Tension-free Herniorrhaphy Using PerFix(R) Plug: A Preliminary Report

Kim, Seung Hoon; Chung, Jae Hee; Song, Young Tack

Abstract

PURPOSE
The PerFix(R) plug is preformed as a Marlex mesh hernia plug, and consists of a fluted outer layer combined with an inner arrangement of eight mesh "petals." In contrast to hand-rolled hernia plugs, which can collapse on themselves, the PerFix(R) plug's petals maintain the device's open conelike shape. The fluted design allows the plug to more readily conform to the configuration of any indirect or direct defect. METHODS: Bewteen January 1996 and April 2000 126 conventional herniorrhaphies (C group: Bassini: 23, Shouldice: 15, McVay: 5, Lichtenstein: 83) were performed, and between May 2000 and April 2002, 124 PerFix(R) plug repairs (P group) were completed. The operation times, lengths of hospital stay, visual analogue pain scales, time of analgesics use, and complication and recurrence rates were compared between these two groups. RESULTS: The operation times and lengths of hospital stay for groups C and P were 56.4 vs. 31.1 minutes and 4.4 vs. 2.8 days, respectively, so where significantly shorter in the P group (P<0.01). The times of use for the analgesics, AAP and Nubaine, were 6.6 vs. 0.6 times and 1.7 vs. 0.9 times, in group C and P, respectively, so were significantly fewer in the P group (P<0.01). There were 5 recurrences (3.9%) in the C group during the follow up period (2~6 years), but there were none in the P group during the follow up period (5 months~2 years). The complications were similar in both groups. CONCLUSION: Compared with conventional surgical techniques, including the Lichtenstein tension free method, the PerFix(R) plug method is the most simple, and shows superiority in the following areas; the operation time, length of hospital stay, times of analgesics use and recurrence. However, with regard to the recurrence, longer follow up and observation periods are required.