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

Surgical Endoscopy
Christophe Berney, Joseph Descallar

Abstract

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. 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). No conversion to open surgery was observed. There wer...Continue Reading

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Citations

Apr 2, 2017·Surgical Endoscopy·Raquel Kelner SilveiraGuillaume Portier
Sep 3, 2017·Hernia : the Journal of Hernias and Abdominal Wall Surgery·A BarbaroG J Maddern
Nov 27, 2019·Macromolecular Bioscience·Iwan Vaughan RobertsNicola Tirelli
Mar 10, 2020·ANZ Journal of Surgery·Thomas J Hugh
Jun 27, 2020·Plastic and Reconstructive Surgery·Shervin A EtemadBenjamin K Poulose

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