Simplifying mesh placement during laparoscopic hernia repair

1995 ◽  
Vol 82 (5) ◽  
pp. 642-642 ◽  
Author(s):  
C. Avery ◽  
R. J. E. Foley ◽  
A. Prasad
Keyword(s):  
Hernia Repair ◽  
Laparoscopic Hernia Repair ◽  
Mesh Placement

scholarly journals Preventing Hernia Recurrence: Optimising Mesh Use in Incisional Hernia Repair

2020 ◽  
Vol 1 (4) ◽  
Author(s):  
Lily Goldblatt ◽  
Julia Merchant
Keyword(s):  
Chronic Pain ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Laparoscopic Hernia Repair ◽  
Mesh Fixation ◽  
Anatomical Location ◽  
Mesh Placement ◽  
Risk Of Recurrence ◽  
Fixation Methods ◽  
Reduced Risk

Incisional hernia is a common complication of abdominal surgery, affecting up to a quarter of patients undergoing laparotomy. This case report discusses a 72-year-old lady with a recurrent incisional hernia following an emergency Hartman’s procedure. The discussion covers the properties of synthetic vs biological meshes, the significance of the anatomical location of the mesh, fixation methods, laparoscopic surgery, short and long term complications. Key points: The ideal mesh is biocompatible, strong, resistant to infection, has minimal bioreactivity and non-immunogenic Pore size is important to the degree of mesh integration, infection risk and the development of chronic pain Synthetic mesh is useful in contaminated cases but adds a significant cost to the procedure Sublay mesh placement is associated with a reduced risk of recurrence Most recurrences occur at the edge of the mesh. Surgeons should ensure a 5cm overlap between the mesh and native tissues and consider dual fixation methods Laparoscopic hernia repair has been associated with a shorter post-op recovery, less pain and a short term reduced risk of recurrence, however there is a greater risk of bowel injury and development of adhesions Composite meshes can reduce the risk of adhesions with intraperitoneal mesh placement Chronic pain is associated with the use of tacks, heavy weight synthetic meshes and chronic infection Resorbable meshes have not been shown to reduce chronic pain The choice of mesh, method of repair and surgical approach should be individualised to the patient.

scholarly journals Non-closure of the Free Peritoneal Flap During Laparoscopic Hernia Repair of Lower Abdominal Marginal Hernia: A Retrospective Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Qian Xu ◽  
Guangyong Zhang ◽  
Linchuan Li ◽  
Fengting Xiang ◽  
Linhui Qian ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Laparoscopic Hernia Repair ◽  
Abdominal Hernia ◽  
Visceral Injury ◽  
Mesh Placement ◽  
Peritoneal Flap ◽  
Flap Closure

Background: During lower abdominal marginal hernia repair, the peritoneal flap is routinely freed to facilitate mesh placement and closed to conclude the procedure. This procedure is generally called trans-abdominal partial extra-peritoneal (TAPE). However, the necessity of closing the free peritoneal flap is still controversial. This study aimed to investigate the safety and feasibility of leaving the free peritoneal flap in-situ.Methods: A retrospective review was conducted on 68 patients (16 male, 52 female) who underwent laparoscopic hernia repair between June 2014 and March 2021. Patients were diagnosed as the lower abdominal hernia and all required freeing the peritoneal flap during the operation. Patients were divided into 2 groups: one group was TAPE group with the closed free peritoneal flap, another group left the free peritoneal flap unclosed. Analyses were performed to compare both intraoperative parameters and postoperative complications.Results: There were no significant differences in demographic, comorbidity, hernia characteristics and ASA classification. The intra-operative bleeding volume, visceral injury, hospital stay, urinary retention, visual analog scale (VAS) score, dysuria, intestinal obstruction, surgical site infection, mesh infection, recurrence rate and hospital stay were similar among the two groups. Mean operative time of the flap closing procedure was higher than for patients with the free peritoneal flap left in-situ (p = 0.002). Comparisons of postoperative complications showed flap closure resulted in a higher incidence of seroma formation (p = 0.005).Conclusion: Providing a barrier-coated mesh is used during laparoscopic lower abdominal marginal hernia repair, it is safe to leave the free peritoneal flap in-situ and this approach may prevent the occurrence of seromas.

A Single Institution Experience with Laparoscopic Hernia Repair in 500 Children

2021 ◽  
Author(s):  
Wendy Jo Svetanoff ◽  
Charlene Dekonenko ◽  
Obiyo Osuchukwu ◽  
Joshua Hill ◽  
Rebecca M. Rentea ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Laparoscopic Hernia Repair ◽  
Single Institution

Variation in mesh placement for ventral hernia repair: an opportunity for process improvement?

2008 ◽  
Vol 196 (2) ◽  
pp. 201-206 ◽  
Author(s):  
Stephen H. Gray ◽  
Catherine C. Vick ◽  
Laura A. Graham ◽  
Kelly R. Finan ◽  
Leigh A. Neumayer ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Process Improvement ◽  
Ventral Hernia Repair ◽  
Mesh Placement

scholarly journals Comparative study between laparoscopic trans-abdominal preperitoneal and open mesh hernioplasty in repair of non-complicated inguinal hernia

2019 ◽  
Vol 7 (1) ◽  
pp. 24
Author(s):  
Waleed Yusif El Sherpiny
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Group ◽  
Routine Activities ◽  
Group A ◽  
Group B ◽  
Open Hernia Repair ◽  
Mesh Hernioplasty

Background: Inguinal mesh hernioplasty is one of the common procedures performed all over the world. It can be done either through open or laparoscopic techniques. The aim of this study was to compare the outcomes of Lichtenstein tension free hernioplasty versus laparoscopic transabdominal pre-peritoneal (TAPP) mesh repair considering, duration of the surgery, hospital stay, and duration to resume normal activity, degree of postoperative pain, wound infection, recurrence and complications.Methods: Adult patients presented to the general surgical OPD, with the diagnosis of inguinal hernia underwent either Lichtenstein repair or laparoscopic repair by TAPP.Results: Patients in Group A (open-repair) had significantly greater level of local pain during rest and during routine activities than those within Group B (laparoscopic group) during the postoperative period assessed on the visual-analogue scale. Mean operative time for open hernia repair was 43.7 minutes and for laparoscopic hernia repair was 59.03 minutes and the difference were statistically significant (p=0.0001). The mean duration of hospital stay for open hernia repair was 2.16 days and that for laparoscopic hernia repair was 1.08 days with a (p=0.00001) which was statistically significant. The time to resume routine activities was much shorter among Group B patients than patients in Group A. Only one recurrence (3.3%) was seen in Group B after 6 months follow up.Conclusions: It is concluded that laparoscopic TAPP repair of inguinal hernia in adults is safe and preferred operation as compared to open inguinal hernia repair.

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