Frequency of Complications of Laparoscopic Total Extra Peritoneal Inguinal Hernioplasty at Minimal Invasive Surgical Centre, Jamshoro (original) (raw)
Related papers
Pakistan Journal of Medical and Health Sciences
Background: There are multiple techniques used worldwide to repair inguinal hernia. The open mesh hernioplasty is easy to carry out, tension free repair and having good long term results but has few complications as well. Recently the laparoscopic repair of inguinal hernia is the best option because of its merits like lower recurrence rate, lesser postoperative pain, fast recovery and lower risk of complications. The results are controversial so there is a need to evaluate that which technique is better in our population so the aim of current study was to compare the outcome of open mesh hernioplasty versus laparoscopic total extra-peritoneal mesh repair in the treatment of inguinal hernia. Methods: A randomized controlled trial was conducted in the department of surgery, Ziauddin hospital, Karachi during May to December 2021. Patients included in the study were divided into two groups, Group A included those who underwent open mesh hernioplasty while Group B contained patients trea...
The Outcome Comparison of two Groups of total Extraperitoneal and Mesh Repair of Inguinal Hernia
Pakistan Journal of Medical and Health Sciences, 2021
Aim: The outcome comparison of total extraperitoneal versus mesh repair for inguinal hernia. Study design: Quasi experimental study. Place and duration of study: Department of Surgery, M. Islam Teaching Hospital, Gujranwala from March 2018 to March 2019. Methodology: After the approval of hospital ethical committee, a total of 50 patients were included and randomly divided into two groups equally. Group A (Total extraperitoneal), Group B (Mesh repair). An informed consent was taken from every patient about operative procedure and the outcome. A detailed history of the patient i.e. clinical examination, routine investigations (CBC, Urine R/E, urea, creatinine) and some specific investigations (chest X-ray, ECG and ultrasound abdomen and prostate) was done for surgery. All data of patients was collected on proforma and was analyzed with the help of a computer SPSS programme 20. Results: The mean age of patients was 34.22±11.54 years in group A and 35.63±11.25 years in group B. All mal...
Introduction: In the era of minimal invasive surgery, hernia repair has seen a paradigm shift from open to laparoscopic technique.Laparascopic hernioplasty is the latest technique with several advantages over open procedures like reduced post operative pain, shorter recovery period. However the steeper learning curve and cost of the procedure have been cited as limiting factor. Aims and objectives: To study the outcome of laparoscopic transabdominal pre-peritoneal mesh hernioplasty for inguinal hernias in terms of operative time, complications, Hospital stay and recurrence. Material and methods: This study was carried out from December 2011 to January2017. Case records of 112 patients that underwent trans-abdominal pre-peritoneal (TAPP) by a single surgical team were followed prospectively for a period of 1 year. All patients, above 18 years of age with uncomplicated inguinal hernia were included in the study. Complicated hernias, patients unfit for general anesthesia, patients with previous lower abdominal or pelvic surgery and patients unwilling to take part in study were excluded from the study. Data regarding, operative time, complications, chronic post operative pain, hospital stay and recurrence were recorded and evaluated. Results: 112 patients presenting with uncomplicated inguinal hernias were operated over a period of five years. The age of the patients ranges from 15-70 years. There were 106 (94.64 %) male patients and 6 (5.35%) female patients. Mean operative time was 55 minutes (range 40-110 minutes).The complications that occurred, were bleeding 1(0.89%), conversion to open 1(0.89%), seroma 4(3.57%), urinary retention 4 (3.57%), chronic pain 3 (2.67%) and recurrence 3 (2.67%). No incidence of bowel injury, bladder injury, spermatic cord injury, scrotal hematoma, mesh infection and port site infection has been reported. Average Hospital stay was 1.2 days (1-3). 97.33% were satisfied with their repair and returned to work after with a median of 15.1 days (12-21 days). Conclusion: We concluded that TAPP is an effective and safe procedure with low prevalence of chronic pain, that was generally of a mild, infrequent nature, faster convalesce and return to productive activity with fewer complications and a recurrence rate as low as that of an open mesh repair. However operative time is prolonged which decreases with experience. Learning curve is not so steep as claimed, and considering advantages, the cost of the procedure should not be a limiting factor even in developing countries.
The Egyptian Journal of Hospital Medicine, 2021
Background: Surgery for a groin hernia is the most common operation in general surgery. The recurrence rate in non-specialized centres is high, and postoperative pain and discomfort are common. The inguinal hernia repair has been a controversial area in surgical practice ever since it was associated with recurrence rates which have decreased because of the use of prosthetic mesh. Objective: This study was aimed to evaluate the benefits and harms of the total extra-peritoneal technique compared with the Lichtenstein technique for inguinal hernia repair. Patients and Material: This randomized controlled trial study included a total of 40 male patients aged between 14 and 60 years with unilateral or bilateral inguinal hernia, attending at Outpatient Clinic, Aswan University Hospital and followed up there. This study was conducted period from August 2017 to August 2018. They were randomly divided into two groups; Group A Open Lichtenstein hernioplasty and Group B; laparoscopic total extraperitoneal hernioplasty (TEP). Results: There was a statistically significant difference between Groups A and B cases as regard operative time and hospital stay. There was no statistically significant difference between Group A and B cases as regard intraoperative/postoperative complications. Also, there was no s statistically significant difference as regard VAS, recurrence in either group during the follow-up period of 6 months. Conclusions: It could be concluded that laparoscopic total extraperitoneal hernioplasty yielded better results regarding operative time and hospital stay. Yet, better results were found regarding complications, but the study could not detect statistical differences.
International Journal of Medical Science and Clinical invention, 2018
Background: The treatment of hernia has passed through an extensive evolution ever since Eduardo Bassini performed the first tissue repair of inguinal hernia in later half of nineteenth century. There is no single repair that can be considered as a standard repair for inguinal hernia and the process is still evolving. We performed a study to evaluate the outcome of laparoscopic totally extraperitoneal prosthesis repair of inguinal hernia. Method: The study is a prospective observational study conducted in a department of surgery, Govt medical college Srinagar from 2012 onwards. Patients having groin hernia presenting to the OPD of the SMHS hospital were randomly selected for this study. A total of 200 patients were considered for the study. After doing all base line investigations and proper pre anaesthetic check up patients were taken for TEP. Results and Observations: In our study minimum and maximum age was 20 and 80 years for TEP with mean age of 46.76±13.0 years; showing that no age is immune to inguinal hernia. In our study there were only male patients, a total of 200 patients were included in the study. Overall complications in our study were 12.5%. 7.5% cases were converted from TEP to other procedure. Seven patients had vascular injury (inferior epigastric artery) during the procedure. Hemostasis was achieved in 2 parients while as 5 patients were converted to open procedure and ligation of vessel was done. 5% of patients were converted to TAPP because of technical difficulties like loss of pre peritoneum, perforation of peritoneum. Conclusion: We concluded that TEP is a safe and effective procedure of repair for inguinal hernias with minimum morbidity in expert hands with a comparable complication rate to other procedures but has a long learning curve and with experience, the complication rate also reduces.
International Surgery Journal, 2017
Background: Laparoscopic inguinal hernia repair has become increasingly popular as an alternative to open surgery. Aim: To evaluate total extraperitoneal repair with direct telescopic dissection and mesh hernioplasty for inguinal hernias.Methods: This study was conducted at General Surgery department the period of 1 year on 30 patients having inguinal hernia.Results: This prospective study included 30 adult patients with primary unilateral inguinal hernia, all of them were males. Age of study patients ranged from 22 to 64 years old. Intraoperatively, 6 patients were presented to have direct inguinal hernia (20%) while 21 patients had indirect inguinal hernia (70%). In 3 patients, combined direct and indirect hernia defects were present (10%). Mean operative time was 99.30±25.13 min. Mean time for analgesia was 3.62±1.57 days. Hospital stay mean was 1.43±0.62 days. The mean time until return to work was 14.1±3.13 days, the mean time of follow up was 7.1±2.2 months. Intra operatively ...
Comparative study of MESH hernioplasty using laparoscopic TAPP versus open for inguinal hernia
Introduction: Inguinal hernias are treated by several surgical methods. Our main concern is to find a well-accepted method which is cost effective, with minimal complications, with small learning curve and can be attributed to the masses. Objective: To compare the two tension-free methods of hernia repair: trans-abdominal pre-peritoneal laparoscopic mesh repair and the open Lichtenstein mesh technique in terms of operative time, length of hospital stay and chronic post-operative pain and cost effective. Materials and Methods: This study was conducted in Department of Surgery, Fathima Institute of Medical Sciences, Kadapa during March 2013 to Feb 2015 over a period of 2 years. A total of 100 male patients, aged between 16-60 years, were divided into two groups, A and B. Patients were subjected to Trans-abdominal Pre-Peritoneal (TAPP) laparoscopic and Lichtenstein repairs, respectively. The two groups were compared for operative time, length of hospital stay, chronic groin pain and cost of surgery. Percentages were calculated for categorical data while numerical data were represented as mean ± SD. Chi square test and t test were used to compare categorical and numerical variables, respectively. Probability ≤ 0.05 (P ≤ 0.05) was considered significant. Results: Mean operative duration was significantly longer in group A compared to group B (P < 0.01). Mean hospital stay was significantly longer in group B compared to group A (P < 0.01) and mean cost of the procedure was significantly high in group A as compared to group B (P<0.01). Conclusion: Trans-abdominal pre-peritoneal laparoscopic inguinal hernia repair is effective in decreasing the incidence of chronic groin pain and post-operative hospital stay in comparison with to tension free mesh hernioplasty.
Journal of Society of Surgeons of Nepal
Introduction: Inguinal hernias were conventionally treated with open methods like hernioplasty and herniorrhaphy. However, with the development in minimal access surgery, the trends have changed and surgeons are also performing the TEP and TAPP laparoscopic hernia repair routinely. Hence, a retrospective study was performed to assess the safety, feasibility, and associated complications of the TEP laparoscopic hernia repair. Methods: A single institution, single unit retrospective study of all TEP hernia repair was performed at the department of surgery from May 2020 to April 2021. Data of all patients undergoing TEP were obtained from a proforma attached to the case file during patients’ admission and was analyzed. Results: A total number of 30 patients underwent the TEP laparoscopic hernia repair during the study period. Age group ranged from 25 years to 80 years and a male preponderance was noted with all patients being male. Per operative findings of indirect hernia was noted in...
Madridge J Surg, 2018
Background: Laparoscopic TEP and TAPP are the commonly performed methods of laparoscopic repair of inguinal hernia. Lack of documentation and inadequate follow-up have made the learning curve of TEP and TAPP all the more steep thus delaying the standardization of the procedure. The aim of our study is to compare transabdominal preperitoneal mesh repair and total extra-peritoneal repair of inguinal hernia based on post operative pain, duration of Operation, conversion rates to open method, complications of each procedure, duration of stay in hospital, duration required to get back to normal activities, patient satisfaction, recurrence rates, safety and efficacy of either procedures. Methods: A prospective, open label, comparative, hospital based single centred study was conducted among 90 patients attending general surgery OPD, K.R. Hospital attached to Mysore medical college and research institute, Mysore over a period of 2 years. All patients aged 18 years and above diagnosed with inguinal hernia were included in the study. Patients with failed laparoscopic inguinal hernia and complicated inguinal hernias which required emergency exploration were excluded from the study. Descriptive statistics, student t-test and chi-square or fischer exact test were used to analyse the results. Results: The mean age of study subjects was 49.46+/-7.38 years. The mean operative time required for TAPP 88 minutes and TEP was 70 minutes. 66.7% of the TAPP patients had a pain score of 1 to 2 and 80% of the TEP patients had pain score of 1 to 2 according to visual analogue scale. The hospital stay in TAPP was 2.27 days and 2.53 days in TEP. Recovery period in TAPP was 6.43 days and 7.20 days for TEP. Conclusion: Laparoscopic Total Extra-Peritoneal (TEP) mesh repair and Trans Abdominal Pre-Peritoneal (TAPP) mesh repair of inguinal hernia are both safe and efficacious, but long term Randomised Control Trials with enhanced sample size and reduced confounding factors are still required to establish the absolute superiority of TEP over TAPP.
Benha Journal of Applied Sciences, 2022
Background: Inguinal hernias are a significant cause of patient morbidity. It is the most common type of hernia, accounting for 75% of all the abdominal wall hernias. Several methods of inguinal hernia repair have been described and have been evolved over time. The Laparoscopic approach for inguinal hernia repair was first reported by Ger, who performed a high ligation of the sac without mesh placement. Total extraperitoneal repair was developed because of concern for possible complications associated with intra-abdominal access, which was required for the transabdominal preperitoneal approach. Laparoscopic total extra peritoneal repair (TEP) of inguinal hernia is associated with less postoperative pain and morbidity than open hernia repair. The TEP method allows access to the preperitoneal space and avoids the need for a peritoneal incision. The study is aimed to evaluate the role of laparoscopic total extra peritoneal hernia repair without mesh fixation in early ambulation, recurr...