Use of fibrin glue in preventing pseudorecurrence after laparoscopic total extraperitoneal repair of large indirect inguinal hernia

Abstract

PurposeSeroma is among the most common complications of laparoscopic total extraperitoneal (TEP) for especially large indirect inguinal hernia, and may be regarded as a recurrence by some patients. A potential area localized behind the mesh and extending from the inguinal cord into the scrotum may be one of the major etiological factors of this complication. Our aim is to describe a novel technique in preventing pseudorecurrence by using fibrin sealant to close that potential dead space.MethodsForty male patients who underwent laparoscopic TEP for indirect inguinal hernia with at least 100-mL volume were included in this prospective clinical study. While fibrin sealant was used to close the potential dead space in the study group, nothing was used in the control group. The volume of postoperative fluid collection on ultrasound was compared between the groups.ResultsPatient characteristics and the volumes of hernia sac were similar between the 2 groups. The mean volume of postoperative fluid collection was found as 120.2 mL in the control group and 53.7 mL in the study group, indicating a statistical significance (P < 0.001).ConclusionMinimizing the potential dead space with a fibrin sealant can reduce the amount of postoperative fluid collection, namely the incidence of pseudorecurrence.

Laparoscopic inguinal hernia repair and Lichtenstein tension-free hernia repair for children in 13-18 years old: a prospective, randomized, single-blind controlled trial

“…In addition, the conditions of the hospital and the laparoscopic technique and experience of the surgeons were also important factors that must be considered. Otherwise it might produce unnecessary recurrence and complications [13,14]. This study indicated that the cost of surgery in TEP group and TAPP group was significantly higher than that in Lichtenstein group.…”

Robotic hernia surgery I. English version

“…Pini et al sutured the transversalis fascia with V-Loc suture on 61 r-TAPP sites and observed neither seroma nor recurrence after 30 days, and no prolonged or chronic pain over a 10-month follow-up [25]. There is one small randomized trial of fibrin sealant in 40 patients, showing that seroma prevention is significant in the intervention group (p < 0.001; [26]). In the current series, 17 of 20 seromas were observed in lateral hernias, of which only 1 patient had been sealed with fibrin glue.…”

Robotische Hernienchirurgie I

“…haben an 61 r‑TAPP-Seiten die Fascia transversalis mit V‑Loc-Naht gerafft und nach 30 Tagen weder ein Serom noch ein Rezidiv sowie keine prolongierten oder chronischen Schmerzen in einem Follow-up von 10 Monaten beobachtet [ 25 ]. Zur Fibrinkleberversiegelung liegt eine randomisierte Studie vor, die an 40 Patienten zeigt, dass die Seromprophylaxe signifikant ist ( p < 0,001; [ 26 ]). In der aktuellen Serie sind 17 von 20 Seromen bei lateralen Hernien beobachtet worden, von denen nur 1 Patient mit Fibrinkleber versiegelt worden war.…”