title: [Use of fibrin glue (Tissucol) for mesh fixation in laparoscopic transabdominal hernia repair].
abstract: The aim of this study was to demonstrate the efficacy and safety and report the results of prosthesis fixation by means of fibrin glue during laparoscopic treatment of inguinal and femoral hernias. From September 2001 to December 2004 we employed fibrin glue (Tissucol, Baxter, Maurepas) as a means of fixation during a transabdominal preperitoneal procedure in 230 patients (225 M, 5 F) with an average age of 45 years (range: 20-75) presenting a total of 320 hernias: 140/230 (60.8%) were monolateral and 90 (39.2%) bilateral; 267/320 hernias (83.6%) were primary and 53 (16.4%) recurrent. We had no perioperative complications. After an average follow-up of 26 months (range: 1-40) the only postoperative complications we encountered were 6 seromas (1.8%) and 1 trocar-site haematoma (0.3%). None of the patients developed scrotal haematomas. None of the patients complained of immediate or subsequent paraesthesia or cruralgia. No recurrences have occurred to date. The mean operative time was 30 minutes for monolateral hernias (range: 15-45) and about 50 minutes for bilateral hernias (range: 30-75). This was true of both primary and recurrent hernias. Patients are usually discharged on day 1 postoperatively. In the absence of pain, working activities are resumed after 5 days and sports can be practiced after 10 days. In our experience, fibrin glue (Tissucol) is the best way of fixing the mesh during a transabdominal preperitoneal procedure. It is better than mechanical devices because, though guaranteeing prosthetic stability, it is completely non-traumatic and presents none of the problems of metal clips.
authors.affiliation: II UO Chirurgia Generale, Centro di Chirurgia Laparoscopica e Mini-invasiva Ospedale S. Gerardo, Monza.
authors.forename: Stefano
authors.initials: S
authors.lastname: Olmi
authors.forename: Luigi
authors.initials: L
authors.lastname: Erba
authors.forename: Aimone
authors.initials: A
authors.lastname: Bertolini
authors.forename: Alberto
authors.initials: A
authors.lastname: Scaini
authors.forename: Emanuele
authors.initials: E
authors.lastname: Mastropasqua
authors.forename: Matteo
authors.initials: M
authors.lastname: Conti
authors.forename: Enrico
authors.initials: E
authors.lastname: Croce
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D046449:Hernia, Abdominal / Q000601:surgery*; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013526:Surgical Mesh; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives