Innovative Suture Technique for Endoscopic Hernia Incision
- Conditions
- Medical GlueSuture Techniques
- Interventions
- Procedure: Dermal barb suture combined with medical glue
- Registration Number
- NCT05781932
- Lead Sponsor
- Yizhuo Lu, MD
- Brief Summary
The minimally invasive surgical technique represented by endoscopy is one of the most important inventions in the medical field of the 20th century. Laparoscopic surgery is a technique in which a rod-shaped camera and special surgical instruments are inserted into the body cavity (abdominal cavity, chest cavity, etc.) to complete the surgical operation by poking 3-4 holes (0.5-2 cm in size) in the body wall\[2\]. These holes are known as poke holes, and the closure of poke holes is a technique that every young surgeon must master. Currently, the proportion of endoscopic minimally invasive surgeries, including inguinal hernia repair, has increased widely in China. Currently, most of inguinal hernia repairs at our center are performed laparoscopically. Shortening the suture time and healing time of the stuck hole, improving the healing strength of the skin, and reducing scar hyperplasia are issues worth discussing.
Barbed sutures were first used in plastic surgery and are now widely used in laparoscopic tissue suturing. Because it is knot-free and one-way tightening, the tension of the incision can be released evenly, avoiding excessive local tension in the incision and causing ischemia and necrosis, which in turn affects the healing of the incision. Barbed thread sutures can be used to quickly close the incision and achieve excellent results. A good incision reduces tension and prevents scarring. Medical glue can quickly form a thin waterproof film on the surface of an incision, which promotes blood coagulation, wound shrinkage, and sealing.
Inguinal hernia is a common and frequently occurring condition. Minimally invasive surgery for an inguinal hernia can reduce postoperative pain, help patients resume daily activities early, and achieve rapid recovery; therefore, it is being accepted by an increasing number of people\[12\]. After laparoscopy, the treatment of poking holes is an indispensable part of surgery and is directly related to postoperative recovery, aesthetics, and patient satisfaction. Combining the continuous tension reduction suture of the dermis barbed suture with epidermis glue should help achieve better incision healing, reduce incision scars, and simultaneously return to daily activities faster, shower after surgery, and improve the medical treatment experience. This is the first study to try this novel approach.
A total of 100 patients who underwent laparoscopic total extraperitoneal (TEP) inguinal hernia repair in the General Surgery Department of Zhongshan Hospital Affiliated with Xiamen University from January 2022 to May 2022 were selected as the research subjects. They were randomly divided into two groups; the traditional Vicryl interrupted suture was used to poke the hole (control group), and the dermis barbed suture was used for continuous tension reduction suture combined with the epidermis glue to poke the hole (experimental group). Statistical differences were compared between the two stitching methods regarding operation time, incision healing, incision healing scars, and incision complications.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 100
- (1) outpatients diagnosed with inguinal hernia by color Doppler ultrasound or CT examination and
- (2) signed informed consent.
- (1) other serious diseases of the system, such as severe cardiopulmonary dysfunction and liver and kidney insufficiency;
- (2) obvious abnormal coagulation function;
- (3) history of open lower abdominal surgery;
- (4) inability to complete follow-up or treatment compliance;
- (5) high risk of incision infection.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Histoacryl medical tissue glue Dermal barb suture combined with medical glue specification:0.5 ml/piece, main components: n-butyl 2-cyanoacrylate (embutate), pigment (1-hydroxy-4\[(toluene)amino\]-9,10-anthraquinone), and stabilizers (p-diphenol, sulfur dioxide, phosphoric acid)
- Primary Outcome Measures
Name Time Method Surgical incision healing 2 weeks after the operation, the wound healing grading standard (grade A healing: the incision healed well without adverse reactions; grade B healing: inflammation, such as redness and swelling at the wound healing site. , induration but not suppuration; Grade C healing: incision suppuration, incision, and drainage are required).
During surgery The time required to close the abdominal wall incision The time of suturing the punch hole was recorded.
Scar scoring Three months after the operation, Vancouver scar scale (VSS).The VSS mainly evaluates the color, thickness, softness, and vascular distribution of scars, with a total score of 15 points, with higher scores indicating more severe scars.
Pain score: 1 week after the operation According to the corresponding numbers, pain can be divided into different degrees: grade 0, no pain, grade 1-3, mild pain; grade 4- Grade 6 is moderate pain; and grades 7-10, severe pain.
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
Yizhuo Lu
🇨🇳Xiamen, Fujian, China