Three-Component Intraperitoneal Mesh Fixation for Laparoscopic Repair of Anterior Parasternal Costodiaphragmatic Hernias

Abstract Aim Choice of the best fixation system in terms of safety and effectiveness for intraperitoneal mesh placement in hernia surgery remains controversial. The aim of this study was to compare the performance of four fixation systems in a swine model of intraperitoneal mesh fixation. Material and Methods Fourteen Landrace swine were utilized and the experiment included two stages. Initially, four pieces of polypropylene mesh with hydrogel barrier coating1 were fixed intraperitoneally to reinforce 4 small full thickness abdominal wall defects created with diathermy. Each mesh was anchored with a different tack device between titanium2, steel3 or absorbable (4,5) fasteners. The second stage took place after 60 days and included euthanasia, laparoscopy, and laparotomy. The primary endpoint was to compare the peel strength of the compound tack/mesh from the abdominal wall. Secondary parameters were the extent and quality of visceral adhesions to the mesh, the degree of mesh shrinkage and the histological response around the tacks. Results Thirteen out of 14 animals survived the experiment and 10 were included in the final analysis. Steel tacks had higher peel strength when compared to titanium and absorbable fasteners. No significant differences were noted regarding the secondary endpoints. Conclusions Steel fasteners provided higher peel strength that the other devices in this swine model of intraperitoneal mesh fixation. Our findings generate the hypothesis that this type of fixation may be superior in a clinical setting. Clinical trials with long-term follow-up are required to assess the safety and efficacy of mesh fixation systems in hernia surgery.

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Comparison of Mesh Fixation Techniques in Elective Laparoscopic Repair of Incisional Hernia-ReliaTack™ v ProTack™ (TACKoMesh) - A double-blind randomised controlled trial

BMC Surgery ◽

10.1186/s12893-018-0378-3 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 2

Author(s):

Aali J. Sheen ◽

J. James Pilkington ◽

Minas Baltatzis ◽

Ahmed Tyurkylmaz ◽

Panagiotis Stathakis ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Incisional Hernia ◽

Laparoscopic Repair ◽

Controlled Trial ◽

Mesh Fixation ◽

Double Blind ◽

Fixation Techniques ◽

Randomised Controlled

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Laparoscopic Spigelian Hernia Repair: The Scroll Technique

The American Surgeon ◽

10.1177/000313480807400203 ◽

2008 ◽

Vol 74 (2) ◽

pp. 108-112 ◽

Cited By ~ 2

Author(s):

Alan A. Saber ◽

Mohamed H. Elgamal ◽

Arun J. Rao ◽

Robert L. Osmer ◽

Ed A. Itawi

Keyword(s):

Hernia Repair ◽

Laparoscopic Repair ◽

Operative Time ◽

Simple Technique ◽

Mesh Fixation ◽

Case Series ◽

Spigelian Hernia ◽

Mesh Placement ◽

Vague Abdominal Pain

Spigelian hernia is a rare clinical entity. It has a subtle clinical presentation with vague abdominal pain that may warrant laparoscopy. Even though laparoscopic ventral hernia repair is increasingly popular, laparoscopic repair of spigelian hernia has not been adequately studied. Eight patients who underwent laparoscopic spigelian hernia repair are presented herein, along with a description of our simple technique for mesh placement. In addition, literature review of laparoscopic repair of spigelian hernia is also presented. Our case series included six females and two males; two patients presented acutely whereas the others presented with chronic pain. Laparoscopic repair was successfully performed in all of our patients with a mean operative time of 92.5 minutes. There were no postoperative complications or recurrence with a mean follow up of 36 months. Our scroll technique for laparoscopic repair is simple and feasible. It minimizes intra-corporeal mesh manipulation, facilitates mesh fixation to the anterior abdominal wall, and maintains a precise orientation of the mesh in relation to the defect.

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Laparoscopic Repair of Boundary Incisional Hernia in a Kidney Transplant Patient: A Safe Tacks-Fibrin Glue Combined Mesh Fixation Technique

Transplantation Proceedings ◽

10.1016/j.transproceed.2018.04.084 ◽

2019 ◽

Vol 51 (1) ◽

pp. 215-219 ◽

Cited By ~ 1

Author(s):

G. Damiano ◽

V.D. Palumbo ◽

S. Fazzotta ◽

S. Buscemi ◽

S. Ficarella ◽

...

Keyword(s):

Incisional Hernia ◽

Kidney Transplant ◽

Fibrin Glue ◽

Laparoscopic Repair ◽

Transplant Patient ◽

Mesh Fixation ◽

Kidney Transplant Patient ◽

Fixation Technique

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Adhesions to sutures, tackers, and glue for intraperitoneal mesh fixation: an experimental study

Hernia ◽

10.1007/s10029-013-1192-6 ◽

2013 ◽

Vol 18 (6) ◽

pp. 865-872 ◽

Cited By ~ 10

Author(s):

M. H. F. Schreinemacher ◽

K. W. Y. van Barneveld ◽

E. Peeters ◽

M. Miserez ◽

M. J. J. Gijbels ◽

...

Keyword(s):

Experimental Study ◽

Mesh Fixation ◽

Intraperitoneal Mesh

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Laparoscopic hernioplasty of large ventral hernia with transfascial sutures: short term utility and outcome

Journal of Society of Surgeons of Nepal ◽

10.3126/jssn.v18i3.15314 ◽

2016 ◽

Vol 18 (3) ◽

pp. 52

Author(s):

A Kumar ◽

CS Agrawal ◽

S Sah ◽

RK Gupta

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Laparoscopic Repair ◽

Ventral Hernia Repair ◽

Open Repair ◽

Mesh Fixation ◽

Laparoscopic Approach ◽

Laparoscopic Ventral Hernia Repair ◽

University Hospital ◽

Large Ventral Hernia

Introduction: The laparoscopic approach to repairing ventral and incisional hernias has gained increasing popularity worldwide. The approximation of the hernia defect during laparoscopic ventral hernia repair, prior to mesh fixation, provides a more physiologic and anatomic repair. Defect closure also provides more defect overlap with mesh placement and, possibly decreases recurrence rates. We reviewed the experience of laparoscopic repair of large ventral hernia (diameter ≥5cm) at a university hospital in the Nepal with particular reference to patients with massive defects (diameter ≥15cm) and transfascial closure.Methods: A total of 32 patients underwent laparoscopic ventral (incisional or umbilical/paraumbilical) hernia repair between July 2014 and September 2015.Results: The prevalence of conversion to open surgery was 3.1%. The prevalence of postoperative complications was 15.6%. Median postoperative follow-up was 8.2 months. A total of 9.4% cases suffered late complications and 3.1% developed recurrence. Twelve patients underwent repair of defects ≥10cm in diameter with no recurrence. Three patients underwent repair of ‘massive’ incisional hernia (diameter ≥15cm) with a prevalence of recurrence of 3.1%. Ten patients with a body mass index (BMI) ≥30kg/m2 (range, 32–35kg/m2) underwent laparoscopic repair without any recurrence.Conclusions: Laparoscopic ventral hernia repair with transfascial suturing can be carried out safely with a low prevalence of recurrence. It may have advantages in obese patients in whom open repair would represent a significant undertaking. Laparoscopic ventral hernia repair may be used in cases of large and massive hernias, in which the risk of recurrence increases but is comparable with open repair and associated with low morbidity.

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