Gernot Köhler1,2, Michael Lechner3, Franz Mayer3, Ferdinand Köckerling4, Rudolf Schrittwieser5, René H Fortelny3,6, Daniela Adolf7, Klaus Emmanuel8. 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.
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.
Authors: A Kingsnorth; M Gingell-Littlejohn; S Nienhuijs; S Schüle; P Appel; P Ziprin; A Eklund; M Miserez; S Smeds Journal: Hernia Date: 2012-03-28 Impact factor: 4.739
Authors: M Miserez; J H Alexandre; G Campanelli; F Corcione; D Cuccurullo; M Hidalgo Pascual; A Hoeferlin; A N Kingsnorth; V Mandala; J P Palot; V Schumpelick; R K J Simmermacher; R Stoppa; J B Flament Journal: Hernia Date: 2007-03-13 Impact factor: 4.739
Authors: H Pokorny; A Klingler; T Schmid; R Fortelny; C Hollinsky; R Kawji; E Steiner; H Pernthaler; R Függer; M Scheyer Journal: Hernia Date: 2008-02-19 Impact factor: 4.739
Authors: M P Simons; T Aufenacker; M Bay-Nielsen; J L Bouillot; G Campanelli; J Conze; D de Lange; R Fortelny; T Heikkinen; A Kingsnorth; J Kukleta; S Morales-Conde; P Nordin; V Schumpelick; S Smedberg; M Smietanski; G Weber; M Miserez Journal: Hernia Date: 2009-07-28 Impact factor: 4.739
Authors: Charles P Shahan; Nathaniel N Stoikes; Esra Roan; James Tatum; David L Webb; Guy R Voeller Journal: Surg Endosc Date: 2016-07-21 Impact factor: 4.584