Format

Send to

Choose Destination
World J Surg. 2016 Feb;40(2):298-308. doi: 10.1007/s00268-015-3313-0.

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

Author information

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.koehler@bhs.at.
2
Department of Surgery, Paracelsus Medical University, Salzburg, Austria. gernot.koehler@bhs.at.
3
Department of Surgery, Paracelsus Medical University, Salzburg, Austria.
4
Department of Surgery and Centre of Minimally Invasive Surgery, Vivantes Hospital, Berlin, Germany.
5
Department of General Surgery, Landeskrankenhaus Hochsteiermark, Bruck an der Mur, Austria.
6
Department of General, Visceral and Oncological Surgery, Wilhelminenspital, Vienna, Austria.
7
Institut StatConsult GmbH®, Magdeburg, Germany.
8
Department of General and Visceral Surgery, Linz, Academic Teaching Hospital of the Medical Universities Graz and Innsbruck, Sisters of Charity Hospital, 4010, Linz, Austria.

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.

PMID:
26546187
DOI:
10.1007/s00268-015-3313-0
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center