scholarly journals Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Using Memory-Ring Mesh: A Pilot Study

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Takeshi Matsutani ◽  
Tsutomu Nomura ◽  
Nobutoshi Hagiwara ◽  
Akihisa Matsuda ◽  
Yoshimune Takao ◽  
...  

Purpose.To evaluate the feasibility, safety, and effectiveness of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair using a memory-ring patch (Polysoft™mesh).Patients and Methods.Between April 2010 and March 2013, a total of 76 inguinal hernias underwent TAPP repair using Polysoft mesh in 67 adults under general anesthesia. Three different senior resident surgeons performed TAPP repair under the instruction of a specialist surgeon. Nine patients had bilateral hernias. The 76 hernias included 37 indirect inguinal hernias, 29 direct hernias, 1 femoral hernia, 1 pantaloon hernia (combined direct/indirect inguinal hernia), and 8 recurrent hernias after open anterior hernia repair. The immediate postoperative outcomes as well as the short-term outcomes (mainly recurrence and incidence of chronic pain) were studied.Results.There was no conversion from TAPP repair to anterior open repair. The mean operation time was 109 minutes (range, 40–132) for unilateral hernia repair. Scrotal seroma was diagnosed at the operation site in 5 patients. No patient had operation-related orchitis, testicle edema, trocar site infection, or chronic pain during follow-up.Conclusions.The use of Polysoft mesh for TAPP inguinal hernia repair does not seem to adversely affect the quality of repair. The use of this mesh is therefore feasible and safe and may reduce postoperative pain.

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A B Lachin ◽  
A A Abdrabbu ◽  
A A F Darwish ◽  
M M K Ali

Abstract Background inguinal hernia repair is the most common procedure in general and visceral surgery worldwide. Several studies have shown that laparoscopic repair offers the advantage of minimally invasive surgery to the patient. The mesh can be placed without fixation or can be fixed into place with tuckers. Aim of the Work this study aimed to compare mesh fixation versus non-fixation in laparoscopic transabdominal preperitoneal (TAPP) repair of inguinal hernia, as regards the operation time, hospitalization, postoperative complication, recurrence and chronic pain. Patients and Methods sixty adult males with inguinal hernia were repaired with laparoscopic transabdominal preperitoneal inguinal hernia repair, divided into; mesh fixation group (n = 35) versus non-fixation group (n = 25), and certain parameters were assessed during the operative, postoperative and follow-up periods. Results mean operation time and mean hospital stay time were significantly higher in mesh fixation group than non-fixation group. VAS scores 2days, 3months, and 6months postoperative were less for non-fixation group. Non-significant difference was found between both groups regarding intraoperative injury, hernia recurrence, wound seroma, mesh infection, chronic pain, return to physical activity. Conclusion TAPP inguinal hernioplasty without mesh fixation does not increase recurrence rate, but reduces operative duration, hospital stay duration and decreases the incidence of postoperative pain.


Author(s):  
Sabriye Dayı

INTRODUCTION: Inguinal hernia repair is one of the most common surgical procedures in pediatric surgery. In parallel with the advances in the field of medicine, various laparoscopic techniques have been developed in inguinal hernia repair. The Burnia technique is one of the latest published techniques and it is the cauterization of the inguinal hernia sac laparoscopically without using sutures in girls. The aim of this study is the investigation of the use of Burnia technique in clinical practice, and its postoperative outcomes. Any article concerning the use of this technique in Turkey has not been encountered. METHODS: The demographic features of patients, preoperative, peroperative, postoperative and follow-up results of 41 patients who had been operated with Burnia technique by a single surgeon within 2 years were reviewed retrospectively. Laparoscopically, the camera was first placed at an inclination of 30 degrees to the umbilical region using Hasson technique, and then, a single port was used for cauterization of the hernia sac. The Hernia sac was pulled into the abdominal cavity and cauterized. RESULTS: Burnia technique was applied to 62 inguinal hernia sacs in 41 girls. Their ages ranged from 1.5 to 16 years (median 36 months) with body weights ranging between 3.5 kg-40 kg (median 12 kg). Preoperatively 15 patients had right (37%), 19 patients left (46%), 7 patients bilateral inguinal hernias (17%). During surgery, 14 of the unilateral inguinal hernias were found to have a hernia sac on the contralateral side, and the rate of bilateral hernia increased to 51 percent. In one patient ovary was in the inguinal canal, and after its reduction, we proceeded with the operation Unexpectedly. in one patient, right ovarian torsion was detected which was detorsioned, and hernia surgery was performed in the same session. The duration of the operation was 5-35 min (median 15 min) for unilateral and 8-45 min (median 20 minutes) for bilateral hernias. None of these patients developed peroperative and postoperative complications. Follow-up time was minimum 10 months, and maximum 3 years. Recurrence was not detected. DISCUSSION AND CONCLUSION: Burnia technique seems to be effective and safe. The contralateral side and other intra-abdominal pathologies are explored. The cosmetic appearance is its another advantage. The operation time is very short due to the fact that only the hernia sac is cauterized. Comparison of this technique with other laparoscopic techniques is planned in the future study.


2017 ◽  
Vol 4 (4) ◽  
pp. 1244
Author(s):  
Sudarshan P. B. ◽  
Sundaravadanan B. S. ◽  
Prabu Shankar S.

Background: The two common procedures which are nowadays commonly performed for laparoscopic repair of inguinal hernia are transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) mesh repair. This retrospective study was aimed to compare these two, TAPP and TEP laparoscopic approaches for inguinal hernia repair in terms of various outcomes.Methods: In this retrospective study, we included 50 cases of inguinal hernia who underwent laparoscopic approach of inguinal hernia repair at Saveetha medical college and hospital between 2014 and 2016 for a duration of 3 years. Various parameters including the age, sex of patient, type of hernia, preoperative and post-operative complications, duration of hospital stay was analysed.Results: Of the 50 patients who underwent laparoscopic repair, 26 patients underwent TEP and 24 patients under went TAPP procedure. 31 cases were indirect inguinal hernias and 30 cases were direct inguinal hernias, totalling 61 hernia repairs, as 11 patients had bilateral hernia. One female inguinal hernia and 4 cases of recurrent hernia were operated by TAPP method. Postoperative complications like seroma formation; subcutaneous emphysema was seen in TEP group. Two cases of TEP were converted to TAPP and open lichenstein procedure. Postoperative pain was less in both the group. Patients who underwent TEP procedure spent less time in the hospital compared to those who underwent TAPP procedure.Conclusions: There is no major difference in the outcome after TEP and TAPP surgeries except for some minor complications and the results are comparable in both techniques TAPP and TEP. Both the procedures can be practiced according to surgeon’s familiarity of the procedure.


BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jie Liu ◽  
XiongWei Wu ◽  
WenLi Xiu ◽  
XiWei Hao ◽  
Jing Zhao ◽  
...  

Abstract Background Pediatric inguinal hernia (PIH) is a common disease in children. Laparoscopic hernia repair (LHR) has developed rapidly in recent years, but there are still different opinions compared with traditional open hernia repair (OHR). The purpose of this study was to compare the advantages and disadvantages of LHR and OHR in the treatment of pediatric inguinal hernia. Methods We performed a retrospective review of all children (< 14 years) who underwent repair of inguinal hernia in the pediatric surgery center of the Affiliated Hospital of Qingdao University from January 2015 to December 2015. We collected the medical records of all the children and analyzed the clinical characteristics, operation-related information and follow-up. Results In the OHR group, 202 cases underwent unilateral inguinal hernia repair, and 43 cases underwent bilateral inguinal hernia repair. In the LHR group, 168 cases underwent unilateral inguinal hernia repair, and 136 cases underwent bilateral inguinal hernia repair. There was a significant difference in the operation time between the two groups, but there were no significant differences in postoperative hospitalization time and incidence of ipsilateral recurrent hernia between the two groups. The incidence rates of metachronous contralateral hernia (MCH) and surgical site infection in LHR group were significantly lower than those in the OHR group. Conclusion Our study shows that compared with OHR, LHR has the advantages of concealed incision, minimal invasiveness, reduced operation time, detection of contralateral patent processus vaginalis, and reduced incidence of MCH. In conclusion, LHR is safe and effective in the treatment of pediatric indirect inguinal hernia.


2019 ◽  
Vol 34 (11) ◽  
pp. 4857-4865 ◽  
Author(s):  
Hanna E. Koppatz ◽  
Jukka I. Harju ◽  
Jukka E. Sirén ◽  
Panu J. Mentula ◽  
Tom M. Scheinin ◽  
...  

Abstract Background Three-dimensional (3D) laparoscopy improves technical efficacy in laboratory environment, but evidence for clinical benefit is lacking. The aim of this study was to determine whether the 3D laparoscopy is beneficial in transabdominal preperitoneal laparoscopic inguinal hernia repair (TAPP). Method In this prospective, single-blinded, single-center, superior randomized trial, patients scheduled for TAPP were randomly allocated to either 3D or two-dimensional (2D) TAPP laparoscopic approaches. Patients were excluded if secondary operation was planned, the risk of conversion was high, or the surgeon had less than five previous 3D laparoscopic procedures. Patients were operated on by 13 residents and 3 attendings. The primary endpoint was operation time. The study was registered in ClinicalTrials.gov (NCT02367573). Results Total 278 patients were randomized between 5th February 2015 and 23rd October 2017. Median operation time was shorter in the 3D group (56.0 min vs. 68.0 min, p < 0.001). 10 (8%) patients in 3D group and 6 (5%) patients in 2D group had clinically significant complications (Clavien–Dindo 2 or higher) (p = 0.440). Rate of hernia recurrence was similar between groups at 1-year follow-up. In the subgroup analyses, operation time was shorter in 3D laparoscopy among attendings, residents, female surgeons, surgeons with perfect stereovision, surgeons with > 50 3D laparoscopic procedures, surgeons with any experience in TAPP, patients with body mass indices < 30, and bilateral inguinal hernia repairs. Conclusion 3D laparoscopy is beneficial and shortens operation time but does not affect safety or long-term outcomes of TAPP.


2017 ◽  
Vol 74 (8) ◽  
pp. 773-777
Author(s):  
Miroslav Ilic ◽  
Srdjan Putnik ◽  
Ivan Kuhajda ◽  
Dejan Ivanov

Background/Aim. Despite a huge success in decrease rate of recurrences of inguinal hernia in mesh and ?plug in? techniques, a new problem appears such as chronic pain and other complications. The aim of this paper was to present the original modification of bilayer patch device (Prolene Hernia System?, Ethicon) insertion in ?non-plugged? fashion and 11-year experience with this open technique for the indirect hernia repair in a male. Methods. This retrospective study included 96 male patients with 103 indirect unilateral and bilateral inguinal hernias, operated due to a primary or recurrent hernia in an 11-year interval (2004?2015). In all operation an extended Prolene Hernia System? (PHS) bilayer patch device was inserted medially of inferior epigastric vessels through a small incision in Hasselbach's triangle, thus avoiding plug component of device connector into the internal ring. All data were taken from the medical records, operative protocols, and telephone questionnaire. Results. Non-plugged technique of bilayer patch device insertion was presented in details. Mean age of patients was 59 years. There were 3 (2.91%) patients with procedure-related complications, two patients with postoperative seroma and one with scrotal ecchymosis. There were 86 (89.6%) patients who answered on the questionnaire. During 11 years of following, recurrence of a hernia occurred in 1 patient, one had funiculocele and only one had chronic pain during 6 months. Almost all patients (97.68%) were satisfied with the procedure and results of hernia surgery. Conclusion. Nonplugged insertion of bilayer patch device is a safe technique for solving the primary and recurrent indirect inguinal hernias. The low incidence of the recurrence and chronic pain many years after the operation justifies this technique even in hospitals not specialized for the hernioplasty.


2017 ◽  
Vol 5 (4) ◽  
pp. 120-123
Author(s):  
Suman Kumar Shrestha

Background: Over the past years, several surgical techniques have been evolved, among which total extraperitoneal inguinal hernia repair is the laparoscopic technique which is more popular now.Objective: To evaluate the outcome of totally extra peritoneal laparoscopic hernioplasty in terms of operation time, hospital stay and complications.Methods: The prospectively designed descriptive study was carried out at Department of Surgery Unit III, Kathmandu Medical College Teaching Hospital from February 2014 to April 2015. Forty seven consecutive patients above 15 years of age underwent totally extra peritoneal repairs for inguinal hernias. The selection criteria were reducible primary or recurrent, unilateral, direct and indirect inguinal hernias. All the relevant details of each patient were noted subsequently and analyzed statistically using Statistical Program for Social Sciences (SPSS) version 15.Results: The mean age of patient was 49±2.5 years. The mean operation time was 65±5.3 minutes. There were no serious complications except four (8.5%) cases of groin seroma which resolved after single time aspiration. Three (6.3%) cases had developed recurrence, two (4.2%) had developed hydrocele in a median follow up period of 6±1.5 (range, 3-9months). The mean inpatient hospital stay was 1.7±0.2 (range, 1-2.4days).Conclusion: Total extra peritoneal hernioplasty is safe and feasible with acceptable complications and recurrence rates.Journal of Kathmandu Medical College, Vol. 5, No. 4, Issue 18, Oct.-Dec., 2016, page: 120-123


2021 ◽  
Vol 8 (4) ◽  
pp. 1080
Author(s):  
Hongfu Lin ◽  
Yu Zhao ◽  
KunSong Wang ◽  
Caixing Huang ◽  
Zihua Li ◽  
...  

Background: Current investigation was conducted to explore the clinical application of self-made electric hook in laparoscopic indirect inguinal hernia repair.Methods: Randomized controlled trial was conducted that compared two groups of patients who underwent laparoscopic inguinal hernia repair from 2013 to 2017 at our institution. A laparoscopic indirect inguinal hernia repair with beak-like electrocoagulation instrument as modified trans-abdominal preperitoneal prosthesis was performed on 42 patients. As a comparison, 40 patients with traditional TAPP were collected and analyzed. In the end, we compared the operation time, blood loss, complications, and recurrence of two groups.Results: 82 patients have successfully completed surgery without conversion to open inguinal hernia repair. Patients were follow-up visited for 18 to 78 months, and no recurrence was found. 1 case of scrotal edema occurred using a self-made electric hook in modified TAPP, and cured by conservative treatment. In traditional TAPP group, there was 1 case of postoperative seroma, which cured by conservative treatment. There was no significant difference between these 2 groups in terms of complications and recurrence (p>0. 05). However, the differences in operation time and blood loss were significant (p<0. 05).Conclusions: Self-made electrical hook showed in laparoscopic inguinal hernia repair of indirect inguinal hernia has the advantages of shortening operation time, reducing bleeding, easing the difficulty of operation, and improving the safety of surgery, it is worthy of further clinical application.


2020 ◽  
Vol 22 (1) ◽  
pp. 21-24
Author(s):  
Mohammad Masum ◽  
Md Aminul Islam ◽  
Masflque Ahmed Bhuiyan ◽  
Kazi Mazharul Lslam ◽  
Md Selim Morshed ◽  
...  

Background: In the practice of General Surgery, hernia repair is the second most common procedure after appendectomy. Several methods have been developed over the years to try to improve hernia repair. Good result can be expected using Bassini's, McVay's, Shouldice's techniques provided the exact nature of hernia is recognized and the repair is done without tension using healthy tissue. The introduction of synthetic mesh started a new era in hernia surgery. The use of synthetic mesh repair of primary and recurrent hernias has gradually gained acceptance among surgeons. Objective: To find out the outcome and complications of open inguinal hernia repair with prolene mesh. Methods: This is a prospective cross sectional study conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from December, 2011 to May, 2012. One hundred patients of inguinal hernia admitted in different surgical units of BSMMU, Dhaka for elective surgery were studied. We have given 1 gm ijv Cephradine per operatively and then 500 gm cephradine ijv 6 hourly for 24 hours followed by oral form of Cephradine for next 5 days. Polypropylene mesh of 11 cm x 7 cm size was used in all cases. All the operations were done by open tension free prolene mesh repair technique. Patients were followed for one year to see the outcome. Results: Out of 100 cases of inguinal hernia, 71 patients (71%) had indirect inguinal hernia and 29 cases (29%) had direct inguinal hernia; 90 cases (90%) were primary hernia and only 10 cases (10%) were recurrent hernia; 58 cases were right sided, 34 cases (34%) were left sided and 8 cases (8%) were bilateral. Complications of mesh repair of groin hernia in this study included wound infection (5%), scrotal oedema (2%), mesh infection (0%), scrotal hematoma (2%), echymoces of peri-incisional skin (5%), early wound and groin pain (7%), chronic inguinodynia (2%), hernia recurrence (1%). Conclusion: In the present study an attempt is made to evaluate the outcome of patients undergoing inguinal hernia repair by prolene mesh. The results confirm that Lichtenstein tension free mesh repair of inguinal hernia is safe and reliable for both primary and recurrent groin hernia, with less recurrence rate. Patient's compliance was good with minimum morbidity. Journal of Surgical Sciences (2018) Vol. 22 (1): 21-24


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