Use of fibrin glue (Tissucol) in laparoscopic repair of abdominal wall defects: preliminary experience.
BACKGROUND
The aim of this study was to establish the efficacy and tolerability of human fibrin glue (Tissucol) for the nontraumatic fixation of a composite prosthesis (Parietex) in the laparoscopic repair of small to medium-sized incisional hernias and primary defects of the abdominal wall.


METHODS
From October 2003 to October 2005, 40 patients underwent laparoscopic repair at the hands of one surgeon with expertise in laparoscopic surgery; all meshes were implanted in an intraperitoneal position. Follow-up visits were scheduled for 7 days and 1, 6, and 12 months. These included assessments for pain and postoperative complications.


RESULTS
Forty patients (24 females, 16 males) with a mean age of 50 years (range, 26-65 years) and a mean Body Mass Index (BMI) of 27 (range 25 to 30) were included in the study. Sixteen patients had incisional hernias, and 24 had primary defects. The size of the defects varied from 2 to 7 cm. Adhesiolysis was necessary in 92.5% of cases (25/40). There were no intraoperative complications or conversions. After a mean follow-up of 16 months (range, 3-24 months), no postoperative complications were observed. The mean surgical intervention time was 36 min (range, 12-40 min), with an average hospitalization time of 1 day.


CONCLUSIONS
The use of fibrin glue in the present study provided stable and uniform fixation of the prosthesis and minimized intraoperative and postoperative complications. Consequently, laparoscopic treatment of small to medium-sized abdominal defects using this approach is our therapeutic option of choice.
Olmi
S
S
Department of General Surgery, Centre for Laparoscopic and Minimally Invasive Surgery, Ospedale San Gerardo, Monza, Italy. stefanoolmi@tiscali.it
Scaini
A
A
Erba
L
L
Croce
E
E
D034861:Abdominal Wall / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005500:Follow-Up Studies; D046449:Hernia, Abdominal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D019919:Prosthesis Implantation / Q000295:instrumentation / Q000379:methods; D020127:Recovery of Function; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome
D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives