title: Mesh fixation using staples in Lichtenstein's inguinal hernioplasty: fewer complications and fewer recurrences.
abstract: BACKGROUND
  Fixation of the mesh in Lichtenstein's inguinal hernioplasty is traditionally performed with polypropylene sutures. A modification of this technique uses staples for securing of the mesh.
  
  
  METHODS
  A retrospective comparative study of 149 elective repairs of a primary inguinal hernia was performed: a control group of 67 patients undergoing mesh fixation using sutures and a study group of 82 patients undergoing staple fixation. Operating time, recurrence, postoperative pain, complications and costs were studied.
  
  
  RESULTS
  Seven recurrences (11%) occurred in the polypropylene group as compared to one recurrence (1%) in the staple group (P < 0.01). There was a trend of fewer complications in the staple group. Operative time and long-term postoperative pain did not differ significantly between the two groups. The costs per surgery for mesh fixation and skin closure were euro 11.13 for the suture group and euro 24.35 for the staple group.
  
  
  CONCLUSIONS
  Staple fixation of the mesh in Lichtenstein's inguinal hernioplasty can be considered equal to traditional fixation with sutures with regard to operating time and postoperative pain. However, staple fixation seems to show fewer recurrences and fewer complications.
authors.affiliation: Department of Surgery, Albert Schweitzer Hospital, 3300 AK, Dordrecht, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: van der Zwaal
authors.forename: I R
authors.initials: IR
authors.lastname: van den Berg
authors.forename: P W
authors.initials: PW
authors.lastname: Plaisier
authors.forename: R P
authors.initials: RP
authors.lastname: Tutein Nolthenius
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D019919:Prosthesis Implantation / Q000295:instrumentation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D013528:Surgical Staplers; D013536:Suture Techniques / Q000295:instrumentation*; D016896:Treatment Outcome