Trial reportHernia : the journal of hernias and abdominal wall surgery2026
Cruciate gear suture: a simple and effective technique for pseudo-sac management in TAPP.
Trial report in Hernia : the journal of hernias and abdominal wall surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate the Cruciate Gear Suture (CGS) technique for pseudo-sac management in transabdominal preperitoneal prosthesis (TAPP) repair of direct inguinal hernias.
methodsA prospective randomized controlled single-center trial was undertaken on adult patients with primary direct inguinal hernia from April to August 2025. A computer-generated random number table assigned patients to the CGS (experimental) and single-hand four-needle suture (control) groups. The primary and secondary outcomes encompassed management time for the pseudo-sac, total operation duration, length of hospital stay, medical expenses, postoperative 24-h Visual Analog Scale (VAS) score, one-week postoperative Carolina Comfort Scale (CCS) score, incidence of seroma, and recurrence rate. SPSS 31.0 was used for data analysis.
resultsThe trial included 53 patients (71 pseudo-sacs), 26 in the experimental group and 27 in the control group. Baseline factors (age, BMI, comorbidities, hernia defect size) were not significantly different across groups (P > 0.05). CGS had a substantially shorter pseudo hernia sac suturing time than the control group [188 (165, 213.5) s vs 220 (195, 281) s, Z = −2.929, P = 0.003]. Subgroup analyses showed further benefits for 2–3 cm (Z = −2.700, P = 0.006) and 3–4 cm (Z = −2.088, P = 0.036) defects. Total operation time, 24-h VAS score, hospital stay, medical expenses and one-week postoperative CCS score did not differ (P > 0.05). With an average follow-up period of 4.85 months, no significant differences were observed in the duration of postoperative groin irritation (P > 0.05), and the incidence of seroma and recurrence rates were 0% in both groups.
conclusionThe CGS technique significantly reduces pseudo-sac suturing time while maintaining comparable safety, efficacy, and cost-effectiveness to the conventional single-hand four-needle group.
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