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Indian Journal of Surgery
Medknow Publications on behalf of Association of Surgeons of India
ISSN: 0972-2068
Vol. 67, Num. 1, 2005, pp. 56-56

Indian Journal of Surgery, Vol. 67, No. 1, January-February, 2005, pp. 56

Letter To Editor

Use of skin stapler in Lichensteins mesh repair

Dept. of Surgery, Base Hospital, Delhi Cantt, Delhi - 110 010
Correspondence Address:Dept. of Surgery, Base Hospital, Delhi Cantt, Delhi - 110 010 Email: ashutoshchauhan@medknow.com

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

1.Garg CP, Bhatnagar AM, Parmar CD, et al. Comparative study of skin staples and polypropylene sutures for securing the mesh in Lichenstein's tension free inguinal hernia repair: A prospective randomized controlled clinical trial. Indian J Surg 2004;66:152-5.  Back to cited text no. 1    

Copyright 2005 - Indian Journal of Surgery

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