Prematurity, not age at operation or incarceration, impacts complication rates of inguinal hernia repair

Background: Synthetic mesh based hernia repair is usually avoided in contaminated and dirty inguinal hernia repair to minimize the risk of infection. Desarda’s technique is a tissue based inguinal hernia repair method which avoids the use of prosthetic mesh. So this study was conducted with the aim to observe the outcome of Desarda’s technique in incarcerated inguinal hernia repair as an alternative procedure to mesh repair.Methods: This study was conducted in Emergency surgery department KGMU Lucknow. Total 30 patients with incarcerated inguinal hernia were included. Patients with recurrent hernia were excluded. Desarda repair was done in all patients. Patients were followed for 1 year to assess the outcome.Results: The mean age was 52±3 years. Mean operative time was 55±5 mins. Total duration of hospital stay was 4-16 days. Mild to moderate pain observed more frequently on 3rd and 7th post-operative day. Complication rates were found to be SSI (6%), seroma (3%), and recurrence (3%). Time taken to return to daily basic and work activities was 3 (3-5) and 15 days respectively. Patients’ subjective assessment of foreign body sensation done at 6th and 12th month follow up was found in 16% and 13% cases and that of abdominal wall stiffness in 23% followed by a reduction of upto 16% cases by 12th month.Conclusions: Desarda’s method is a safe, effective technique and may potentiate the use of tissue based repair for treating incarcerated, contaminated inguinal hernia repair. It has very low rate of recurrence and low cost of treatment.

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Using inferior epigastric vascular anatomical landmarks for anterior inguinal hernia repair

BMC Surgery ◽

10.1186/s12893-019-0627-0 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Weiming Li ◽

Yijun Li ◽

Lili Ding ◽

Xiongzhi Chen ◽

Qingwen Xu ◽

...

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Inguinal Hernia Repair ◽

Foreign Bodies ◽

Length Of Hospital Stay ◽

Operation Time ◽

Complication Rates ◽

Anatomical Landmarks ◽

Post Operative Pain

Abstract Background Inferior epigastric vascular anatomical landmarks for anterior inguinal hernia repair is an alternative surgical procedure. We present our experience and outcome of the way. Methods We performed a retrospective analysis of 230 patients who received anterior tension-free hernia repair between May 2016 to May 2017. Among these cases, 120 were performed using the traditional transinguinal preperitoneal (TTIPP) technique while 100 were performed using the vascular anatomic landmark transinguinal preperitoneal (VALTIPP) technique. Between these two groups, we compared the operation time, length of hospital stay, complication rates, and the visual analog scale (VAS) for pain at 2 days, 3 months, and 6 months after surgery. Results Surgery was well-tolerated in both groups with no significant hemorrhage or complications. The operation times for the VALTIPP and TTIPP groups were 42.52 ± 9.15 and 53.84 ± 10.64 min (P < 0.05), respectively. Ten patients in the VALTIPP group and 17 patients in the TTIPP group reported sensations of foreign bodies (P < 0.05). The VAS pain score in VALTIPP patients at 2 days (4.0 ± 0.5), 3 months (1.0 ± 0.3), and 6 months (0.9 ± 0.3) were significantly lower when compared with those of TTIPP patients (5.3 ± 0.9 at 2 days, 1.8 ± 0.4 at 3 months, and 1.1 ± 0.1 at 6 months, p < 0.05). No statistically significant differences were found in age, gender, BMI, hernia type and location, follow-up period, incidence of post-operative seromas, recurrence rate, or length of hospital stay. Conclusion Anterior inguinal hernia repair using inferior epigastric vascular anatomical landmarks may lead to reduced operation times, reduced sensations of foreign bodies, and reduced post-operative pain. This technique is simple, practical, and effective in the management of inguinal hernias.

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EP.TH.375Inguinal hernia repair: A systematic analysis of online patient information using the modified Ensuring Quality Information for Patients tool

British Journal of Surgery ◽

10.1093/bjs/znab309.049 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Siobhan Chien ◽

Danielle Cunningham ◽

Khurram Khan

Keyword(s):

Inguinal Hernia ◽

Patient Education ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Patient Information ◽

International Standards ◽

Online Resources ◽

Quality Information ◽

Complication Rates

Abstract Aims Online resources are a fundamental source of healthcare information due to the increasing popularity of the Internet, therefore ensuring accuracy and reliability of websites is crucial to improving patient education and enhancing patient outcomes. Inguinal hernia repair is the most commonly performed general surgical procedure worldwide. This study aims to analyse the quality of online patient information on inguinal hernia repair using the modified Ensuring Quality Information for Patents (EQIP) tool. Method A systematic review of online information on inguinal hernia repair was conducted using 4 search terms: “inguinal hernia”, “groin hernia”, “inguinal hernia repair” and “inguinoscrotal hernia”. The top 100 websites for each term identified using Google were assessed using the modified EQIP tool (score 0-36). Websites for the paediatric population or intended for medical professional use were excluded from analysis. Results 142 websites were eligible for analysis. 52.8% of websites originated from the UK. The median EQIP score for all websites was 17/36 (IQR 14-21). The median EQIP scores for Content, Identification and Structure were 8/18, 2/8, and 8/12, respectively. Complications of inguinal hernia repair were included in 46.5% of websites, with 9.2% providing complication rates and 14.1% providing information on how complications are handled. Conclusions This study highlights that the current quality of online patient information on inguinal hernia repair is poor, with minimal information available on complications, hindering patients’ ability to make informed decisions regarding their healthcare. To improve patient education, there is an immediate need for improved quality online resources to meet international standards.

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Comparison of Recurrence and Complication Rates Following Laparoscopic Inguinal Hernia Repair among Preterm versus Full-Term Newborns: A Systematic Review and Meta-Analysis

Children ◽

10.3390/children8100853 ◽

2021 ◽

Vol 8 (10) ◽

pp. 853

Author(s):

Zenon Pogorelić ◽

Sachit Anand ◽

Zvonimir Križanac ◽

Apoorv Singh

Keyword(s):

Systematic Review ◽

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Laparoscopic Hernia Repair ◽

Meta Analysis ◽

Laparoscopic Inguinal Hernia Repair ◽

Full Term ◽

Complication Rates ◽

Laparoscopic Inguinal Hernia

Background: Laparoscopic inguinal hernia repair (LHR) in children has been widely performed in the last decades, although it is still not sufficiently researched in preterm infants. This systematic review and meta-analysis compared the recurrence and complication rates following laparoscopic hernia repair among preterm (PT) versus full-term (FT) newborns. Methods: Scientific databases (PubMed, EMBASE, Scopus, and Web of Science databases) were systematically searched for relevant articles. The following terms were used: (laparoscopic hernia repair) AND (preterm). The inclusion criteria were all preterm newborns with a unilateral or bilateral inguinal hernia who underwent LHR. The main outcomes were the incidence of recurrence of hernia and the proportion of children developing postoperative complications in comparison with FT newborns following LHR. Results: The present meta-analysis included four comparative studies. Three studies had a retrospective study design while one was a prospective study. A total of 1702 children were included (PT n = 523, FT n = 1179). The incidence of hernia recurrence showed no significant difference between the PT versus FT groups (RR = 2.58, 95% CI 0.89–7.47, p = 0.08). A significantly higher incidence of complications was observed in the PT group compared to the FT group (RR = 4.05, 95% CI 2.11–7.77, p < 0.0001). The PT group of newborns accounted for 81% and 72% of the major and minor complications. The major complications were either non-surgical (i.e., severe respiratory distress requiring reintubation with prolonged ventilation (or high-frequency ventilation), seizures, bradycardia), or surgical (i.e., hydroceles requiring operative intervention and umbilical port-site hernia). Conclusions: LHR in PT infants is associated with similar recurrence rates as in FT infants. However, the incidence of complications is significantly higher in PT versus FT infants.

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LAPAROSCOPIC TOTAL EXTRAPERITONEAL (TEP) REPAIR OF INGUINAL HERNIA: A PROSPECTIVE CONTROLLED STUDY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2012.3.2 ◽

2012 ◽

pp. 9-14

Author(s):

Dinh Tuan Dung Phan ◽

Nhu Hiep Pham ◽

Loc Le

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Groin Hernia ◽

Controlled Study ◽

Complication Rates ◽

Tep Repair ◽

Totally Extraperitoneal ◽

Inguinal Hernias ◽

Laparoscopic Tep

Objectives: Inguinal hernia is the most common hernia and inguinal hernia repair is the most frequently performed operation in gerenal surgery. Hernioplasty by laparoscopy was gradually the standard method for inguinal hernia repair all over the world. The objective of this study is to demonstrate the effectness and safeness of laparoscopic totally extraperitoneal (TEP) hernia repair. Materials and methods: A prospective analysis of patients, admitted for groin hernia and operated by laparoscopic TEP hernia repair, performed between June 2010 and December 2011. Data were collected regarding general characteristics, complication rates, length of hospital stay and the recurrence rate postoperative of this laparoscopic method. Results: 35 patients underwent laparoscopic totally extraperitoneal (TEP) hernia repair with an average age of 51.3±13.8 years (range 31 – 72 years); 5.7% of the inguinal hernias were operated bilaterally, peritoneal laceration was noticed during dissection in 14.3%, there was no injury of the inferior epigastric vessels during dissection. Unilateral hernia had an operative time of 66.52 ± 17.4 minutes (range 45 – 115 minutes) and bilateral hernia took 107.5 minutes (range 95 – 120 minutes). All of these patients in the study were controlled, 5.7% had seroma at the time 3 months postoperative, there were no recurrences during follow-up ranging from 3 – 18 months (average 9.6 months). Conclusions: The laparoscopic (TEP) repair of inguinal hernia is safe and effective. That laparoscopy method should be the gold standard technique in treatment for the repair of inguinal hernias. Keywords: groin hernia – TEP hernioplasty - laparoscopy

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The Impact of Groin Surgery during Childhood on the Incidence of Inguinal Hernia Repair and Its Postoperative Complications in Adult Life

European Journal of Pediatric Surgery ◽

10.1055/s-0038-1641598 ◽

2018 ◽

Vol 29 (03) ◽

pp. 271-275

Author(s):

Arestis Sokratous ◽

Johanna Österberg ◽

Gabriel Sandblom

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Postoperative Complication ◽

Inguinal Hernia Repair ◽

Adult Life ◽

Operation Time ◽

Study Cohort ◽

Complication Rates ◽

Increased Risk ◽

The Impact

Background Pediatric inguinal hernia, hydrocele, and cryptorchidism are common congenital anomalies affecting children, and require surgical intervention in some cases. The association between surgical treatment of these conditions and acquired inguinal hernia later in life is poorly understood. The aim of this cohort study was to examine the effect of groin surgery during childhood on the incidence and surgical outcome of inguinal hernia repair in adult life. Materials and Methods Data from the Swedish Inpatient Register and the Swedish Hernia Register were cross-linked using the patient personal identity numbers. The incidence of inguinal hernia repair in patients 15 years or older in the study cohort, as well as postoperative complication rates, were compared with the expected incidence and complication rates extrapolated from the general Swedish population in 2014, stratifying for age and gender. Results Note that 68,238 children aged 0 to 14 years were found to have undergone groin surgery between 1964 and 1998. The median follow-up time after an operation in the groin was 30.8 years (21.0–50.0). Of those, 1,118 were found to have undergone inguinal hernia repair as adults (> 15 years old) between 1992 and 2013. The incidence of inguinal hernia repair in the cohort was significantly higher than that expected (1.43 [1.33–1.53]), both for men (1.32 [1.25–1.41]) and women (4.30 [3.28–5.55]). The incidence was also increased in the subgroup of patients that had undergone more than one procedure during childhood. No significant impact on postoperative complication rate, reoperation rate, or operation time was identified. Conclusion Individuals undergoing surgery in the groin during childhood are at increased risk for acquired inguinal hernia surgery later in life. Inguinal surgery during childhood did not affect the outcome of hernia repair in adult age.

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Glue versus suture for mesh fixation in open inguinal hernia repair

International Surgery Journal ◽

10.18203/2349-2902.isj20181127 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1443

Author(s):

Jeyakumar S. ◽

Tharun Ganapathy Chitrambalam ◽

Shruthi Chandrasekaran

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Operative Time ◽

Mesh Fixation ◽

Research Centre ◽

Complication Rates ◽

Suture Fixation ◽

Tissue Glue ◽

Significant Difference

Background: Inguinal hernia is the most common surgical problem presenting to the surgical OPD. Lichenstein’s tension free hernioplasty is the one of the first surgeries learnt by surgical residents. Pain after inguinal hernia surgery is found to be debilitating and alters the quality of life in several patients, which has been attributed to the traumatic fixation of the mesh with sutures. Hence this study, to compare traumatic and atraumatic methods of mesh fixation in inguinal hernia repair. The aim of this study was to compare suture fixation versus tissue glue fixation of the mesh in inguinal hernia repair. Objective was to compare the immediate and chronic post- operative pain, intra operative time and complications if any.Methods: This study was done in the General Surgery Department of SRM Hospital, Medical College and Research Centre, Kattangulathur after ethics committee clearance. It is a single blinded study conducted on 51 consenting patients and meeting the inclusion criteria from March 2016 to August 2017, of which 26 were selected for glue (N Butyl-2-Cyanoacrylate) fixation and 25 for suture fixation according to simple randomization. A note of the pain on VAS scale at various time intervals, operative time and any complications were also recorded was made.Results: Results developed using SPSS software show a significant difference in the intraoperative time by both methods, with glue taking a significantly lower time than sutures. A Significantly lower immediate and chronic postoperative pain is observed in the glue group. However, the complication rates in both the groups were found to be equal.Conclusion: It can thus be concluded from this study that tissue glue mesh fixation is superior to suture mesh fixation in open inguinal repair in terms of operative time, immediate and chronic post-operative time.

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Outcome of tension free open mesh repair of inguinal hernia

Journal of Surgical Sciences ◽

10.3329/jss.v22i1.44010 ◽

2020 ◽

Vol 22 (1) ◽

pp. 21-24

Author(s):

Mohammad Masum ◽

Md Aminul Islam ◽

Masflque Ahmed Bhuiyan ◽

Kazi Mazharul Lslam ◽

Md Selim Morshed ◽

...

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Mesh Repair ◽

Groin Hernia ◽

Synthetic Mesh ◽

Indirect Inguinal Hernia ◽

Prolene Mesh ◽

Tension Free ◽

Open Mesh Repair

Background: In the practice of General Surgery, hernia repair is the second most common procedure after appendectomy. Several methods have been developed over the years to try to improve hernia repair. Good result can be expected using Bassini's, McVay's, Shouldice's techniques provided the exact nature of hernia is recognized and the repair is done without tension using healthy tissue. The introduction of synthetic mesh started a new era in hernia surgery. The use of synthetic mesh repair of primary and recurrent hernias has gradually gained acceptance among surgeons. Objective: To find out the outcome and complications of open inguinal hernia repair with prolene mesh. Methods: This is a prospective cross sectional study conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from December, 2011 to May, 2012. One hundred patients of inguinal hernia admitted in different surgical units of BSMMU, Dhaka for elective surgery were studied. We have given 1 gm ijv Cephradine per operatively and then 500 gm cephradine ijv 6 hourly for 24 hours followed by oral form of Cephradine for next 5 days. Polypropylene mesh of 11 cm x 7 cm size was used in all cases. All the operations were done by open tension free prolene mesh repair technique. Patients were followed for one year to see the outcome. Results: Out of 100 cases of inguinal hernia, 71 patients (71%) had indirect inguinal hernia and 29 cases (29%) had direct inguinal hernia; 90 cases (90%) were primary hernia and only 10 cases (10%) were recurrent hernia; 58 cases were right sided, 34 cases (34%) were left sided and 8 cases (8%) were bilateral. Complications of mesh repair of groin hernia in this study included wound infection (5%), scrotal oedema (2%), mesh infection (0%), scrotal hematoma (2%), echymoces of peri-incisional skin (5%), early wound and groin pain (7%), chronic inguinodynia (2%), hernia recurrence (1%). Conclusion: In the present study an attempt is made to evaluate the outcome of patients undergoing inguinal hernia repair by prolene mesh. The results confirm that Lichtenstein tension free mesh repair of inguinal hernia is safe and reliable for both primary and recurrent groin hernia, with less recurrence rate. Patient's compliance was good with minimum morbidity. Journal of Surgical Sciences (2018) Vol. 22 (1): 21-24

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