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Vacuum suction fixation versus staple fixation in TAPP laparoscopic hernia repair: introduction of a new technique for mesh fixation

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Abstract

Background

Proper mesh fixation is critical for successful TAPP laparoscopic hernia repair. Conventional mesh fixation may cause chronic neuralgia, groin paresthesia or other complications. This study aimed at introducing a new vacuum suction technique for mesh fixation and evaluating its efficacy and safety compared with traditional staple fixation way.

Methods

Clinical data of 242 patients undergoing TAPP from July 2011 to March 2014 were retrospectively analyzed. Patients were divided into vacuum suction fixation group and staple fixation group. The operation time, hospital stay, complications, recurrence, visual analogue scale pain score and cost were evaluated.

Results

All surgeries were successful. The operation time of staple group was (42.34 ± 10.15) min for unilateral hernia and (64.08 ± 16.01) min for bilateral hernias. The postoperative hospital stay was (2.76 ± 0.84) days. One recurrence was observed (0.90 %). For vacuum group, the operation time was (42.66 ± 7.76) min and (63.92 ± 10.49) min, and hospital stay was (2.60 ± 0.74) days. No recurrence was observed. There was no significant difference in recurrence, operation time, postoperative pain and hospital stay between two groups (P > 0.05). Average cost were (11,714 ± 726) RMB for vacuum group which was lower than staple group (14,837 ± 1568) RMB (P < 0.05). The top three complications of staple group were scrotal emphysema (10.81 %), scrotal seroma (6.31 %) and temporary nerve paresthesia (4.50 %) while for vacuum group, they were scrotal seroma (3.82 %), temporary nerve paresthesia (3.05 %), scrotal emphysema (1.53 %) and uroschesis (1.53 %). The incidence of scrotal emphysema was lower in vacuum group (P < 0.05). No significant difference was observed in other complications (P > 0.05).

Conclusion

Both techniques for mesh fixation are safe and effective. There is no significant difference in recurrence, operation time, postoperative pain or hospital stay. The vacuum suction fixation technique is more economical with lower incidence of scrotal emphysema.

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References

  1. Taylor C, Layani L, Liew V, Ghusn M, Crampton N, White S (2008) Laparoscopic inguinal hernia repair without mesh fixation, early results of a large randomised clinical trial. Surg Endosc 22(3):757–762. doi:10.1007/s00464-007-9510-7

    Article  PubMed  Google Scholar 

  2. Brugger L, Bloesch M, Ipaktchi R, Kurmann A, Candinas D, Beldi G (2012) Objective hypoesthesia and pain after transabdominal preperitoneal hernioplasty: a prospective, randomized study comparing tissue adhesive versus spiral tacks. Surg Endosc 26(4):1079–1085. doi:10.1007/s00464-011-2003-8

    Article  PubMed  Google Scholar 

  3. Fortelny RH, Petter-Puchner AH, May C, Jaksch W, Benesch T, Khakpour Z, Redl H, Glaser KS (2012) The impact of atraumatic fibrin sealant vs. staple mesh fixation in TAPP hernia repair on chronic pain and quality of life: results of a randomized controlled study. Surg Endosc 26(1):249–254. doi:10.1007/s00464-011-1862-3

    Article  PubMed  CAS  Google Scholar 

  4. Miserez M, Peeters E, Aufenacker T, Bouillot JL, Campanelli G, Conze J, Fortelny R, Heikkinen T, Jorgensen LN, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Simons MP (2014) Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 18(2):151–163. doi:10.1007/s10029-014-1236-6

    Article  PubMed  CAS  Google Scholar 

  5. Kleidari B, Mahmoudieh M, Yaribakht M, Homaei Z (2014) Mesh fixation in TAPP laparoscopic hernia repair: introduction of a new method in a prospective randomized trial. Surg Endosc 28(2):531–536. doi:10.1007/s00464-013-3198-7

    Article  PubMed  Google Scholar 

  6. Tolver MA, Rosenberg J, Juul P, Bisgaard T (2013) Randomized clinical trial of fibrin glue versus tacked fixation in laparoscopic groin hernia repair. Surg Endosc 27(8):2727–2733. doi:10.1007/s00464-012-2766-6

    Article  PubMed  Google Scholar 

  7. Ceccarelli G, Casciola L, Pisanelli MC, Bartoli A, Di Zitti L, Spaziani A, Biancafarina A, Stefanoni M, Patriti A (2008) Comparing fibrin sealant with staples for mesh fixation in laparoscopic transabdominal hernia repair: a case control-study. Surg Endosc 22(3):668–673. doi:10.1007/s00464-007-9458-7

    Article  PubMed  Google Scholar 

  8. Melissa CS, Bun TA, Wing CK, Chung TY, Wai NE, Tat LH (2014) Randomized double-blinded prospective trial of fibrin sealant spray versus mechanical stapling in laparoscopic total extraperitoneal hernioplasty. Ann Surg 259(3):432–437. doi:10.1097/SLA.0b013e3182a6c513

    Article  PubMed  Google Scholar 

  9. Fortelny RH, Petter-Puchner AH, Glaser KS, Redl H (2012) Use of fibrin sealant (Tisseel/Tissucol) in hernia repair: a systematic review. Surg Endosc 26(7):1803–1812. doi:10.1007/s00464-012-2156-0

    Article  PubMed  Google Scholar 

  10. Bittner R, Schwarz J (2012) Inguinal hernia repair: current surgical techniques. Langenbeck’s Arch Surg 397(2):271–282. doi:10.1007/s00423-011-0875-7

    Article  CAS  Google Scholar 

  11. Junge K, Rosch R, Klinge U, Schwab R, Peiper C, Binnebosel M, Schenten F, Schumpelick V (2006) Risk factors related to recurrence in inguinal hernia repair: a retrospective analysis. Hernia 10(4):309–315. doi:10.1007/s10029-006-0096-0

    Article  PubMed  CAS  Google Scholar 

  12. van Veen RN, Wijsmuller AR, Vrijland WW, Hop WC, Lange JF, Jeekel J (2007) Long-term follow-up of a randomized clinical trial of non-mesh versus mesh repair of primary inguinal hernia. Br J Surg 94(4):506–510. doi:10.1002/bjs.5627

    Article  PubMed  Google Scholar 

  13. Butters M, Redecke J, Koninger J (2007) Long-term results of a randomized clinical trial of Shouldice, Lichtenstein and transabdominal preperitoneal hernia repairs. Br J Surg 94(5):562–565. doi:10.1002/bjs.5733

    Article  PubMed  CAS  Google Scholar 

  14. Lovisetto F, Zonta S, Rota E, Mazzilli M, Bardone M, Bottero L, Faillace G, Longoni M (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):222–231. doi:10.1097/01.sla.0000245832.59478.c6

    Article  PubMed  PubMed Central  Google Scholar 

  15. McCormack K, Scott NW, Go PM, Ross S, Grant AM (2003) Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev (1):CD001785. doi:10.1002/14651858.CD001785

  16. Bueno J, Serralta A, Planells M, Rodero D (2004) Inguinodynia after two inguinal herniorrhaphy methods. Surg Laparosc Endosc Percutaneous Tech 14(4):210–214

    Article  Google Scholar 

  17. Mahon D, Decadt B, Rhodes M (2003) Prospective randomized trial of laparoscopic (transabdominal preperitoneal) vs open (mesh) repair for bilateral and recurrent inguinal hernia. Surg Endosc 17(9):1386–1390. doi:10.1007/s00464-002-9223-x

    Article  PubMed  CAS  Google Scholar 

  18. The MRC Laparoscopic Groin Hernia Trial Group (1999) Laparoscopic versus open repair of groin hernia: a randomised comparison. Lancet 354(9174):185–190

    Article  Google Scholar 

  19. Belyansky I, Tsirline VB, Klima DA, Walters AL, Lincourt AE, Heniford TB (2011) Prospective, comparative study of postoperative quality of life in TEP, TAPP, and modified Lichtenstein repairs. Ann Surg 254(5):709–714. doi:10.1097/SLA.0b013e3182359d07 (discussion 714–705)

    Article  PubMed  Google Scholar 

  20. Bansal VK, Misra MC, Babu D, Victor J, Kumar S, Sagar R, Rajeshwari S, Krishna A, Rewari V (2013) A prospective, randomized comparison of long-term outcomes: chronic groin pain and quality of life following totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) laparoscopic inguinal hernia repair. Surg Endosc 27(7):2373–2382. doi:10.1007/s00464-013-2797-7

    Article  PubMed  Google Scholar 

  21. Dion YM, Morin J (1992) Laparoscopic inguinal herniorrhaphy. Can J Surg 35(2):209–212

    PubMed  CAS  Google Scholar 

  22. Lowham AS, Filipi CJ, Fitzgibbons RJ Jr, Stoppa R, Wantz GE, Felix EL, Crafton WB (1997) Mechanisms of hernia recurrence after preperitoneal mesh repair. Traditional and laparoscopic. Ann Surg 225(4):422–431

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  23. Felix E, Scott S, Crafton B, Geis P, Duncan T, Sewell R, McKernan B (1998) Causes of recurrence after laparoscopic hernioplasty: a multicenter study. Surg Endosc 12(3):226–231

    Article  PubMed  CAS  Google Scholar 

  24. Phillips EH, Rosenthal R, Fallas M, Carroll B, Arregui M, Corbitt J, Fitzgibbons R, Seid A, Schultz L, Toy F et al (1995) Reasons for early recurrence following laparoscopic hernioplasty. Surg Endosc 9(2):140–144 (discussion 144–145)

    Article  PubMed  CAS  Google Scholar 

  25. Sajid MS, Ladwa N, Kalra L, Hutson K, Sains P, Baig MK (2012) A meta-analysis examining the use of tacker fixation versus no-fixation of mesh in laparoscopic inguinal hernia repair. Int J Surg 10(5):224–231. doi:10.1016/j.ijsu.2012.03.001

    Article  PubMed  CAS  Google Scholar 

  26. Tam KW, Liang HH, Chai CY (2010) Outcomes of staple fixation of mesh versus nonfixation in laparoscopic total extraperitoneal inguinal repair: a meta-analysis of randomized controlled trials. World J Surg 34(12):3065–3074. doi:10.1007/s00268-010-0760-5

    Article  PubMed  Google Scholar 

  27. Teng YJ, Pan SM, Liu YL, Yang KH, Zhang YC, Tian JH, Han JX (2011) A meta-analysis of randomized controlled trials of fixation versus nonfixation of mesh in laparoscopic total extraperitoneal inguinal hernia repair. Surg Endosc 25(9):2849–2858. doi:10.1007/s00464-011-1668-3

    Article  PubMed  Google Scholar 

  28. Hollinsky C, Sandberg S, Koch T, Seidler S (2008) Biomechanical properties of lightweight versus heavyweight meshes for laparoscopic inguinal hernia repair and their impact on recurrence rates. Surg Endosc 22(12):2679–2685. doi:10.1007/s00464-008-9936-6

    Article  PubMed  Google Scholar 

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Disclosures

Guangyong Zhang, Xiang Zhang, Hanxiang Zhan and Sanyuan Hu declare that there are no conflicts of interest.

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    Authors and Affiliations

    1. Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, People’s Republic of China

      Guangyong Zhang, Xiang Zhang, Hanxiang Zhan & Sanyuan Hu

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    1. Guangyong Zhang
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    2. Xiang Zhang
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    Correspondence to Sanyuan Hu.

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    Guangyong Zhang, Xiang Zhang and Hanxiang Zhan have contributed equally to this work.

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    Zhang, G., Zhang, X., Zhan, H. et al. Vacuum suction fixation versus staple fixation in TAPP laparoscopic hernia repair: introduction of a new technique for mesh fixation. Surg Endosc 30, 114–120 (2016). https://doi.org/10.1007/s00464-015-4168-z

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