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Indian Journal of Surgery, Vol. 67, No. 1, January-February, 2005, pp. 56 Letter To Editor Use of skin stapler in Lichensteins mesh repair Chauhan Ashutosh Dept. of Surgery, Base Hospital, Delhi Cantt, Delhi - 110 010 Code Number: is05015 Sir, 1. We read with interest the article by Garg et al.[1] 2. We tried the technique described by the author in a series of 10 cases of Lichenstein′s Mesh Hernia repair and compared it with the standard technique with prolene sutures. Our experience is as follows: a. It is extremely difficult, if not impossible, to staple the mesh to pubic tubercle as there is virtually no ′give′ in the periosteum for the staple to hold. b. As there is no space to manoeuvre the broad head of the stapler when we try to staple the inferior edge of the mesh to the upturned portion of the inguinal ligament, it is very cumber some trying to align the inferior edge of the mesh to the inguinal ligament. c. In both the above situations we had to resort to applying prolene sutures additionally to secure the mesh as we were not convinced of the integrity of the mesh repair with stapler application only. d. The mean operative time was noted from insertion of the mesh to placement of the last staple / prolene suture. The mean time in 10 cases of staples was 14 min (09-17 min) while in 10 cases of prolene sutures it was 11 min (09-14 min). 3. Hence we do not agree with the authors′ conclusion in ibid article that using skin staplers is as effective as conventional repair or that there is significant reduction in operative time. References
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