Advertisement

Hernia

, Volume 16, Issue 6, pp 647–653 | Cite as

Clinical outcome and quality of life in 100 consecutive laparoscopic totally extra-peritoneal (TEP) groin hernia repairs using fibrin glue (Tisseel™): a United Kingdom experience

  • N. S. Shah
  • A. I. Bandara
  • A. J. SheenEmail author
Original Article

Abstract

Purpose

The use of fibrin sealant (FS) (Tisseel™) for mesh fixation in patients undergoing laparoscopic groin hernia surgery is a well-recognised technique in Europe, but no study to date has examined effect on quality of life (QoL) on patients undergoing FS mesh fixation. A prospective study was therefore conducted to examine the effects on QoL of patients undergoing laparoscopic groin hernia surgery using FS in the United Kingdom.

Materials and methods

Between March 2007 and January 2011, all patients undergoing laparoscopic total extra preperitoneal (TEP) groin hernia repair using FS were included in the study. A validated hernia questionnaire from The Royal College of Surgeons of England supplemented by the EORTC QLQ C-30 to assess the pre- and postoperative QoL, pain scores and health outcome measures was used. All the patient’s demographics, duration of surgery, size of hernia, recurrence, morbidity and hospital stay were recorded.

Results

Data from 92 patients (87 males and 5 females) with a median age of 46 years (range, 19–82 years) was collected for the study (response rate of 92/121, 73 %). A total of 58 patients (63 %) had a unilateral and 34 patients (37 %) a bilateral hernia repair, of which 6 (7 %) were recurrent inguinal hernia. The mean operating time for a unilateral hernia was 36 min (30–62), and that for a bilateral hernia was 59 min (51–83). There were no conversions to open surgery out of the 92 patients included with the recorded morbidity of 7 %. There were no early recurrences. Eighty-nine patients (98 %) of patients were discharged in the first 24 h after surgery. There was a significant statistical difference recorded in patients visual analogue pain score (VAS 0–10) before and after surgery (P < 0.0001, Mann–Whitney U test). The physical, emotional, social and health components of the questionnaire were statistically significant pre- and postoperatively (P < 0.001 Mann–Whitney U test).

Conclusion

Groin hernia TEP repair with FS fixation did not have a detrimental effect on QoL and pain scores. In addition, the low early recurrence rate provided good evidence of the mesh fixation properties of FS. FS can therefore be continued to be recommended, as an alternative fixation method in laparoscopic groin hernia surgery.

Keywords

Inguinal hernia Fibrin sealant Fixation Quality of life 

Notes

Acknowledgments

Professor Ajith K Siriwardena, Head of Department; Linda Pendlebury, Medical Secretary.

References

  1. 1.
    McCormack K, Scott NW, Go PM et al (2003) EU Hernia Trialists Collaboration. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev 1(1):CD001785Google Scholar
  2. 2.
    Arregui ME, Davis CJ, Yucel O, Nagan RF (1992) Laparoscopic mesh repair of inguinal hernia using a preperitoneal approach: a preliminary report. Surg Laparosc Endosc 2(1):53–8Google Scholar
  3. 3.
    Dion YM, Morin J (1992) Laparoscopic inguinal herniorrhaphy. Can J Surg 35(2):209–212PubMedGoogle Scholar
  4. 4.
    Dulucq JL (1992) Treatment of inguinal hernia by insertion of a subperitoneal patch under pre-peritoneoscopy. Chirurgie 118(1–2):83–85PubMedGoogle Scholar
  5. 5.
    McCormack K, Wake B, Perez J et al (2005) Laparoscopic surgery for inguinal hernia repair: systematic review of effectiveness and economic evaluation. Health Technol Assess 9(14):1–203, iii–ivGoogle Scholar
  6. 6.
    Douek M, Smith G, Oshowo A et al (2003) Prospective randomised controlled trial of laparoscopic versus open inguinal hernia mesh repair: five year follow up. BMJ 326(7397):1012–1013PubMedCrossRefGoogle Scholar
  7. 7.
    Kraus MA (1993) Nerve injury during laparoscopic inguinal hernia repair. Surg Laparosc Endosc 3(4):342–345PubMedGoogle Scholar
  8. 8.
    Stark E, Oestreich K, Wendl K (1999) Nerve irritation after laparoscopic hernia repair. Surg Endosc 13(9):878–881PubMedCrossRefGoogle Scholar
  9. 9.
    Katkhouda N (2004) A new technique for laparoscopic hernia repair using fibrin sealant. Surg Technol Int 12:120–126PubMedGoogle Scholar
  10. 10.
    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 8(4):291–293PubMedCrossRefGoogle Scholar
  11. 11.
    Katkhouda N, Mavor E, Friedlander MH et al (2001) Use of fibrin sealant for prosthetic mesh fixation in laparoscopic extraperitoneal inguinal hernia repair. Ann Surg 233(1):18–25PubMedCrossRefGoogle Scholar
  12. 12.
    Lau H, Patil NG (2003) Selective non-stapling of mesh during unilateral endoscopic total extraperitoneal inguinal hernioplasty: a case-control study. Arch Surg 138(12):1352–1355PubMedCrossRefGoogle Scholar
  13. 13.
    Topart P, Vandenbroucke F, Lozac’h P (2005) Tisseel versus tack staples as mesh fixation in totally extraperitoneal laparoscopic repair of groin hernias: a retrospective analysis. Surg Endosc 19(5):724–727PubMedCrossRefGoogle Scholar
  14. 14.
    Schwab R, Willms A, Kröger A et al (2006) Less chronic pain following mesh fixation using a fibrin sealant in TEP inguinal hernia repair. Hernia 10(3):272–277PubMedCrossRefGoogle Scholar
  15. 15.
    Olmi S, Scaini A, Erba L et al (2007) Quantification of pain in laparoscopic transabdominal preperitoneal (TAPP) inguinal hernioplasty identifies marked differences between prosthesis fixation systems. Surgery 142(1):40–46PubMedCrossRefGoogle Scholar
  16. 16.
    Bright E, Reddy VM, Wallace D et al (2010) The incidence and success of treatment for severe chronic groin pain after open, transabdominal preperitoneal, and totally extraperitoneal hernia repair. World J Surg 34(4):692–696Google Scholar
  17. 17.
    Simons MP, Aufenacker T, Bay-Nielsen M et al (2009) European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 13(4):343–403PubMedCrossRefGoogle Scholar
  18. 18.
    Courtney CA, Duffy K, Serpell MG et al (2002) Outcome of patients with severe chronic pain following repair of groin hernia. Br J Surg 89(10):1310–1314PubMedCrossRefGoogle Scholar
  19. 19.
    Amid PK, Hiatt JR (2007) New understanding of the causes and surgical treatment of postherniorrhaphy inguinodynia and orchalgia. J Am Coll Surg 205(2):381–385PubMedCrossRefGoogle Scholar
  20. 20.
    (2004) NICE TA083 guidance DOHGoogle Scholar
  21. 21.
    Novik B, Hagedorn S, Mörk UB et al (2006) Fibrin glue for securing the mesh in laparoscopic totally extraperitoneal inguinal hernia repair: a study with a 40-month prospective follow-up period. Surg Endosc 20(3):462–467PubMedCrossRefGoogle Scholar
  22. 22.
    Schopf S, von Ahnen T, von Ahnen M et al (2011) Chronic pain after laparoscopic transabdominal preperitoneal hernia repair: a randomized comparison of light and extralight titanized polypropylene mesh. World J Surg 35(2):302–310PubMedCrossRefGoogle Scholar
  23. 23.
    Schwab R, Schumacher O, Junge K et al (2008) Biomechanical analyses of mesh fixation in TAPP and TEP hernia repair. Surg Endosc 22(3):731–738PubMedCrossRefGoogle Scholar
  24. 24.
    Byrne DJ, Hardy J, Wood RAB et al (1991) Effect of fibrin glues on the mechanical properties of healing wounds. Br J Surg 78:841–843PubMedCrossRefGoogle Scholar
  25. 25.
    Chevrel JP, Rath AM (1997) The use of Fibrin glues in the surgical treatment of incisional hernias. Hernia 1:9–14CrossRefGoogle Scholar
  26. 26.
    Kumar S, Wilson RG, Nixon SJ et al (2002) Chronic pain after laparoscopic and open mesh repair of groin hernia. Br J Surg 89(11):1476–1479PubMedCrossRefGoogle Scholar
  27. 27.
    Garg P, Rajagopal M, Varghese V et al (2009) Laparoscopic total extraperitoneal inguinal hernia repair with nonfixation of the mesh for 1,692 hernias. Surg Endosc 23(6):1241–1245PubMedCrossRefGoogle Scholar
  28. 28.
    Felix E, Scott S, Crafton B et al (1998) Causes of recurrence after laparoscopic hernioplasty a multicenter study. Surg Endosc 12(93):226–231PubMedCrossRefGoogle Scholar
  29. 29.
    Taylor C, Layani L, Liew V (2008) Laparoscopic inguinal hernia repair without mesh fixation, early results of a large randomised clinical trial. Surg Endosc 22(3):757–762PubMedCrossRefGoogle Scholar
  30. 30.
    Phillips EH, Rosenthal R, Fallas M et al (1995) Reasons for early recurrence following laparoscopic hernioplasty. Surg Endosc 9(2):140–144PubMedCrossRefGoogle Scholar
  31. 31.
    Ceccarelli G, Casciola L, Pisanelli MC et al (2008) Comparing fibrin sealant with staples for mesh fixation in laparoscopic transabdominal hernia repair: a case control-study. Surg Endosc 22(3):668–673PubMedCrossRefGoogle Scholar
  32. 32.
    Benizri EI, Rahili A, Avallone S et al (2006) Open inguinal hernia repair by plug and patch: the value of fibrin sealant fixation. Hernia 10(5):389–394PubMedCrossRefGoogle Scholar
  33. 33.
    Lovisetto F, Zonta S, Rota E et al (2007) Use of human fibrin glue (Tissucol) versus staples for mesh fixation in laparoscopic transabdominal preperitoneal hernioplasty: a prospective, randomized study. Ann Surg 245(2):222–231PubMedCrossRefGoogle Scholar
  34. 34.
    Lau H (2005) Fibrin sealant versus mechanical stapling for mesh fixation during endoscopic extraperitoneal inguinal hernioplasty: a randomized prospective trial. Ann Surg 242(5):670–675PubMedCrossRefGoogle Scholar
  35. 35.
    Canonico S, Benevento R, Della Corte A et al (2007) Sutureless tension-free hernia repair with human fibrin glue (tissucol) in soccer players with chronic inguinal pain: initial experience. Int J Sports Med 28(10):873–876PubMedCrossRefGoogle Scholar
  36. 36.
    Santoro E, Agresta F, Buscaglia F et al (2007) Preliminary experience using fibrin glue for mesh fixation in 250 patients undergoing minilaparoscopic transabdominal preperitoneal hernia repair. J Laparoendosc Adv Surg Technol A 17(1):12–15CrossRefGoogle Scholar
  37. 37.
    Khaleal F, Berney C (2011) The role of fibrin glue in decreasing chronic pain in laparoscopic totally extraperitoneal (TEP) inguinal hernia repair: a single surgeon’s experience. ANZ J Surg 81(3):154–158PubMedCrossRefGoogle Scholar
  38. 38.
    Dulucq JL, Wintringer P, Mahajna A (2009) Laparoscopic totally extraperitoneal inguinal hernia repair: lessons learned from 3,100 hernia repairs over 15 years. Surg Endosc 23(3):482–486PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Department of SurgeryCentral Manchester Foundation NHS Trust, Manchester Royal InfirmaryManchesterUK
  2. 2.University of ManchesterManchesterUK

Personalised recommendations