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Self-Gripping Meshes for Lichtenstein Repair. Do We Need Additional Suture Fixation?
Gernot Köhler1,2, Michael Lechner3, Franz Mayer3
1Department 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.
World Journal of Surgery
|November 8, 2015
Summary
Additional suture fixation for self-gripping meshes in inguinal hernia repair is not necessary. This study found no significant differences in recurrence rates, complications, or chronic pain, and shorter operation times without fixation.
Area of Science:
- General Surgery
- Hernia Repair
- Surgical Materials
Background:
- The Lichtenstein repair is a standard treatment for inguinal hernias.
- Self-gripping meshes are increasingly used, often with additional suture fixation.
- The necessity and impact of additional mesh suturing remain unclear.
Purpose of the Study:
- To evaluate the benefits and risks of additional suture fixation for self-gripping meshes in Lichtenstein hernia repair.
- To compare recurrence rates, postoperative complications, and chronic pain between fixed and unfixed meshes.
Main Methods:
- Analysis of the Herniamed register for unilateral Lichtenstein operations (2009-2013).
- Inclusion of patients with self-gripping meshes (Progrip®) and 1-year follow-up.
- Comparison of outcomes between groups with (Fix) and without (No Fix) additional suture fixation.
Main Results:
- 2095 patients analyzed; 38.95% received additional fixation.
- No significant differences in 1-year recurrence rates (0.86% vs. 1.17%).
- Comparable postoperative complications and chronic pain rates between groups.
Conclusions:
- Additional suture fixation of self-gripping meshes in Lichtenstein repair does not improve outcomes.
- Operations were significantly shorter by 8 minutes without fixation.
- Eliminating fixation may streamline the procedure without compromising patient safety or efficacy.
