Preliminary Report of a Sutureless Onlay Technique for Incisional Hernia Repair Using Fibrin Glue Alone for Mesh Fixation

2013 ◽  
Vol 79 (11) ◽  
pp. 1177-1180 ◽  
Author(s):  
Nathaniel Stoikes ◽  
David Webb ◽  
Ben Powell ◽  
Guy Voeller
Keyword(s):  
Hernia Repair ◽  
Fibrin Glue ◽  
Operative Time ◽  
Mesh Fixation ◽  
Prospective Trial ◽  
Fascial Closure ◽  
Mesh Placement ◽  
Early Results ◽  
Onlay Technique ◽  
Primary Fascial Closure

The Rives repair for ventral/incisional (V/I) hernias involves sublay mesh placement requiring retrorectus dissection and transfascial stitches. Chevrel described a repair by onlaying mesh after a unique primary fascial closure. Although Chevrel fixated mesh to the anterior fascia with sutures, he used fibrin glue for fascial closure reinforcement. We describe an onlay technique with mesh fixated to the anterior fascia solely with fibrin glue without suture fixation. From January 2010 to January 2012, 50 patients underwent a V/I hernia onlay technique with fibrin glue mesh fixation. Records were reviewed for technical details, demographics, mesh characteristics, and postoperative outcomes. Primary fascial closure with interrupted permanent suture was done with or without myofascial advancement flaps. Onlay polypropylene mesh was placed providing 8 cm of overlap. Fibrin glue was applied over the prosthesis and subcutaneous drains were placed. Mean age was 62.4 years. Mean body mass index was 30.1 kg/m2. Average mesh size was 14.5 cm 3 19.1 cm. Mean operative time was 144.4 minutes (range, 38 to 316 minutes). Mean discharge was postoperative Day 2.9 (range, 0 to 15 days). Morbidity included eight seromas, one hematoma, and three wound infections. Seventeen patients required components separation. Mean follow-up was 19.5 months with no recurrences. This is the first series describing fibrin glue alone for mesh fixation for V/I hernia repair. It allows for immediate prosthesis fixation to the anterior fascia. Early results are promising. Potential advantages include less operative time, less technical difficulty, and less long-term pain. A prospective trial is needed to evaluate this approach.

Laparoscopic Spigelian Hernia Repair: The Scroll Technique

2008 ◽  
Vol 74 (2) ◽  
pp. 108-112 ◽  
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.

Fibrin Glue Mesh Fixation in Hernia Repair

2007 ◽  
Vol 246 (5) ◽  
pp. 906-908 ◽  
Author(s):  
Bengt Novik
Keyword(s):  
Hernia Repair ◽  
Fibrin Glue ◽  
Mesh Fixation

Laparoscopic ventral hernia repair with primary fascial closure versus bridged repair: a risk-adjusted comparative study

2015 ◽  
Vol 30 (8) ◽  
pp. 3231-3238 ◽  
Author(s):  
John Emil Wennergren ◽  
Erik P. Askenasy ◽  
Jacob A. Greenberg ◽  
Julie Holihan ◽  
Jerrod Keith ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Comparative Study ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Laparoscopic Ventral Hernia Repair ◽  
Fascial Closure ◽  
Primary Fascial Closure

Laparoscopic-assisted Ventral Hernia Repair: Primary Fascial Repair with Polyester Mesh versus Polyester Mesh Alone

2016 ◽  
Vol 82 (3) ◽  
pp. 236-242 ◽  
Author(s):  
Farah Karipineni ◽  
Priya Joshi ◽  
Afshin Parsikia ◽  
Teena Dhir ◽  
Amit R.T. Joshi
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Fascial Closure ◽  
Recurrence Rates ◽  
Polyester Mesh ◽  
Significant Difference ◽  
Laparoscopic Assisted ◽  
Closure Group ◽  
Primary Fascial Closure

Laparoscopic-assisted ventral hernia repair (LAVHR) with mesh is well established as the preferred technique for hernia repair. We sought to determine whether primary fascial closure and/or overlap of the mesh reduced recurrence and/or complications. We conducted a retrospective review on 57 LAVHR patients using polyester composite mesh between August 2010 and July 2013. They were divided into mesh-only (nonclosure) and primary fascial closure with mesh (closure) groups. Patient demographics, prior surgical history, mesh overlap, complications, and recurrence rates were compared. Thirty-nine (68%) of 57 patients were in the closure group and 18 (32%) in the nonclosure group. Mean defect sizes were 15.5 and 22.5 cm2, respectively. Participants were followed for a mean of 1.3 years [standard deviation (SD) = 0.7]. Recurrence rates were 2/39 (5.1%) in the closure group and 1/18 (5.6%) in the nonclosure group ( P = 0.947). There were no major postoperative complications in the nonclosure group. The closure group experienced four (10.3%) complications. This was not a statistically significant difference ( P = 0.159). The median mesh-to-hernia ratio for all repairs was 15.2 (surface area) and 3.9 (diameter). Median length of stay was 14.5 hours (1.7–99.3) for patients with nonclosure and 11.9 hours (6.9–90.3 hours) for patients with closure ( P = 0.625). In conclusion, this is one of the largest series of LAVHR exclusively using polyester dual-sided mesh. Our recurrence rate was about 5 per cent. Significant mesh overlap is needed to achieve such low recurrence rates. Primary closure of hernias seems less important than adequate mesh overlap in preventing recurrence after LAVHR.

scholarly journals Early outcomes of laparoscopy for totally extra - peritoneal (TEP) inguinal hernia repair at E Hospital

2019 ◽  
Vol 9 (2) ◽  
Author(s):  
Đức Anh Lương ◽  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Advanced Technique ◽  
Mesh Placement ◽  
Tep Repair ◽  
Early Results ◽  
Technical Issues ◽  
Alternative Choice ◽  
Laparoscopic Tep

Tóm tắt Đặt vấn đề: Phẫu thuật nội soi đi đường ngoài phúc mạc hoàn toàn đặt lưới để điều trị bệnh thoát vị bẹn (TVB) ở người lớn là một tiến bộ kỹ thuật đang được phát triển và áp dụng bổ sung cho các phương pháp khác, nhưng đây lại là phương pháp có nhiều thách thức về kỹ thuật nhất với các phẫu thuật viên. Tại Bệnh viện E từ tháng 5/2017 đến tháng 5/2019 có 35 ca được mổ theo phương pháp này. Mục tiêu nghiên cứu nhằm đánh giá kết quả sớm, một số kinh nghiệm về chỉ định và kỹ thuật mổ. Phương pháp nghiên cứu: Thiết kế nghiên cứu can thiệp, một nhóm, dạng quan sát mô tả tiến cứu, đánh giá kết quả trước và sau can thiệp. Kết quả: 35 bệnh nhân (BN) TVB gồm 2 nữ, 33 nam; tuổi TB 66,2±10,65 (41- 91); TVB 1 bên: 33 (94,3%), 2 bên: 2 (5,7%); TVB trực tiếp: 13 (37,1%), gián tiếp: 22 (62,9%); một ca có tiền sử mổ Bassini hai lần cùng bên và tái phát được mổ thành công. Hai ca thủng phúc mạc trong khi phẫu tích, khắc phục không phải chuyển TAPP. Thời gian mổ: 121,1±33,20 phút (90-190). Kết luận: Phương pháp khả thi an toàn thời gian nằm viện giảm, thẩm mỹ và ít đau, tuy nhiên có nhiều điểm cần lưu ý trong kỹ thuật cần nghiên cứu tiếp tục liên quan đến kết quả mổ như nhận định giải phẫu, phẫu tích, xử lý thủng khi thủng phúc mạc, cố định chắc chắn vật liệu vào khoang để che phủ lỗ thoát vị... Abstract Introduction: Laparoscopic totaly extraperitoneal inguinal hernia repair with placement of a mesh outside the peritoneum to repair inguinal hernia in adult patients is an advanced technique has been developing as alternative choice for surgeons. However, this method has is challenging in technical issues for surgeons. Over a 24-month period (May 2017 through May 2019), a total of 35 laparoscopic TEP inguinal hernia repairs were carried out. This paper aimed to evaluate the early results and discuss some important technical issues as well. Material and Methods: A prospective observational study, one group, evaluating results before and after intervention. Results: 35 patients including 2 females and 33 males with mean age of 66,2±10,65 years old (41- 91); unilateral inguinal hernia (IH): 33 patients (94,4%), bilateral IH: 2 patients (5,7%); direct IH: 13 patients (37,1%), indirect IH: 22 (62,9%); One patient underwent two times previously by Bassini procedure due to recurrence. Per-operative adverse events including: peritoneum laceration during dissection in 2 cases, overcome by repair peritoneum damaged without conversion into TAPP. Mean operative time: 121,1±33,20 min (90-190). Conclusion: Laparoscopic TEP IH repair with prolene mesh placement is a suitable treatment option for selected inguinal hernia patients. However, some technical issues should be considered such as accuracy recognization of endoscopic anatomy landmarks during dissecting inguinal canal elements and management of incident happened management for example peritoneum being lacerated, clearing the pre- peritoneal space for laying mesh, substantial fine fixation of mesh... may cause the outcomes. Keywords: Laparoscopy, Inguinal hernia, TEP repair.

scholarly journals P149 THE IMPACT OF COVID-19 ON TACKOMESH RANDOMISED CONTROLLED TRIAL COMPARING SPIRAL-TACK MESH-FIXATION DEVICES IN LAPAROSCOPIC INCISIONAL HERNIA REPAIR USING THE MANCHESTER TECHNIQUE

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
James Pilkington ◽  
Catherine Fullwood ◽  
Aali Sheen
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Controlled Trial ◽  
Mesh Fixation ◽  
Operating Time ◽  
Incisional Hernia Repair ◽  
Fascial Closure ◽  
Fixation Time ◽  
Laparoscopic Incisional Hernia Repair ◽  
The Impact

Abstract Aim Provide a report on all patients who underwent laparoscopic incisional hernia repair as part of the TACKoMesh RCT prior to unblinding of treatment arms. Material and Methods Trial recruitment was for primary incisional hernia with a defect diameter of 3–10cm. 63 patients (target 74-136) were operated on prior to the outbreak of COVID-19. Post-operative pain is the primary trial outcome. Surgery was performed with either spiral-tack mesh-fixation device (Protack (permanent) or Reliatack (absorbable)), Symbotex IPOM mesh, and fascial closure with no 1 Maxon suture(s) using extracorporeal knot ties – the Manchester Technique. Data was collected on trial forms and lifestyle questionnaires (SF-36 and CCS). All data were explored and described in RStudio v1.4.1106. Results Patients were aged 36-80 and 36(57.1%) patients were male. Mean preoperative BMI was 30.91(sd5.11,range21.15–43.93). Mean operating time was 80.81(37.34,20-240)minutes. In 13(20.6%) patients multiple hernia defects were identified. A good degree of fascial closure was achieved in all patients using a median of 3(IQR 2.0-3.5)knots. Median mesh-fixation time was 286(159.5-428.0)seconds and a mean 25.24(5.49,14-41)tacks/patient were used. Median length of hospital stay was 3.5(2.0–6.0)days. Patients were asked “Please indicate on this scale [VAS 0–10] the pain that you currently experience from your incisional hernia during activity?”. Median responses for Day0/pre-op, Day1, Day6, Day30 and Day365 were 4.5, 8.0, 6.0, 3.0 and 1.5 respectively. At one year, 7(11%) patients had experienced hernia recurrence and 33(52%) post-operative seroma. Conclusions Target recruitment was not possible owing to COVID-19. The Manchester Technique has comparable recurrence rates. Reported pain increases post-operatively but is reduced at post-operative day30 and day365.

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