Penetrating fixation device versus fibrin sealant for mesh fixation in laparoscopic repair of ventral hernia: a randomized controlled trial.

IF 2.6 2区医学 Q1 SURGERY

Hernia Pub Date : 2025-02-18 DOI:10.1007/s10029-025-03294-y

Hemanga Kumar Bhattacharjee, Vishal Anand, Mithun Nk, Ashwani Kumar Mishra, Aditya Baksi, Mohit Joshi, Suhani, Rajinder Parshad

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引用次数: 0

Abstract

Purpose: Post-operative pain following intra peritoneal onlay mesh (IPOM) repair of ventral hernia is commonly attributed to mechanical fixation devices. Fibrin sealant is a novel technique of mesh fixation purported to cause less pain. The aim of this study was to compare postoperative pain in these two methods of mesh fixation.

Methods: This was a double-blinded, randomized controlled trial. Eighty patients with primary ventral hernia underwent laparoscopic IPOM repair using PROCEED™ mesh, which was fixed with either mechanical fixation device, SECURESTRAP™ (MF group) or fibrin sealant, TISSEEL™ (FS group). Primary end point was postoperative pain at rest and movement on a Visual Analogue Scale (VAS) of 0-10. Operative time, recurrence, seroma and quality of life (QoL) were secondary outcomes. Patients were followed up for one year.

Results: There was no significant difference in pain score at 12 h, 24 h, 7 days, 1, 3 and 12 months between the groups, except pain on movement, which was significantly less in the FS group on the seventh day (median VAS 3 vs. 2, p = 0.01). Mean operative time was 8 min longer in the FS group (p = 0.001). Two patients in the FS and none in the MF group had recurrence at one year (p = 0.18). Seroma formation, postoperative QoL and patient satisfaction scores were similar in both groups.

Conclusions: Use of fibrin sealant for mesh fixation does not provide significant advantage over mechanical fixation in laparoscopic IPOM repair.

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穿透固定装置与纤维蛋白密封剂用于腹腔镜腹疝修补补片固定：一项随机对照试验。

目的：腹膜内补片（IPOM）腹疝修补术后疼痛通常归因于机械固定装置。纤维蛋白密封胶是一种新型的网状固定技术，旨在减少疼痛。本研究的目的是比较这两种补片固定方法的术后疼痛。方法：双盲、随机对照试验。80例原发性腹疝患者采用PROCEED™补片进行腹腔镜IPOM修复，用机械固定装置SECURESTRAP™（MF组）或纤维蛋白密封剂TISSEEL™（FS组）进行固定。主要终点为术后休息和运动时疼痛，视觉模拟评分（VAS） 0-10分。手术时间、复发率、血肿和生活质量（QoL）是次要指标。患者随访1年。结果：两组患者在12 h、24 h、7 d、1、3、12个月的疼痛评分差异无统计学意义，但FS组患者在第7天的运动疼痛评分明显低于对照组（VAS中位数3比2，p = 0.01）。FS组平均手术时间延长8 min （p = 0.001）。FS组2例，MF组无复发（p = 0.18）。两组患者血清肿形成、术后生活质量和患者满意度评分相似。结论：在腹腔镜IPOM修复中，使用纤维蛋白密封胶进行补片固定并不比机械固定有明显优势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.