TA083guidance
Novik B (2004) Randomized trial of fixation vs nonfixation of mesh in total extraperitoneal hernioplasty. Arch Surg 140: 811–812
Poobalan AS, Bruce J, Smith WC, King PM, Krukowski ZH, Chambers WA (2003) A review of chronic pain after inguinal herniorrhaphy. Clin J Pain 19: 48–54
Spitz JD, Arregui ME (2000) Sutureless laparoscopic extraperitoneal inguinal herniorrhaphy using reusable instruments: two hundred three repairs without recurrence. Surg Lap Endosc Percut Techn 10: 24–99
U.S. Food and Drug Administration (2002) Indermil: summary of safety and effectiveness data. Accessed April 24, 2005 at http://www.fda.gov/cdrh/pdf2/P010002b.pdf
Acknowledgments
We are indebted to professor Hans Hedelin at Skaraborg Hospital in Skövde for overall support. The study was sponsored by a grant from the Skaraborg Hospital Research and Development Council, a public nonprofit institution. The commercial companies mentioned in the article were not involved in and have had no influence on the study or the manuscript.
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Novik, B., Hagedorn, S., Mörk, UB. et al. Fibrin glue for securing the mesh in laparoscopic totally extraperitoneal inguinal hernia repair. Surg Endosc 20, 462–467 (2006). https://doi.org/10.1007/s00464-005-0391-3
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DOI: https://doi.org/10.1007/s00464-005-0391-3