Department of General Surgery, Royal Lancaster Infirmary, University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, LA1 4RP, UK.
Hernia. 2020 Dec;24(6):1387-1396. doi: 10.1007/s10029-020-02144-3. Epub 2020 Feb 25.
The purpose of this study was to evaluate a novel hernia repair glue fixation device (LiquibandFix8™) in laparoscopic IPOM repair for incisional hernias.
All ventral incisional hernia patients requiring laparoscopic IPOM repair were included in the study. A retrospective review of the data was performed.
137 patients underwent 138 laparoscopic IPOM repairs for incisional hernias using n-butyl-2-cyanoacrylate (LiquibandFix8™) for mesh fixation over a 40-month period by a single experienced laparoscopic surgeon. There were 70 males and 67 females, median age 54 years (range 23-80 years). Defects were predominantly midline n = 123/138 (89%) and were closed by transfascial sutures in 126/138 (91%) prior to IPOM repair (IPOM plus). Mesh fixation was successful in all 138 repairs. Synthetic meshes (Symbotex™ [polyester/collagen composite, Medtronic] n = 80, and Dynamesh [polypropylene/PVDF composite, FEG Textiltechnik mbH] n = 5) and biologic meshes (Surgimend [bovine collagen dermal matrix, Integra] n = 53) were used. Median follow-up was 32 months (range 12-48 months). There were 16 adverse events in 12 patients (9%): conversion to open surgery (inadvertent enterotomy) 2 (1.5%), bladder perforation 1, intraperitoneal bleeding 2, port-site haematoma 2, port site wound infection 1, post-op ileus 2, chest infection 1, seroma 1 (1%), hernia recurrence 3 (2%) and chronic pain 2 (1.5%).
This retrospective study shows that mesh fixation in laparoscopic IPOM using cyanoacrylate glue with the Liquiband Fix8™ device is feasible, safe, easy to learn, and is associated with a low risk of seroma, hernia recurrence and chronic pain with short-medium term follow-up.
本研究旨在评估一种新型疝修补胶固定装置（LiquibandFix8™）在腹腔镜 IPOM 修补切口疝中的应用。
所有需要腹腔镜 IPOM 修补的腹壁切口疝患者均纳入本研究。回顾性分析数据。
在 40 个月的时间里，由一位经验丰富的腹腔镜外科医生对 137 例腹壁切口疝患者（共 138 例）进行了腹腔镜 IPOM 修补术，使用 n-丁基-2-氰基丙烯酸酯（LiquibandFix8™）固定补片。其中男 70 例，女 67 例，中位年龄 54 岁（23-80 岁）。切口疝以正中切口为主（n=123/138，89%），在 IPOM 修复（IPOM 加）前，126/138 例（91%）通过筋膜间缝合关闭。所有 138 例手术均成功固定补片。使用合成补片（Symbotex™[聚酯/胶原复合材料，美敦力]n=80 例和 Dynamesh[聚丙烯/PVDF 复合材料，FEG Textiltechnik mbH]n=5 例）和生物补片（Surgimend[牛胶原蛋白真皮基质，英特格拉]n=53 例）。中位随访 32 个月（12-48 个月）。12 例患者（9%）出现 16 例不良事件：2 例（1.5%）中转开腹（意外肠穿孔），1 例膀胱穿孔，2 例腹腔内出血，2 例端口部位血肿，1 例端口部位伤口感染，2 例术后肠梗阻，1 例胸部感染，1 例血清肿（1%），3 例疝复发（2%）和 2 例慢性疼痛（1.5%）。
本回顾性研究表明，使用氰基丙烯酸酯胶和 LiquibandFix8™装置固定腹腔镜 IPOM 中的补片是可行的、安全的、易于学习的，并且具有较低的血清肿、疝复发和慢性疼痛风险，在中短期随访中。
