scholarly journals Litigation claims following laparoscopic and open inguinal hernia repairs

Hernia ◽  
2020 ◽  
Vol 24 (5) ◽  
pp. 1113-1120
Author(s):  
R. Varley ◽  
C. Lo ◽  
B. Alkhaffaf
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Vascular Injury ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Hernia Surgery ◽  
Visceral Injury ◽  
Inguinal Hernia Surgery ◽  
The Uk

Abstract Purpose Groin hernia repair is the most frequently performed general surgical operation in the UK. Complications from laparoscopic and open repair are well recognised; however, potential differences are yet to be considered in relation to litigation. Methods Administrative data were obtained and analysed from the NHS Litigation Authority for inguinal hernia-related claims from 1995 to 2016. Claims identified as using an open or laparoscopic approach were compared. Results 880 claims were made, 760 had been settled. 88 laparoscopic and 241 open procedures were identified; 65% laparoscopic and 63% open hernia claims were found to be in favour of the claimant. Payouts totalled to 4.1GBP/4.8EUR/5.3USD million and 9.4GBP/11.0EUR/12.1USD million for laparoscopic (mean 82,824GBP/96,579EUR/106,453USD) and open (mean 66,796GBP/77,892EUR/85,852USD) approaches, respectively. The most common reasons for claim initiation were visceral/vascular injury (54%) in the laparoscopic group, and testicular complications or chronic pain (35%) in the open group. Additional procedures were necessary for 48% and 44% of laparoscopic and open claims, respectively. The highest average payouts were associated with visceral injury, (laparoscopic 116,482GBP/135,820EUR/149,715USD; open 199,103GBP/232,246EUR/255,905USD) and vascular injury (laparoscopic 88,624GBP/103,369EUR/113,892USD; open 64,460GBP/75,163EUR/82,870USD). Additional procedures resulted in an average payout of 93,352GBP/108,917EUR/120,008USD (laparoscopic) and 60,408GBP/70,506EUR/77,657USD (open). The most common additional procedures were corrective visceral/vascular repairs, orchidectomy and recurrent hernia repair. Conclusions The rate of litigation for clinical negligence in inguinal hernia surgery in the UK is increasing. Whilst there has been a recent increase in laparoscopic hernia repair claims, the volume and burden of claims related to open procedures remain greater.

scholarly journals TAPP technique for congenital inguinal hernia

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Dan Dumitrescu ◽  
Costel Savlovschi ◽  
Victor Dumitrescu
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Surgical Intervention ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Approach ◽  
Surgical Team ◽  
Hernia Surgery ◽  
New Era ◽  
Recommended Treatment ◽  
The Right

Laparoscopic hernia repair has opened a new era in hernia surgery shifting paradigms from anterior to posterior approaches. This has exposed surgeons to new anatomical perspective, tehnical challenges and clinical implication. We present the case of a 53-year-old patient admitted to surgery in outpatient conditions with the diagnosis of bulky inguinal-scrotum hernia. Transabdominal pre-peritoneal (TAPP) repair was our option to solve the inguinal parietal defect. Intraoperatively, in the peritoneal cavity, lateral to the epigastric vessels, the parietal flaccid defect was revealed, communicating with the right scrotum cavity, with clear evidence of testicle, suggestive of external congenital oblique hernia. Peritoneal sectioning and take-off, with Cooper's, spermatic vessels and the relevant channel, were the precursors of the dissection and 360-degree take-off of the herniated sac, with the support of the herniated suture ligament, followed by in-line, and the abandonment of the distal, open, unbounded end. The application of the 3D-MAX mesh, fixed with Capsure at the Cooper ligament, preperitoneal drainage and closure of the resorbable thread peritoneum were the endpoints of surgical intervention. The postoperative progression was favorable with discharge on the 2nd postoperative day. Control at 30 days postoperatively did not identify possible complications, it presented without painful accusations, without suggestive elements for hydrocele and without signs of relapse. The laparoscopic approach, even in the case of bulky parietal defects, remains a recommended treatment option with the best results, but largely depending on the surgical team experience.

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.

scholarly journals Postoperative condition of patients as a result of treatment of inguinal hernias by laparoscopic and open methods

2021 ◽  
pp. 30-35
Author(s):  
V.V. Skyba ◽  
◽  
A.V. Ivanko ◽  
N.V. Voytyuk ◽  
V.V. Lysytsia ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Open Access ◽  
Hospital Stay ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Lower Percentage ◽  
Hernia Surgery ◽  
Inguinal Hernias ◽  
Inguinal Hernia Surgery

Purpose – to analyze condition of patients after surgical treatment of inguinal hernias by laparoscopic and open methods. Materials and methods. A retrospective review of medical histories and outpatient charts of all patients who underwent inguinal hernia surgery at the Kyiv City Clinical Hospital No. 1 from January 2018 to July 2020 was conducted. Results. During the above period of time in our hospital open hernioplasty was performed in 86 patients, laparoscopic hernioplasty – 138 patients. With open hernioplasty, the average duration of surgical treatment was 40±12 minutes. The laparoscopic technique was 35±12 minutes. The length of hospital stay was significantly longer in the group of patients with the open method (48±12 hours) than in the group of laparoscopic plastic surgery (12±3 hours). From the group of patients who underwent open hernioplasty, 62 patients complained of long-term pain syndrome, from the group of laparoscopy – 12 patients. The cosmetic appearance was dissatisfied with 34 patients in the open access group and only 2 patients in the laparoscopic plastic group. Postoperative complications were observed in 34 patients who underwent surgical treatment through open access, and in 15 patients – by laparoscopy. Conclusions. The laparoscopic approach of inguinal hernia surgery is superior to open access, as it reduces the length of hospital stay, postoperative recovery, improves the aesthetic effect of the operation, reduces the frequency of infection of incisions. According to the results of the study, this technique gives a better result in the early postoperative period, a lower percentage of chronic pain and a higher degree of patient satisfaction compared to open access with the same low recurrence rate. Therefore, in our opinion, laparoscopic access to hernioplasty is the optimal method of treatment and can be recommended as a method of choosing inguinal hernia surgery. Postoperative assessment of the quality of life of patients after treatment of inguinal hernia by laparoscopic and open methods. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: inguinal hernia, laparoscopy, open access surgery, analysis of methods, operation.

scholarly journals Audit of Referral Patterns for Hernia Repair – Are General Practitioners Aware of the Changing Face of Herniorrhaphy?

2008 ◽  
Vol 90 (2) ◽  
pp. 140-141 ◽  
Author(s):  
JE Coulston ◽  
GL Williams ◽  
BM Stephenson
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
General Practitioners ◽  
Groin Hernia ◽  
Postal Questionnaire ◽  
Further Education ◽  
General Surgeon ◽  
Hernia Surgery ◽  
Referral Patterns ◽  
Inguinal Hernia Surgery

INTRODUCTION The objective of this study was to examine referral patterns from general practitioners for groin hernia surgery and to assess their knowledge of services available to their patients. PATIENTS AND METHODS An anonymous postal questionnaire was sent to 120 general practitioners (GPs) in the South East Wales region who routinely refer patients for inguinal hernia surgery to the Royal Gwent Healthcare NHS Trust. RESULTS A total of 86 questionnaire replies were returned. There was variation in referral patterns between the GPs with the majority (84%) referring their patients for groin hernia repair to either a general surgeon or as an open referral. Only 14% referred directly to a hernia specialist and none regularly referred to a laparoscopic surgeon. CONCLUSIONS Referral patterns for inguinal hernia surgery do not reflect services provided in secondary care. Further education is required so that a patient's care can be optimised.

Absorbable Meshes in Inguinal Hernia Surgery: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 24 (3) ◽  
pp. 289-298 ◽  
Author(s):  
Stina Öberg ◽  
Kristoffer Andresen ◽  
Jacob Rosenberg
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hernia Surgery ◽  
Absorbable Mesh ◽  
Inguinal Hernia Surgery ◽  
Increased Risk ◽  
Meta Analyses

Purpose. Absorbable meshes used in inguinal hernia repair are believed to result in less chronic pain than permanent meshes, but concerns remain whether absorbable meshes result in an increased risk of recurrence. The aim of this study was to present an overview of the advantages and limitations of fully absorbable meshes for the repair of inguinal hernias, focusing mainly on postoperative pain and recurrence. Methods. This systematic review with meta-analyses is based on searches in PubMed, Embase, Cochrane, and Psychinfo. Included study designs were case series, cohort studies, randomized controlled trials (RCTs), and non-RCTs. Studies had to include adult patients undergoing an inguinal hernia repair with a fully absorbable mesh. Results. The meta-analyses showed no difference in recurrence rates (median 18 months follow-up) and chronic pain rates (1 year follow-up) between absorbable- and permanent meshes. Crude chronic pain rates for the RCTs were 2.1% for the absorbable meshes and 7.6% for the permanent meshes. For the absorbable meshes, medial hernias were more susceptible for recurrence compared with lateral hernias ( P < .0005). None of the studies reported allergic reactions or other serious adverse events related to the absorbable mesh. Conclusions. Patients with an absorbable mesh seem to have less chronic pain following inguinal hernia surgery compared with permanent meshes, without increased risk of recurrence.

scholarly journals SEROMA AFTER TENSION-FREE INGUINAL HERNIA REPAIR – OUR EXPERIENCE

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Vinod Kumar Nigam ◽  
Siddarth Nigam
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Dead Space ◽  
Hernia Surgery ◽  
Tension Free ◽  
Body Tissues ◽  
Inguinal Hernia Surgery ◽  
Tissue Dissection ◽  
Low Incidence

Seroma Is a collection of fluid called serum that gets collected at the site of inguinal hernia surgery. It is common after inguinal hernia repair with a mesh. Usually seroma develops after 7 to 10 day of operation but can develop even earlier depending upon the amount of tissue dissection. More the dissection more the chances of development of seroma. The fluid in seroma is usually clear or straw colored. Seroma generally does not require any treatment; it disappears by absorption by body tissues within few weeks. Large seromas may require repeated aspiration. To avoid developing seroma after inguinal hernia surgery is to do minimal tissue dissection and avoid dead space formation. We operated 400 cases of inguinal hernia by a modified Lichtenstein tension-free procedure called NICH (Nigam’s inverted curtain hernioplasty) our incidence of development of seroma was 1.5% against international incidence of 7% which is a real low incidence. We have discussed the ways to avoid formation of seroma after open inguinal hernioplasty. Keywords: dead space, dissection, inguinal hernia, Lichtenstein, mesh, NICH, seroma.

scholarly journals Laparoscopic total extraperioneal mesh hernioplasty is a novel approach for inguinal hernia: our experience over 7 years

2019 ◽  
Vol 6 (11) ◽  
pp. 3982
Author(s):  
Dheer Singh Kalwaniya ◽  
Ranjith Mahadevan ◽  
Satya V. Arya ◽  
Jaspreet Singh Bajwa ◽  
Gowtham K. Gowda ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Mesh Repair ◽  
Wound Complications ◽  
Indirect Inguinal Hernia ◽  
Bilateral Inguinal Hernia ◽  
Hernia Surgery ◽  
Early Recovery ◽  
Inguinal Hernia Surgery ◽  
Laparoscopic Tep

Background: Inguinal hernia surgery is the most common performed surgery all over the world. Among them laparoscopic totally extra-peritoneal (TEP) mesh repair fulfils all the requirements with better clinical outcomes than other procedures.Methods: Data was collected from the inpatient and out-patient records of 60 patients who underwent laparoscopic TEP for unilateral or bilateral inguinal hernia in a single unit in the Department of General Surgery during May 2012-June 2019 including the two years of follow-up. 3D mesh was used for application and was fixed with tackers. Then patients were followed up in outpatient department after 1 week, 2 week, and 3 months, 6 months and yearly up to two years. In every visit post-operative pain (assessed by visual analogue scale), local wound complication (hematoma, seroma, wound infection) and recurrence were noted. The data was collected and evaluated and the results shown.Results: All patients were men, with average age of 36.5 years (range 32-58). On categorization 53 (88.3%) of them had unilateral inguinal hernia and 7 (11.6%) of them had bilateral inguinal hernia. Intra operatively 12 (20%) of them had direct inguinal hernia and 48 (80%) of them had indirect inguinal hernia. Haematoma was seen in 1 patients, surgical emphysema in 3, seroma in 5 and recurrence in 2 patients.Conclusions: Laparoscopic TEP mesh repair was effective and safe tool for hernia repair, in terms of lesser postoperative painless number of hospital days, early recovery and lesser wound complications. However recurrence rates are comparable with other methods of hernia repair.

scholarly journals Role of Prophylactic Antibiotics in Open Mesh Inguinal Hernia Repair

2019 ◽  
Vol 13 (2) ◽  
pp. 18-21
Author(s):  
Md Ataur Rahman Siddiqui ◽  
Mohammad Abdul Aleem ◽  
Md Shahinur Rahman ◽  
Farzana Zafreen
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Prophylactic Antibiotic ◽  
Prophylactic Antibiotics ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery ◽  
Group A ◽  
Group B ◽  
Open Mesh

Introduction: The role of prophylactic antibiotics in open mesh repair of inguinal hernia is still controversial. The dogmatic hernia specialists are always in favour of no use of antibiotic in case of inguinal hernia repair on contrary, many others favour the use of prophylactic antibiotic. Objective: To determine the role of prophylactic antibiotic in case of open mesh inguinal hernia surgery by a prospective randomized study. Materials and Methods: This prospective randomized interventional and observational study was conducted from March to December 2017 at Combined Military Hospital, Chattogram. Total 40 patients selected for open inguinal hernia surgery were grouped as Group-A and Group-B containing 20 in each group on the basis of systematic random sampling. The Group-A and Group-B patients were treated with a single dose of prophylactic antibiotic (1.5gm Cefuroxime) and a similar quantity of normal saline respectively. Data were recorded, compiled, edited and analyzed by SPSS version 23. Results: The mean age of Group-A and B respondents were 53.16±7.76 and 52.39±5.69 years respectively. Mean duration of surgery was 59.76±2.1 and 54.56±18.3 minutes in Group-A and B respectively. Surgical site infection (SSI) was present in 2(10%) cases of Group-A and 5(25%) of Group-B. Though it was little higher in Group-B, the difference was not statistically significant (p>0.05). Staphylococcus was most prevalent in Group-A and multiple organisms in Group-B. Conclusion: Prophylactic antibiotic is not able to significantly decrease the rate of SSI. Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 18-21

An Analysis of Early Postoperative Returns after Inguinal Hernia Surgery

2018 ◽  
Vol 84 (10) ◽  
pp. 1613-1616 ◽  
Author(s):  
Nikhil Crain ◽  
Talar Tejirian
Keyword(s):  
Inguinal Hernia ◽  
Urinary Retention ◽  
Laparoscopic Group ◽  
Urgent Care ◽  
Hernia Surgery ◽  
Kaiser Permanente ◽  
Inguinal Herniorrhaphy ◽  
Medical Centers ◽  
Inguinal Hernia Surgery ◽  
Risk Patients

Although inguinal herniorrhaphy is low risk, patients still return to the urgent care or ED. We performed a retrospective study on 19,296 inguinal hernia operations across 14 Southern California Kaiser Permanente medical centers over five years. Unplanned returns within the first postoperative week were evaluated focusing on four potentially avoidable diagnoses (AD): pain, constipation, urinary retention, and nausea/vomiting. Overall, 1370 (7%) patients returned to the urgent care/emergency department, of which 537 (39%) had an AD. There was no difference in total returns (7.1 vs 7.4%, P = 0.33) or AD returns [2.8 vs 2.6%, ( P = 0.44)] for males vs females. Of the 537 total AD returns, there were 205 (38%) patients with pain, 191 (36%) with urinary retention, 112 (21%) with constipation, and 29 (5%) with nausea/vomiting. Most AD returns (78%) occurred within the first three postoperative days. Pain was greater in open operations [44 vs 26%, ( P < 0.05)], and urinary retention was greater in the laparoscopic group [27 vs 55%, ( P < 0.05)]. The overall rate of return was higher for laparoscopic compared with open unilateral operations [8 vs 6%, ( P < 0.05)], but similar between approaches for bilateral operations [11 vs 10%, ( P = 0.32)].

Effects of Electroacupuncture on Local Anaesthesia for Inguinal Hernia Repair: A Randomised Placebo-Controlled Trial

2010 ◽  
Vol 28 (2) ◽  
pp. 65-70 ◽  
Author(s):  
Marcio Dias ◽  
Norton Moritz Carneiro ◽  
Luiz Antônio Vanni Guerra ◽  
Guillermo Coca Velarde ◽  
Pedro Assaf Teixeira de Souza ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Local Anaesthesia ◽  
Single Case ◽  
Controlled Trial ◽  
Control Group ◽  
Blood Levels ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery

Objective To assess the effect of electroacupuncture (EA), akin to percutaneous electroneurostimulation, on pain and biochemical measures during and after inguinal hernia repair. Methods Thirty-three patients were randomised to EA (n=16) or sham transcutaneous electrical nerve stimulation (TENS) control (n=17). EA was applied at different frequencies, through needles inserted around the incision, over selected peripheral nerve branches and in the ear, from 30 min before surgery until the end of surgery, when needles were removed. All patients also received routine sedation and local anaesthesia. Results There was no difference between the pain scores in the groups receiving EA and sham TENS in the immediate postoperative period, which may be owing to adequate levels of analgesia from conventional techniques. On the fourth and seventh postoperative days, less pain and lower consumption of analgesic drugs were reported in the treatment group. Seroma occurred more frequently in the control group, which also had higher glucose blood levels in the immediate postoperative surgery period. The single case of chronic postoperative pain occurred in the control group. Conclusions The sample size was too small to draw any conclusions about the effect of EA on pain and other parameters following inguinal hernia surgery, but our observations suggest that future studies in this area are justified.

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