Research Information System
24TH EUPSA CONGRESS, İzmir, Turkey, 7 - 10 June 2023, pp.120-121
Aim: Several laparoscopic inguinal hernia repair (IHR) and
suture techniques have been developed. We have been performing single port
laparoscopic IHR with ''Single Port Incisionless – Intracorporeal Conventional
Equipment-Endoscopic Surgery'' (SPICES) method since 2005. In this method,
transfixion suture was placed in addition to intracorporeal purse-string
suture. An experimental study was conducted to investigate the effects of
suture techniques on collagen formation, which is an indicator of fibrosis in
the peri-hernia neck sac.
Methods: Thirty-five adult male, Wistar-Albino rats (260-300 g)
were used in the current study. Rat testes being intraabdominal physiologically
provided an open inguinal channel model. The testes were descended to the
scrotum with silk suture. Suture techniques were applied and on 15th
day post-operative inguinal channels were examined.
Results were statistically analyzed and a p-value
<0,05 was considered statistically significant. There were 5 experimental groups:
Group 1: Control group (n=7)
Group 2: Sham group (n=7)
Group 3: IHR with purse-string suture only
(n=7)
Group 4: IHR with transfixion suture only
(n=7)
Group 5: IHR with purse-string suture plus
transfixion suture (n=7)
Main results: Collagen thickness of the peritoneum around the
internal inguinal ring were similar in the control and sham groups. The
collagen thickness in group 5 was significantly higher compared with groups 4
and 3 (p<0.001). However, no statistical difference was found between
groups 4 and 3 (p=0.5468).
Conclusion: The combined use of purse-string and transfixion
suture in laparoscopic inguinal hernia repair stimulates collagen formation,
hence fibrosis, the most and thus prevents recurrence.