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Indian Journal of Surgery
Medknow Publications on behalf of Association of Surgeons of India
ISSN: 0972-2068
Vol. 67, Num. 4, 2005, pp. 225-225
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Indian Journal of Surgery, Vol. 67, No. 4, July-August, 2005, pp. 225
Letter To Editor
Skin stapler in Lichtenstein's mesh repair
Doctor HG
8/29, Dani Sadan, 113, Walkeshwar Road,
Correspondence Address:8/29, Dani Sadan, 113, Walkeshwar Road, hdoctor@jnjin.jnj.com
Code Number: is05070
Dear Editor,
I read with interest the ′Letter to the Editor′ by Ashutosh Chauhan on the ′Use of skin stapler in Lichtenstein′s Mesh Repair′ in the February 2005 issue. I had previously read the article on the same subject by Garg et al .
I have also used skin stapler in this procedure. My observations and
suggestions are as follows:
- Now-a-days we avoid suturing mesh with periosteum of pubic
tubercle because it may give rise to osteitis pubis. Instead, we fix
it near the aponeurotic tissue there.
- Around 2.5 cm of the mesh has to be kept protruding beyond
pubic tubercle.
- Because the femoral vessels are underlying the inguinal
ligament, it is preferable to use prolene sutures in this area to fix
the mesh.
- Broad head of the stapler is definitely cumbersome to maneuver
but can be managed by retraction of the skin flaps.
- Formerly an end-on skin stapler was available and that was
very convenient and ideal to use.
- Once the staples are applied, they remain in position.
We had confirmed this in some of our patients by X-rays taken after
a few months.
Copyright 2005 - Indian Journal of Surgery
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