title: Time Savings and Surgery Task Load Reduction in Open Intraperitoneal Onlay Mesh Fixation Procedure.
abstract: BACKGROUND
  This study assessed the reduction in surgeon stress associated with savings in procedure time for mechanical fixation of an intraperitoneal onlay mesh (IPOM) compared to a traditional suture fixation in open ventral hernia repair.
  
  
  METHODS
  Nine general surgeons performed 36 open IPOM fixation procedures in porcine model. Each surgeon conducted two mechanical (using ETHICON SECURESTRAP ™ Open) and two suture fixation procedures. Fixation time was measured using a stopwatch, and related surgeon stress was assessed using the validated SURG-TLX questionnaire. T-tests were used to compare between-group differences, and a two-sided 95% confidence interval for the difference in stress levels was established using nonparametric methodology.
  
  
  RESULTS
  The mechanical fixation group demonstrated an 89.1% mean reduction in fixation time, as compared to the suture group (p < 0.00001). Surgeon stress scores measured using SURG-TLX were 55.5% lower in the mechanical compared to the suture fixation group (p < 0.001). Scores in five of the six sources of stress were significantly lower for mechanical fixation.
  
  
  CONCLUSIONS
  Mechanical fixation with ETHICON SECURESTRAP ™ Open demonstrated a significant reduction in fixation time and surgeon stress, which may translate into improved operating efficiency, improved performance, improved surgeon quality of life, and reduced overall costs of the procedure.
authors.affiliation: Global Health Economics and Market Access, Ethicon, Somerville, NJ, USA.
authors.forename: Sanjoy
authors.initials: S
authors.lastname: Roy
authors.affiliation: Medical Affairs, Ethicon, Somerville, NJ, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Hammond
authors.affiliation: Global Health Economics and Market Access, Ethicon, Somerville, NJ, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Panish
authors.affiliation: Preclinical Research, Ethicon, Somerville, NJ, USA.
authors.forename: Pullen
authors.initials: P
authors.lastname: Shnoda
authors.affiliation: Preclinical Research, Ethicon, Somerville, NJ, USA.
authors.forename: Sandy
authors.initials: S
authors.lastname: Savidge
authors.affiliation: College of Life and Environmental Sciences, University of Exeter, Exeter, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Wilson
mesh_terms: D000818:Animals; D005260:Female; D010537:Peritoneum / Q000601:surgery*; D013526:Surgical Mesh; D034421:Sus scrofa; D013536:Suture Techniques; D013997:Time Factors