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COMPARISON OF SUTURE AND STAPLER PROCEDURES OF MESH FIXATION IN PATIENTS OF VENTRAL HERNIA

Uzma Khalid, Sayyeda Khadija Bukhari, Javairia Saleem

Objective: Occurrence of the chronic pain in 20% to 30% patients after surgical intervention for hernia. As a result of this particular pain, about one third patients are not able to perform their routine activities. The aim of this study is to provide comparison of the polypropylene suture and skin staples for repair of mesh in ventral hernioplasty regarding pain after surgical intervention and to provide the comparison about the duration for fixation of mesh between both procedures in treatment of ventral hernia. Methodology: This research work carried out in Department of Surgery in CMH, Lahore and included 53 patients from February 2018 to December 2019. We took the consent from patients. We operated all the patients under General Anesthesia by same team of professionals. We separated the patients into two groups, in first group we fixed the mesh with the 2/0 polypropylene suture whereas we used the mesh stapler for the patients of second group. We noted the duration of time in minutes for both procedures. We used the VAS scale for the measurement of the severity of pain after surgery after 7 days, 1 month and one year after the process. We used the SPSS V. 22 for the statistical analysis of the collected information. Results: The characteristics of the patients and outcomes of surgery were same in the patients of both groups. And these values were not significant in both groups. Early pain after surgical intervention was high after the suture fixation but this outcome was also not significant. Average scores of pain after 7 days were 3.47 ± 2.7 after sutures whereas 2.91 ± 1.88 after the stapler. After 4 weeks, 0.4 ± 0.49 were after suture whereas 0.35 ± 0.48 after the stapler. In both groups of research work, 30% to 34% patients felt pain in follow ups after one year. Pain’s severity after suture was 0.6 ± 0.62 whereas 1.65 ± 1.94 after mesh stapler, this finding is much significant (p < 0.007). Average duration of surgery was 15.33 ± 6.33 minutes for suture whereas it was 1.56 ± 0.41 minutes’ stapler fixation with P value of 0.001. Conclusion: The fixation procedure is not the reason for important difference in initial pain after surgical intervention but there is high chronic pain after the mesh repair by stapler fixation. However, there was decreased duration of surgery in group of staple fixation in comparison with the group of suture fixation. KEYWORDS: Chronic, Fixation, Abdominal, Significant, Suture, Stapler, Mesh, Hernia.