scholarly journals One surgeon’s experience with r-TAPP: a retrospective analysis of 150 consecutive robotic inguinal hernia cases

Author(s):  
Jorge L. Florin ◽  
Valeria Bianchi ◽  
Daniel D. Wiggan

AbstractThere is a tremendous paucity of literatures regarding the long-term surgical outcomes of the r-TAPP procedure for inguinal hernia repair. Additionally, much of the existing literatures regarding this procedure have limited follow-up of to 12 months. This article presents the outcomes of 150 consecutive r-TAPP inguinal hernia repairs performed on 111 patients using Progrip mesh without fixation, with up to 24 months of follow-up. The initial 150 consecutive r-TAPP inguinal hernia repairs were performed from February 2017 to April 2018 using Progrip without fixation. All patients were seen at 2 weeks, followed by phone follow-up at 6 months, 1 year, and 2 years. Of the 111 patients, 39 had bilateral hernias (35%) and 72 had unilateral hernias (65%). The age range was 18–93 years. The BMI range was 20.7–50.2, with a mean of 26.4 and median of 25.8. Total operative time ranged from 28 to 138 min with a mean of 62.4 min and median of 56 min. ASA classification ranged from 1 to 4, with a mean of 2.1. No significant blood loss was observed in any of the cases. There were no conversions to open surgery. All patients were discharged the same day of the operation. We were able to follow up with 100% of the hernias at 2 weeks, 88% at 6 months, 87% at 1 year, and 80% at 2 years. No recurrences were recorded at 2 weeks, 3 months, 6 months, 1 year, or 2 years. There were no reports of chronic pain up to 2 years in any of the patients. These results indicate that r-TAPP inguinal hernia repair using Progrip without further fixation is safe, effective, and can be performed with minimal recurrences or chronic pain.

2020 ◽  
Vol 7 (7) ◽  
pp. 2147
Author(s):  
Pinak Pani Dhar ◽  
Upasana Mohanty ◽  
Raman Kumar Shankar

Background: The ideal operation to treat inguinal hernia is still far to define. The Shouldice method and other tissue-based techniques are still acknowledged to be acceptable for primary inguinal hernia repair according to European Hernia Society guidelines. Desarda’s technique, presented in 2001, is an original hernia repair method using an undetached strip of external oblique aponeurosis. This randomized trial compared outcomes after hernia repair with Desarda and mesh-based Lichtenstein techniques.Methods: A total of 42 participants (40 males and 2 females) were randomly assigned to the Desarda (group 1) and Lichtenstein (group 2), 19 vs 23 respectively. The primary outcomes measured were recurrence (for maximum follow up of 1 year and minimum of 5 months) and chronic pain. Additionally, operative time, early and late complications, foreign body sensation, and return to everyday activity were examined in hospital and at 7, 30 days, and 6, 12 months after surgery.Results: During the follow-up, one recurrence was observed in Desarda group after 10 months of surgery. Chronic pain was experienced by 10.5% and 8.7% of patients from groups Desarda and Lichtenstein respectively. Foreign body sensation and return to activity were comparable between the two groups. Operative time was less in Desarda group. There was significantly less seroma production in the Desarda group.Conclusions: The results of primary inguinal hernia repair with the Desarda and Lichtenstein techniques are comparable at the 1 year follow up. The technique may potentially increase the number of tissue-based methods available for treating groin hernias. 


2021 ◽  
Author(s):  
Baoshan Li ◽  
Xin Zhang ◽  
Yi Man ◽  
Jiadong Xie ◽  
Wei Hu ◽  
...  

Abstract Porcine small intestine submucosa (SIS) biologic patch has been used in inguinal hernia repair. However, there are little data available to assess the long-term effect after repair. This study aimed to explore the long-term effect of SIS patch in open inguinal hernia repair. Sevent-six patients with unilateral inguinal hernia were treated with Lichtenstein tension-free hernia repair using SIS patch (Beijing Datsing Bio-Tech Co., Ltd.) and Surgisis patch (COOK, USA) in Tianjin Union Medical Center and China-Japan Friendship Hospital. In the trial, the long-term efficacy of the treatment group and the control group were compared. A total of 66 patients in both groups received long-term follow-up (> 5 years) after surgery, with a follow-up rate of 86.8%. During the follow-up period, there was one case of recurrence, one case of chronic pain in the control group. There was no statistically significant difference (P > 0.05) in terms of recurrence, chronic pain, foreign body sensation and infection between the two groups of patients. After long-term observations, it has been found that the porcine small intestinal submucosa (SIS) biological patch is safe and effective for inguinal hernia Lichtenstein repair, and has a low recurrence rate and complication rate.


2016 ◽  
Vol 82 (2) ◽  
pp. 112-116 ◽  
Author(s):  
Malek Tabbara ◽  
Laurent Genser ◽  
Manuela Bossi ◽  
Maxime Barat ◽  
Claude Polliand ◽  
...  

To review our experience and outcomes after inguinal hernia repair using the lightweight self-adhering sutureless mesh “Adhesix™” and demonstrate the safety and efficacy of this mesh. This is a 3-year retrospective study that included 143 consecutive patients who underwent 149 inguinal hernia repairs at our department of surgery. All hernias were repaired using a modified Lichtenstein technique. Preoperative, perioperative, and postoperative data were prospectively collected. Incidence of chronic pain, postoperative complications, recurrence, and patient satisfaction were assessed three years postoperatively by conducting a telephone survey. We had 143 patients with a mean age of 58 years (17–84), who underwent 149 hernia repairs using the Adhesix™ mesh. Ninety-two per cent (131 patients) were males. Only 10 patients (7%) had a postoperative pain for more than three years. In our series, neither age nor gender was predictive of postoperative pain. Only one patient had a hematoma lasting for more than one month and only four patients (2.8%) had a recurrence of their hernia within three years of their initial surgery. Ninety per cent of the patient expressed their satisfaction when surveyed three years after their surgery. In conclusion, the use of the self-adhering sutureless mesh for inguinal hernia repair has been proving itself as effective as the traditional mesh. Adhesix™ is associated with low chronic pain rate, recurrence rate, and postoperative complications rate, and can be safely adopted as the sole technique for inguinal hernia repair.


2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
M. R. Berndsen ◽  
Tomas Gudbjartsson ◽  
Fritz Hendrik Berndsen

Background and Aims. The aim of this prospective single-center study was to evaluate the outcome of inguinal hernia repair. Materials and Methods. A total of 485 inguinal hernias (452 patients and 33 patients with bilateral hernias) were operated between January 2004 and December 2010. Mean age was 56 years, and 93% were male. Patient demographics and operative data were collected, and the operating surgeon assessed the technical difficulty of the operation. Five years after surgery, a questionnaire evaluated recurrence and chronic discomfort according to the Cunningham scale. 372 responded (82%), and mean follow-up was 5.5 years. Results. There were 390 repairs for a primary and 62 for a recurrent hernia. Totally extraperitoneal (TEP) operation was most frequently performed (56%), transabdominal preperitoneal (TAPP) operation in 31%, and Lichtenstein and Shouldice in 12% and 2%, respectively. At 5-year follow-up, the primary outcome of chronic discomfort was 19.5%. The independent positive predictors were young age and operation for a recurrent hernia (OR: 3.7), with TEP operation reducing the risk of chronic discomfort (OR: 0.5). The secondary outcome was the recurrence rate of 2.5%. Risk factors were strenuous work (OR: 13.7), technically difficult repairs (OR: 7.2), and chronic discomfort (OR: 6.7). Conclusions. Every fifth patient had chronic discomfort in long-term follow-up. The recurrence rate was 2.5%, and a technically difficult procedure was a risk factor.


2017 ◽  
Vol 54 (1) ◽  
pp. 119-121
Author(s):  
Dan Bratu ◽  
Adrian Boicean ◽  
Ciprian Tanasescu ◽  
Ciprian Sofariu ◽  
Alin Mihetiu ◽  
...  

The usage of prosthetic devices in the surgery of parietal defect is, nowadays, essential for a good abdominal wall recovery and prevention of the hernia recurrence. A good and suitable textile allograft should poses one or more, ideally all, of the following characteristics: pliable, strong, non-allergenic and with perfect tissue integration behavior. The aim of this paper is to evaluate the immediate and long term tissue reaction of different textile allografts used in open surgery of inguinal hernia repair.


2016 ◽  
Vol 82 (10) ◽  
pp. 1014-1017 ◽  
Author(s):  
Massimo Arcerito ◽  
Eric Changchien ◽  
Oscar Bernal ◽  
Adam Konkoly-Thege ◽  
John Moon

Laparoscopic inguinal hernia repair has been shown to have multiple advantages compared with open repair such as less postoperative pain and earlier resume of daily activities with a comparable recurrence rate. We speculate robotic inguinal hernia repair may yield equivalent benefits, while providing the surgeon added dexterity. One hundred consecutive robotic inguinal hernia repairs with mesh were performed with a mean age of 56 years (25–96). Fifty-six unilateral hernias and 22 bilateral hernias were repaired amongst 62 males and 16 females. Polypropylene mesh was used for reconstruction. All but, two patients were completed robotically. Mean operative time was 52 minutes per hernia repair (45–67). Five patients were admitted overnight based on their advanced age. Regular diet was resumed immediately. Postoperative pain was minimal and regular activity was achieved after an average of four days. One patient recurred after three months in our earlier experience and he was repaired robotically. Mean follow-up time was 12 months. These data, compared with laparoscopic approach, suggest similar recurrence rates and postoperative pain. We believe comparative studies with laparoscopic approach need to be performed to assess the role robotic surgery has in the treatment of inguinal hernia repair.


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