Ann Surg Treat Res.  2016 Sep;91(3):127-132. 10.4174/astr.2016.91.3.127.

Use of fibrin glue in preventing pseudorecurrence after laparoscopic total extraperitoneal repair of large indirect inguinal hernia

• Sürgit O
• ÇavuÅŸoÄŸlu NT
• Kılıç M
• Ãœnal Y
• KoÅŸar PN
• İçen D

• KMID: 2350539
• DOI: http://doi.org/10.4174/astr.2016.91.3.127

Abstract

PURPOSE
Seroma is among the most common complications of laparoscopic total extraperitoneal (TEP) for especially large indirect inguinal hernia, and may be regarded as a recurrence by some patients. A potential area localized behind the mesh and extending from the inguinal cord into the scrotum may be one of the major etiological factors of this complication. Our aim is to describe a novel technique in preventing pseudorecurrence by using fibrin sealant to close that potential dead space.
METHODS
Forty male patients who underwent laparoscopic TEP for indirect inguinal hernia with at least 100-mL volume were included in this prospective clinical study. While fibrin sealant was used to close the potential dead space in the study group, nothing was used in the control group. The volume of postoperative fluid collection on ultrasound was compared between the groups.
RESULTS
Patient characteristics and the volumes of hernia sac were similar between the 2 groups. The mean volume of postoperative fluid collection was found as 120.2 mL in the control group and 53.7 mL in the study group, indicating a statistical significance (P < 0.001).
CONCLUSION
Minimizing the potential dead space with a fibrin sealant can reduce the amount of postoperative fluid collection, namely the incidence of pseudorecurrence.

Keyword

Fibrin sealant; Inguinal hernia; Laparoscopic total extraperitoneal hernia repair; Seroma; Pseudorecurrence

MeSH Terms

Clinical Study
Fibrin Tissue Adhesive*
Fibrin*
Hernia
Hernia, Inguinal*
Humans
Incidence
Male
Prospective Studies
Recurrence
Scrotum
Seroma
Ultrasonography
Fibrin
Fibrin Tissue Adhesive

Figure

• 

  Fig. 1 (A) A drawing showing the placement of the trocars in a patient of study group. (B) Application of fibrin sealant into the potential dead space by using a laparoscopic applicator through the trocar near the anterior superior iliac spine.

• 

  Fig. 2 The image of a pseudorecurrence following laparoscopic total extraperitoneal for left scrotal hernia in a patient of control group.

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