Abstract:

Introduction: The new objective in primary hernia surgery should be the reduction of disabling chronic pain. This article will discuss the safety, efficacy, and reduction of pain of a sutureless glue mesh procedure for primary uncomplicated inguinal hernia repair.
Methods: We began performing sutureless glue mesh repairs in 2004 for primary uncomplicated inguinal hernias with good results. After reduction of the hernia sac, polypropylene medium-weight preshaped flat mesh is fixed to the posterior inguinal wall with 0.5 mL of fibrin glue on the pubic tubercle; another 1.5 mL is sprayed on the entire mesh surface. The cord is positioned in subcutaneous space. The TI.ME.LI (Tissucol/Tisseel® for MEsh fixation in LIchtenstein hernia repair) trial was planned and conducted based on this experience.
Results: In two years, we treated more than 600 primary inguinal hernias with fibrin glue mesh fixation repair. At follow-up (2 to 96 months after surgery), no patients presented with severe pain, 2.7% of patients complained of moderate pain.
Conclusion: Fibrin sealant for mesh fixation in open repair is well tolerated and it should be considered as a first-line option for mesh fixation in open inguinal hernia repair.

Authors:

Giampiero Campanelli, MD, Professor of Sugery, Insubria University of Varese, Chief, Department of General Surgery, Day & Week Surgery Istituto Clinico Sant'Ambrogio, Milano, Italy, Marta Cavalli, MD, Resident in General Surgery, Insubria University of Varese, Istituto Clinico Sant'Ambrogio, Milano, Italy, Cristina Sfeclan, PhD, Resident in General Surgery, University of Pharmacy and Medicine, Craiova, Romania, Antonio Biondi, MD, Assistant Professor of Surgery, University of Catania, Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele, Catania, Italy

PMID: 23109074

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