Hernia : the journal of hernias and abdominal wall surgery
-
In adult patients, most inguinal hernias are treated by implanting a prosthetic mesh. To prevent mesh dislocation and thus recurrence, different types of fixation have been proposed. In contrast to penetrating fixation known to cause acute chronic pain, adhesive fixation is becoming increasingly popular as it reduces markedly the risk of injury and chronic pain. Apart from the biological sealants (e.g., fibrin glue), surgical adhesives include a group of synthetic glues and genetically engineered protein glues. For example, cyanoacrylate is used in various medical and veterinary indications due to its fast action, excellent bonding strength and low price. ⋯ The experimental and clinical data demonstrate the safe use and the excellent cost-benefit ratio of n-butyl cyanoacrylate compared with other techniques of mesh fixation.
-
Randomized Controlled Trial Comparative Study
Comparison of non-mesh (Desarda) and mesh (Lichtenstein) methods for inguinal hernia repair among black African patients: a short-term double-blind RCT.
This study compared the short-term outcomes of the non-mesh (Desarda) and mesh (Lichtenstein) methods of hernia repair among Black African patients, with regard to acute postoperative pain, day of return to normal gait, operative time and complications. ⋯ The results of the study showed that the effectiveness of the Desarda technique with respect to influencing the early clinical outcomes of hernia repair is similar to that of the Lichtenstein method. However, the operator in this study showed that the Desarda repair requires significantly shorter operative time.
-
Umbilical hernia is a common surgical problem. However, there seems to be a certain discrepancy between its importance and the attention it has received in the literature to date. This prospective study aimed to report a detailed analysis of prosthetic umbilical hernia repairs with local anesthesia in a day-case setting. ⋯ The repair of umbilical hernias with local anesthesia in a day-case setting is a good option, with low infection and recurrence rates. Most patients can be discharged early as planned. Separate doses and total volume of local anesthetic agents needed for umbilical hernia repair are clearly higher than those used in inguinal hernia repair. Patients with higher BMI, recurrent hernia, and defects larger than 3 cm may require higher local analgesic doses. The patient satisfaction is very good when the patients are provided with detailed information about day-surgery and local anesthesia.
-
Randomized Controlled Trial Comparative Study
Prospective randomized trial comparing sutured with sutureless mesh fixation for Lichtenstein hernia repair: long-term results.
Following Lichtenstein hernia repair, up to 25% of patients experience prolonged postoperative and chronic pain as well as discomfort in the groin. One of the underlying causes of these complaints are the compression or irritation of nerves by the sutures used to fixate the mesh. We compared the level and rate of chronic pain in patients operated with the classical Lichtenstein technique fixated by sutures to patients with sutureless mesh fixation technique. ⋯ After 5 years, the two techniques of mesh fixation resulted in similar rates of chronic pain. Whereas recurrence rates were comparable, fixation of the mesh with tissue glue decreased operating room time significantly. Hence, suture less mesh fixation with Histoacryl is a sensible alternative to suture fixation and should be especially considered for patients prone to pain.
-
Randomized Controlled Trial Comparative Study
Comparison of ultrasonography and physical examination in the diagnosis of incisional hernia in a prospective study.
Incisional hernia is a frequent complication of abdominal surgery (incidence 2-20%). Diagnosis by physical examination is sometimes difficult, especially in small incisional hernias or in obese patients. The additional diagnostic value of standardized ultrasonography was evaluated in this prospective study. ⋯ There are no clear diagnostic criteria for incisional hernia available in the literature. Standardized combination of ultrasonography with physical examination during follow-up yields a significant number of, mostly asymptomatic, hernias, which would not be found using physical examination alone. This is especially relevant in research settings.