Inguinal Hernioplasty (original) (raw)
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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.
Gomal Journal of Medical Sciences, 2016
Background: There are several different techniques for the treatment of inguinal hernias. The objective of this study was to identify and evaluate the frequency of complications of inguinal hernia repair with a totally extraperitoneal mesh placement. Material & Methods: This descriptive study was done in the Minimal Invasive Surgical Centre, Jamshoro and General Surgical Department, Dow University Hospital, Ojha Campus, Karachi, from January 2014 to December 2014. The sample size was 43. All patients of age >20 years were evaluated, diagnosed with symptomatic inguinal hernia and included in the study. Patient with congenital groin hernia, long standing scrotal hernia, unfit for general anesthesia and previous open surgery for prostate, morbidly obese, elderly patients with co-morbidities complete and complicated hernias were excluded from the present study. The patients were explained the advantages and disadvantages of both the techniques (open and TEP repair techniques). Result...
IOSR Journal of Dental and Medical Sciences, 2016
Introduction: In the last two decades there has been an increased use of laparoscopic inguinal hernia repair compared to open hernia repair. Laparoscopic techniques have been validated as safe and effective in the treatment of groin hernias and have become common where facilities are available. There has been a shift in the last few years from open repair to laparoscopic repair in India. The laparoscopic approach (TEP and TAPP) for inguinal hernia is bound to get more accessible in the near future. Aims and Objectives: The purpose of this study was to compare laparoscopic TAPP (Transabdominal preperitoneal) and laparoscopic TEP (Totally extraperitoneal) repairs for inguinal hernia. Materials and Methodology: This retrospective observational study was conducted in a tertiary care centre from November 2014 to November 2015. It consisted of 60 operated cases of inguinal hernia distributed 30 each in two groups i.e. Group A (TEP) and Group B (TAPP). After taking informed consent, patient details with respect to the study was entered on case record form. Each patient was followed up post-operatively for a period of 3 months. Statistical tests of significance were applied on various intra-operative and post-operative parameters to be compared between the two techniques. Results: The mean duration of surgery by TEP technique was comparatively less than the TAPP technique. The intraoperative bleeding was minimal in cases of those operated by TEP as well as those operated by TAPP. There was no incidence of intraoperative bowel injury in our study in both groups. There was no incidence of intraoperative nerve injury in both groups. There was no difference in intraoperative conversion to open repair rates between TEP and TAPP. Seroma formation in the postoperative period was significant in TEP technique operated patients. There was no evidence of significant cord edema in the early postoperative phase of TEP and TAPP. The postoperative pain was more in TAPP as compared to TEP. There was no incidence of wound infection in TEP and TAPP. There was no difference in duration of hospital stay in TEP and TAPP. There was no difference in cost for surgery between TEP and TAPP. There was no incidence of recurrence of inguinal hernia in TEP as well as TAPP in early post-operative period. There was no difference in patient satisfaction in both the techniques.
A Comparative Study Between Conventional Hernioplasty and Laparoscopic Assisted Hernioplasty
Journal of Evolution of Medical and Dental Sciences, 2018
BACKGROUND The groin is one of the natural weak points 4 of the abdominal wall. The earliest record of inguinal hernia dates back to approx. 1500 BC. Many types of operations were done before, but it was only in the 19 th century that the inguinal canal's anatomy was well defined and the greatest contribution towards hernia surgery was by surgeon Edoardo Bassini, 12 as he was the first surgeon to maintain the functional anatomy of the inguinal canal post-surgery. His method was associated with the lowest mortality and recurrence rates up till then. Therefore, he is called as "father of modern herniorrhaphy." Shouldice described multilayered repair in 1953, which was a notable improvement to Bassini's repair method. The recurrence rates in Shouldice repair was done in Shouldice hospital, Toronto, it was less than 1%. Berliner and Lichtenstein 13 have developed simpler and equally effective methods and are known as modern pioneers of hernia surgery. Aims and Objectives-This study aims at comparing all aspects of laparoscopic hernioplasty with conventional hernioplasty. 19 1. To compare the early complication rates in LAH and conventional hernioplasty. 2. To compare the postoperative mobilisation, duration of hospital stay, and return to work in LAH and conventional hernioplasty.
2014
The aim of study was to observe the outcome and limitations of laparoscopic hernia repair in developing country. Hundred p atients of inguinal hernia who underwent Laparoscopic Transabdominal Pre-Peritoneal (TAPP) hernioplasty were observed for hospital stay, pain and post operative recovery. Mean operative time was 76.95 minutes. Only 12 patients developed complications in form of seroma formation (8 patients) and wound infection (4 patients). All patients were discharged within 48 hours. Mean time of return to work was 12.2 days. Hence, it is concluded that except for its high cost, the procedure is safe and allows less hospital stay and early return to work.
Comparison of Laparoscopic VS Open Inguinal Hernioplasty in a Tertiary Care Hospital
Journal of Enam Medical College, 2020
Background: Inguinal hernia repair is one of the most common surgical procedures in Bangladesh. The option of surgical treatment remains controversial. Laparoscopic hernia repair has all the benefits of a tension free repair. We aimed to compare postoperative outcome and cost between laparoscopic and open inguinal hernia repair. Objective: This study was conducted with an objective to compare the effectiveness of each procedure and complications if any. Materials and Methods: Fifty cases of inguinal hernia admitted in the tertiary care center were selected by nonprobability (purposive) sampling method. All patients with uncomplicated hernia treated by open or laparoscopic method were included. The age/sex, incidence, mode of presentation, surgical treatment and postoperative complications were evaluated and compared with standard published literature. Results: Postoperative wound infection developed in three cases of open hernioplasty and one case in laparoscopic surgery. Hematoma a...
Clujul Medical, 2015
The surgical repair of inguinal hernia represents one of the most frequent procedures used in general surgery. The new surgical techniques are simpler, with a lower morbidity and recurrence of less than 2%. The laparoscopic totally extra-peritoneal (TEP) technique is contraindicated in complicated hernias (occlusion, incarceration) and in voluminous inguino-scrotal hernias.Purpose. the evaluation of the TEP technique, of the risk factors and of the postoperative results on the group of patients who have undergone surgery in the Surgical Clinic 2 Cluj Napoca.Material and method. The study is prospective, on a group of 40 patients operated with the TEP technique in the Surgical Clinic 2 during the period May 2013 – July 2014. The following have been assessed: the demographic data, the risk factors, the immediate complications, the recurrence of the hernias.Results. The average duration of hospitalization was 6.79 days. The intraoperative incidents were: 7 minimal peritoneal lesions wi...
EVALUATION OF THE IMPACT OF PRE-PERITONEAL TRANSABDOMINAL INGUINAL HERNIORRAPHY (TAPP) DURING THE SEVENTH HERNIA EFFORT (Atena Editora), 2023
Introduction: Lichtenstein and transabdominal preperitoneal (TAPP) operations are considered in the repair of inguinal hernias, both with advantages. Determining the superiority between them is done by evaluating the complications -chronic pain and recurrence-, fast recovery, reproducible results and better cost-effectiveness. Objective: To identify the best surgical technique for repairing inguinal hernias in relation to the rate of recurrence, chronic pain and time to return to daily activities, at the Hospital Universitário Ciências Médicas (HUCM), during the Seventh Hernia Campaign, in 2019. Methods: The quantitative-qualitative observational cross-sectional study took place between 2021 and 2022. Patients from the 7th hernia joint effort, promoted by the Brazilian Society of Hernias, treated at a university hospital in Belo Horizonte, were evaluated. men and women of majority, with unilateral and bilateral inguinal hernias, non-recurring, submitted to surgery with TAPP and Lichtenstein. Of these, 17 patients performed a questionnaire and physical examination to investigate chronic pain, time to return to daily activities and recurrence. Results: Two groups composed of eight patients submitted to Lichtenstein (2 women and 6 men) and nine men to TAPP, with a mean age of 63 years (p=0.0885). Chronic pain affected 44.4% of the Lichtenstein group and 37.5% of the TAPP group (p-value>0.999). On physical examination, there was no recurrence in both techniques. Returning to work took more than one month for 44.4% of Lichtenstein members and 25% of TAPP members (p=0.555). Conclusion: Absence of statistical difference to determine which was the best surgical technique applied during the task force at HUCM. However, Lichtenstein meets the needs of the institution, given the socioeconomic conditions, defined by the limited access to the laparoscopic technique by SUS. (Unified Health System)
Needlescopic Totally Extraperitoneal Hernioplasty for Unilateral Inguinal Hernia in Adult Patients
Asian Journal of Surgery, 2011
OBJECTIVE: Totally extraperitoneal (TEP) inguinal hernioplasty for inguinal hernia is associated with less postoperative pain, shorter hospital stays, less chronic pain, and increased patient satisfaction when compared with the open Lichtenstein approach.. However, only few studies to date have compared conventional with needlescopic TEP hernioplasty for treating unilateral inguinal hernias in adult patients. We report our prospective study that compared the postoperative outcomes of these two approaches over a 2-year period. METHODS: From July 2007 to June 2009, a total of 32 patients underwent attempted unilateral needlescopic TEP hernioplasty. All data were prospectively collected and analysed, including demographic features, types of hernia, and postoperative outcome. The results were compared with those of an agematched cohort of 32 patients who underwent conventional TEP hernioplasty in the same period. RESULTS: Needlescopic TEP hernioplasty was successfully performed in 24 patients. The other eight procedures were completed with conventional TEP approaches after changing one or two 5-mm ports. The most common hernia type was Nyhus type III (38/64, 59.3%). There was no significant difference in the mean operative time, hospital stay, and postoperative pain scores between the needlescopic and conventional approaches. There was no major complication detected on the first visit, except seroma formation (9 patients in the needlescopic group and 11 in the conventional group), all of which was resolved with conservative management. No recurrence of hernia was noted in either group during the mean follow-up period of 88.0 weeks. CONCLUSION: Needlescopic TEP hernioplasty was a feasible technique in selected patients for inguinal hernia repair. Postoperative recovery following both approaches was similar. However, because this was a small cohort study, larger prospective, randomized controlled trials are required to establish the longterm benefit, safety and complications of needlescopic surgery.
Prospective Study of Open inguinal Hernioplasty and Short-Term Outcomes
International Journal of Surgical Research, 2013
Inguinal hernia still remains a significant clinical issue and surgeon has to manage. Though, improved surgical techniques and a better understanding of the anatomy and physiology of the inguinal canal have significantly imp roved outcomes for many patients. This study was designed to evaluate the outcomes among hernia patient. Bet ween March 2012 and May 2012, a prospective study of 11 consecutive patients operated for groin hernia using an open preperitoneal tension free mesh technique by a single surgeon was performed in surgical unit, Hospital Universit i Sains Malaysia (HUSM ). The outcome variables being analyzed included time to return to normal activity, pain level, co mplications and recurrence rate. Mean age of the patients was 58.34±14.62 years. Majority of patients (5) had right sided inguinal hernia. Wound infection occurred in 1 patient. No recurrence was observed. Moreover, mild pain were found in 2 patients. A good short-term outcome was found in this study. Lichtenstein's technique of inguinal mesh repair is a safe and effect ive procedure even in co mrobid condition.