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Self-Gripping Meshes for Lichtenstein Repair. Do We Need Additional Suture Fixation?

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Abstract

Background

The Lichtenstein repair is a frequently used treatment of inguinal hernias. In recent years, there has been an increasing tendency to apply self-gripping meshes (s.g). In many cases, additional suture of the mesh is carried out; however, it is uncertain what the benefits or potential risks of this actually are.

Methods

The evaluation was undertaken on the basis of the Herniamed register, and covered all unilateral Lichtenstein operations between 01.09.2009 up to 30.09.2013. The analysis only included patients with whom s.g. meshes with resorbable micro hooks had been used (Progrip®, Covidien) and who had undergone a full 1-year follow-up examination (80.15 %).

Results

In total, 2095 patients were suitable for analysis, of which 816 (38.95 %) cases received an additional suture fixation (Fix). With increasing hernia size, more frequent fixation took place (29.97 % of hernias <1.5 cm vs. 46.65 % of hernias >3 cm, p < 0.001). The recurrence rates 1 year after surgery did not show any significant differences (Fix. 0.86 % vs. No Fix. 1.17 %; p = 0.661) with and without fixation, even when being adjusted for covariables. Likewise, no differences were noted in terms of postoperative complications (Fix. 5.15 % vs. No Fix. 5.08 %; p = 1.0). In addition, the numbers of patients needing to be treated after 1 year for chronic pain were also comparable (Fix. 2.33 % vs. No Fix. 2.97 %; p = 0.411).

Conclusion

Within the group that did not have additional suture fixation of self-gripping meshes (No Fix.), the length of operations was on average 8 min shorter (p < 0.001). No differences could be observed in terms of postoperative complications, treatment requiring chronic pain and recurrence rates.

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Acknowledgments

The authors thank all participants of the Herniamed registry.

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Authors and Affiliations

  1. Department of General and Visceral Surgery, Linz, Academic Teaching Hospital of the Medical Universities Graz and Innsbruck, Sisters of Charity Hospital, 4010, Linz, Austria

    Gernot Köhler & Klaus Emmanuel

  2. Department of Surgery, Paracelsus Medical University, Salzburg, Austria

    Gernot Köhler, Michael Lechner, Franz Mayer & René H. Fortelny

  3. Department of Surgery and Centre of Minimally Invasive Surgery, Vivantes Hospital, Berlin, Germany

    Ferdinand Köckerling

  4. Department of General Surgery, Landeskrankenhaus Hochsteiermark, Bruck an der Mur, Austria

    Rudolf Schrittwieser

  5. Department of General, Visceral and Oncological Surgery, Wilhelminenspital, Vienna, Austria

    René H. Fortelny

  6. Institut StatConsult GmbH®, Magdeburg, Germany

    Daniela Adolf

Authors
  1. Gernot Köhler
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  2. Michael Lechner
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  3. Franz Mayer
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  4. Ferdinand Köckerling
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  7. Daniela Adolf
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Corresponding author

Correspondence to Gernot Köhler.

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Conflict of interest

GK declares no conflicts of interest; ML declares no conflicts of interest; FM declares no conflicts of interest; FK declares Grants for the Herniamed Registry from PFM Medical, Cologne, Johnson&Johnson, Norderstedt, BBraun, Tuttlingen, Bard, Karlsruhe, Dahlhausen, Cologne and MenkeMed, Munich; RS declares no conflict of interest; RHF declares no conflicts of interest; DA declares no conflicts of interest; KE declares no conflicts of interest.

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Köhler, G., Lechner, M., Mayer, F. et al. Self-Gripping Meshes for Lichtenstein Repair. Do We Need Additional Suture Fixation?. World J Surg 40, 298–308 (2016). https://doi.org/10.1007/s00268-015-3313-0

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