Slide 2:
In TAPP procedure the necessity of mesh-fixation is not proven yet and is up to the personal decision of the surgeon Closure of the peritoneum is necessary Tack-fixation Suturing Fibrin-Glue ? How?
Slide 3:
Tack-fixation Fibrin-Glue
Slide 4:
One year later upon cholecystectomy
Slide 5:
Wide mobilization of the peritoneum to achieve
a peritoneal overlap Reduction of pneumoperitoneum to 3-4 mm Hg
while glueing the peritoneum
Slide 6:
Comparative Study Hernias n= 243 Patients n=170 Lost to follow up n=26 Recurrent hernias n=25 Fibrin Glue n=97 Tack Fixation n=120
Slide 7:
57 56 Mean operating time (min) bilateral 1 Wound infection 1 Seroma 1 1 Recurrence rate 10 (8,4%) 2 (2,14%) Chronic groin pain 16 days 12,5 days Normal activity 41 34 Mean operating time (min) unilateral Tack(n=75) Fibrin (n=138)
Slide 9:
Conclusion
-reduced postoperative pain
-faster recovery
-equal recurrence rate
-less chronic groin pain