Background. Lichtenstein tension free repair is the most commonly used technique due to cost effectiveness, low recurrence rate, and better patient satisfaction. This study was done to compare the duration of surgery and postoperative outcome of securing mesh with skin staples versus polypropylene sutures in Lichtenstein hernia repair. Materials and Methods. A total of 96 patients with inguinal hernia undergoing Lichtenstein mesh repair were randomly assigned into two groups. The mesh was secured either by using skin staples (group I) or polypropylene sutures (group II). Results. The operation time was significantly reduced from mesh insertion to completion of skin closure in group I (mean 20.7？min) as compared to group II (mean 32.7？min) with significant value and less complication rate in group I as compared to group II. Conclusion. Mesh fixation with skin staples is as effective as conventional sutures with added advantage of significant reduction in the operating time and complications or recurrence. The staples can be applied much more quickly than sutures for fixing the mesh, thus saving the operating time. Infection rate is significantly decreased with staples. 1. Introduction Hernia is defined as a protrusion of a viscus or a part of viscus through an abnormal opening in the wall of its containing cavity. The most frequent of all hernia is inguinal hernia, which occurs in 73% of all the hernia cases and is 20 times more frequent in males than females [1]. Lichtenstein et al. (1989) reported that excessive tension on the suture line resulted in the high recurrence rate after the primary repair. In 1989, Lichtenstein et al. concluded that with tension free mesh repair of hernia, recurrence can be completely avoided. Although many new techniques are available today for hernia repair (plug and patch, TEP, TAPP, PHS), Lichtenstein tension free repair is the most commonly used technique due to cost effectiveness, low recurrence rate, and better patient satisfaction [2]. The Lichtenstein repair takes into account the important factors identified in the successful outcome of hernia operation—supplementing the strength of transversalis fascia and a tension free repair. The only disadvantage of the mesh operation is that it requires the use of prosthetic material with attendant risk of infection. Any modification which reduces this threat would be useful. The main cause for recurrence of hernia is “Suture line tension” brought by suturing of overcasting between annular and ligamentous flap which are not normally in apposition. Needle hole and the tension
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