Cost-Effectiveness of Open Versus Laparoscopic Repair for Primary Inguinal Hernia

1998 ◽  
Vol 14 (3) ◽  
pp. 472-483 ◽  
Author(s):  
Carmen D. Dirksen ◽  
André J. H. A. Ament ◽  
Eddy M. M. Adang ◽  
Geerard L. Beets ◽  
Peter M. N. Y. H. Go ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Cost Effectiveness ◽  
Return To Work ◽  
Laparoscopic Repair ◽  
Operating Time ◽  
Recurrence Rates ◽  
Hospital Perspective ◽  
Primary Inguinal Hernia ◽  
Bassini Repair ◽  
Open Versus

AbstractA cost-effectiveness (CE) analysis was performed of Bassini versus laparoscopic repair for primary inguinal hernia. Incremental costs per 1 -year recurrence-free patient were calculated for the societal and hospital perspective. From the hospital perspective, the incremental CE ratio of laparoscopic repair is 5.348 guilders. From the societal perspective, laparoscopic repair is both less costly and more effective than Bassini repair. Results were sensitive to assumptions about recurrence rates, laparoscopic operating time, and return to work. Laparoscopic repair should replace Bassini repair in order to benefit society. From the hospital perspective, the decision to accept laparoscopic repair depends on the willingness to pay.

Bassini repair compared with laparoscopic repair for primary inguinal hernia: a randomised controlled trial

2003 ◽  
Vol 164 (6) ◽  
pp. 439-447 ◽  
Author(s):  
Carmen D. Dirksen ◽  
Geerard L. Beets ◽  
Peter M. N. Y. H. Go ◽  
Ferd E. A. Geisler ◽  
Cor G. M. I. Baeten ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Randomised Controlled Trial ◽  
Laparoscopic Repair ◽  
Controlled Trial ◽  
Primary Inguinal Hernia ◽  
Bassini Repair ◽  
Randomised Controlled

scholarly journals Pre-peritonial Repair for Recurrent Inguinal Hernia after Tension free Hernioplasty

2019 ◽  
Vol 2 (3) ◽  
pp. 126-129
Author(s):  
Suresh Raj Poudel ◽  
Narendra Vikram Gurung ◽  
Dhruba Bahadur Adhikari ◽  
Arjun Acharya ◽  
Santosh Shrestha ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Return To Work ◽  
Hospital Stay ◽  
Operative Time ◽  
Operating Time ◽  
Recurrent Hernia ◽  
Recurrent Inguinal Hernia ◽  
Tension Free ◽  
Lichtenstein Hernioplasty ◽  
Stay Time

Background: Inguinal herniorrhaphy is a common general surgical operation. The repair of recurrent hernia is difficult surgery due to obscured and distorted anatomy and risk of further recurrence. The aim of this study is to determine the outcome in terms of operative time, hospital stay, return to work, complications and recurrence of open pre-peritoneal repair for recurrent inguinal hernias after Lichtenstein tension-free hernioplasty. Materials and Method: It is a prospective observational study conducted at Western Regional Hospital, Pokhara from 2013 to 2016. A total of eight patients including referred from other centers were included. Pre-peritoneal repair was performed on recurrent hernias after Lichtenstein tension-free hernioplasty. Age, sex, operating time, hospital stay, time to return work, postoperative complications and recurrence of patients were noted. Statistical analysis was done using SPSS- 21. Patients were called for follow up in 2 weeks, 3 months and 12 months time. Results: Out of eight patients, seven were male, one was female with mean age of 59.5 years. Recurrence was common on direct inguinal hernia (six patients) who had previous Lichtenstein hernioplasty. Mean operative time was 43.13 minutes (35 to 50 minutes), mean hospital stay was 2.5 days (2 to 4 days) and mean time to return to work was 8.12 days (7 to 10 days). There was hematoma formation in one patient. Conclusion: Pre-peritoneal mesh repair is easy, safe, with less operative time, short hospital stay, low recurrence and complication rate for recurrent inguinal hernia after Lichtenstein hernioplasty.  

scholarly journals Cost-effectiveness of alternative methods of surgical repair of inguinal hernia

2004 ◽  
Vol 20 (2) ◽  
pp. 192-200 ◽  
Author(s):  
Luke Vale ◽  
Adrian Grant ◽  
Kirsty McCormack ◽  
Neil W. Scott
Keyword(s):  
Inguinal Hernia ◽  
Cost Effectiveness ◽  
Laparoscopic Repair ◽  
Mesh Repair ◽  
Balance Sheet ◽  
Cost Effective ◽  
Synthetic Mesh ◽  
Alternative Methods ◽  
Economic Evaluations ◽  
Cost Effective Method

Objectives:To assess the relative cost-effectiveness of laparoscopic methods of inguinal hernia repair compared with open flat mesh and open non-mesh repair.Methods:Data on the effectiveness of these alternatives came from three systematic reviews comparing: (i) laparoscopic methods with open flat mesh or non-mesh methods; (ii) open flat mesh with open non-mesh repair; and (iii) methods that used synthetic mesh to repair the hernia defect with those that did not. Data on costs were obtained from the authors of economic evaluations previously conducted alongside trials included in the reviews. A Markov model was used to model cost-effectiveness for a five-year period after the initial operation. The outcomes of the model were presented using a balance sheet approach and as cost per hernia recurrence avoided and cost per extra day at usual activities.Results:Open flat mesh was the most cost-effective method of preventing recurrences. Laparoscopic repair provided a shorter period of convalescence and less long-term pain compared with open flat mesh but was more costly. The mean incremental cost per additional day back at usual activities compared with open flat mesh was €38 and €80 for totally extraperitoneal and transabdominal preperitoneal repair, respectively.Conclusions:Laparoscopic repair is not cost-effective compared with open flat mesh repair in terms of cost per recurrence avoided. Decisions about the use of laparoscopic repair depend on whether the benefits (reduced pain and earlier return to usual activities) outweigh the extra costs and intraoperative risks. On the evidence presented here, these extra costs are unlikely to be offset by the short-term benefits of laparoscopic repair.

scholarly journals Early results of laparoscopic repair for recurrent inguinal hernia by Trans-Abdominal Pre-Peritoneal (TAPP)

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Viêt Khánh Lê ◽  
Keyword(s):  
Inguinal Hernia ◽  
Hospital Stay ◽  
Laparoscopic Repair ◽  
Research Group ◽  
Operating Time ◽  
Surgical Site Infections ◽  
Control Group ◽  
Recurrent Inguinal Hernia ◽  
Tapp Repair ◽  
Early Results

Tóm tắt Đặt vấn đề: Đánh giá kết quả của phẫu thuật nội soi đặt lưới trước phúc mạc, đường vào qua phúc mạc (Trans-Abdominal Pre-Peritoneal: TAPP) điều trị thoát vị bẹn tái phát và so sánh với phương pháp Lichtenstein Phương pháp nghiên cứu: Nhóm nghiên cứu: 11 người bệnh (NB) (nam) được thực hiện phẫu thuật TAPP điều trị thoát vị bẹn tái phát sau mổ mở; nhóm chứng: 8 người bệnh thoát vị bẹn tái phát được thực hiện phẫu thuật Kết quả: Các đặc điểm về tuổi, chỉ số khối cơ thể (BMI), số bệnh lý kèm theo, đường kính cổ bao thoát vị và thời gian tái phát của người bệnh giữa 2 nhóm có sự tương đồng; ở nhóm phẫu thuật TAPP thời gian phẫu thuật dài hơn (TAPP 103,6 và Lich 86,9 phút, p = 0,223); thời gian sử dụng giảm đau sau mổ ngắn hơn (TAPP 1,9 và Lich 2,8 ngày, p = 0,009); thời gian nằm viện ngắn hơn (TAPP 4,2 và Lich 5,9 ngày, p = 0,009); thời gian trở lại công việc sớm hơn (TAPP 19,2 và Lich 26,0 ngày, p = 0,035); nhóm nghiên cứu không có biến chứng trong khi nhóm chứng có 2 trường hợp nhiễm trùng vết mổ và 2 trường hợp đau sau mổ. Kết luận: Phẫu thuật TAPP có hiệu quả tốt trong điều trị thoát vị bẹn tái phát sau mổ mở, sau mổ người bệnh ít đau hơn, giảm thời gian nằm viện, giảm biến chứng sau mổ Abstract Introduction: This study is to evaluate the early results of laparoscopic repair with mesh hernia by Trans-Abdominal Pre-Peritoneal (TAPP) compared with Lichtenstein Materials and Methods: 11 male patients were reoperated with TAPP repair for the recurrent inguinal hernia after open repair enrolled in research group; Control group including 8 patients were reoperated with Lichtenstein technique. Results: The characteristics of patients such as ages, body mass index (BMI), comorbid pathologies, size of neck of the inguinal sac and the recurrent times were similar in both groups; in research group, the operating time was longer (TAPP 103,6 vs Lich 86,9 mins, p=0,223) however the time for pain medication used was shorter (TAPP 1,9 vs Lich 2,8 days, p=0,009), the length of hospital stay was shorter (TAPP 4,2 vs Lich 5,9 days, p=0,009) than control group; in research group, there were no postoperative complication while in control group, there were two patients with postoperative surgical site infections, and two patients with postoperative pains. Conclusion: TAPP repair is an effective option for the treatment of recurrent inguinal hernia; shorter hospital stay, less pains as well as complications. Keywords: Recurrent inguinal hernia, TAPP, Lichtenstein

scholarly journals P030 OPEN VERSUS LAPAROSCOPIC UMBILICAL AND EPIGASTRIC HERNIA REPAIR: NATIONWIDE DATA ON SHORT- AND LONG-TERM OUTCOMES

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Nadia Henriksen ◽  
Lars Nannestad Jorgensen ◽  
Hans Friis Andersen ◽  
Frederik Helgstrand
Keyword(s):  
Surgical Site Infection ◽  
Laparoscopic Repair ◽  
Open Repair ◽  
Reoperation Rate ◽  
Site Infection ◽  
Recurrence Rates ◽  
Severe Condition ◽  
Term Operation ◽  
Open Versus

Abstract Aim The aim of the study was to evaluate the rates of 90-day readmission and reoperation for complication, together with rate of operation for recurrence after either open or laparoscopic mesh repair for primary umbilical or epigastric hernias with defect widths above 1 cm. Material and Methods A merge of data between the Danish Hernia Database and the National Patient Registry provided data from 2007-2018 on perioperative information, 90-day readmission, 90-day reoperation for complication, and long-term operation for hernia recurrence Results A total of 6,855 patients were included, of whom 4,106 (59.9%) and 2,749 (40.1%) patients had an open or laparoscopic repair, respectively. There were significantly more patients readmitted with a superficial surgical site infection 2.5% (102/4,106) after open repair compared with laparoscopic repair (0.5% (15/2,749), P < 0.001. The 90-day reoperation rate for complications was significantly higher for open repairs 5.0% (205/4,106) compared with laparoscopic repairs 2.7% (75/2,749), P < 0.001. The incidence of a reoperation for a severe condition was significantly increased after laparoscopic repair 1.5% (41/2,749) compared with open repair 0.8% (34/4,106), P = 0.010. The 4-year cumulative incidence of operation for recurrence was 3.5% after open and 4.2% after laparoscopic repairs, P = 0.302. Conclusions Recurrence rates were comparable between open and laparoscopic repair of umbilical and epigastric hernias. Open repair was associated with a significantly higher rate of readmission and reoperation due to surgical site infection, whereas the rate of reoperation due to a severe complication was significantly higher after laparoscopic repair.

scholarly journals Laparoscopic repair of primary unilateral inguinal hernia is it to pamper the ego of the surgeon

2017 ◽  
Vol 4 (5) ◽  
pp. 1765
Author(s):  
Suresh Kalyanasundar ◽  
Pradeep Kumar Bandi
Keyword(s):  
Inguinal Hernia ◽  
Return To Work ◽  
Laparoscopic Repair ◽  
Open Repair ◽  
Secondary Level ◽  
Distinct Advantage ◽  
Lichtenstein Repair ◽  
A Prospective Study ◽  
The Cost ◽  
Level Hospital

Background: The study compared the procedure of open Lichtenstein tensionless repair of primary unilateral incomplete uncomplicated inguinal hernia with laparoscopic preperitoneal repair by TEP in a rural secondary level hospital for plantation workers. The aim of the study was to compare both the procedures and if laparoscopic repair had any specific advantage over the conventional open repair with specific relation to time of return to work, recurrence and cost effectiveness of the procedures.Methods: This was a prospective study involving 200 cases which were detected and operated between 2006 and 2014 at our hospital and subsequently followed up till 2016 which is 2 years. The patients selected were plantation workers.Results: In all 200 cases got enrolled in the study 100 underwent open tensionless Lichtenstein repair and 100 of them underwent Laparoscopic repair-TEP.Conclusions: Primary unilateral uncomplicated incomplete inguinal hernia repaired by laparoscopic method has no distinct advantage with reference to return to work recurrence of hernia and the cost involved is more as compared to open Lichtenstein repair.

scholarly journals Inguinal Hernia Mesh Repair: The Factors to Consider When Deciding Between Open Versus Laparoscopic Repair

Cureus ◽  
2021 ◽  
Author(s):  
Sri Vallabh Reddy Gudigopuram ◽  
Ciri C Raguthu ◽  
Harini Gajjela ◽  
Iljena Kela ◽  
Chandra L Kakarala ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Laparoscopic Repair ◽  
Mesh Repair ◽  
Hernia Mesh ◽  
Open Versus ◽  
Hernia Mesh Repair

Comparison of Bassini Repair and Mesh-Plug Repair for Primary Inguinal Hernia: A Retrospective Study

Surgery Today ◽  
2001 ◽  
Vol 31 (7) ◽  
pp. 610-614 ◽  
Author(s):  
Kyosuke Miyazaki ◽  
Fumitaka Nakamura ◽  
Yoshiaki Narita ◽  
Mitsuru Dohke ◽  
Nobuichi Kashimura ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Retrospective Study ◽  
Mesh Plug ◽  
Primary Inguinal Hernia ◽  
Mesh Plug Repair ◽  
Bassini Repair ◽  
Plug Repair

A PROSPECTIVE STUDY OF RESULTS OF MESH HERNIOPLASTY AND MODIFIED DARNING IN PRIMARY INGUINAL HERNIA

2021 ◽  
pp. 20-23
Author(s):  
Rajat Suvra Moral ◽  
Aniruddha Sow ◽  
Rekha Priya
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Mesh Repair ◽  
Abdominal Cavity ◽  
Source Control ◽  
Recurrence Rates ◽  
Primary Inguinal Hernia ◽  
Study Results ◽  
Stay Time ◽  
A Prospective Study

INTRODUCTION: Hernia may be generally dened as a protrusion of abdominal viscera or a part of viscera outside the abdominal cavity through a natural or acquired defect. This denition, however, does not includeinternal hernias in which abdominal viscera, usually the small bowel, enter preformed intraperitoneal sacs commonly found around the duodenum, cecum, and sigmoid colon. AIMS AND OBJECTIVES: Inguinal hernia is one of the commonest surgical operations performed. There are many ways of repairing an inguinal hernia. Various techniques claim superiority over one another. The preferred method of inguinal hernia repair at all centres, particularly training institutes, utilize mesh because recurrence rates are low. However, it is shown that the less costly technique of “Darning” has the same incidence of complications and recurrence. This emphasizes the importance of training and supervision no matter which technique is employed. MATERIALS AND METHODS: Synthetic Non absorbable monolament material like polypropylene mesh andProlinne 2-0 Suture inGroin hernia repair. Patients with Groin hernia attending at OPD of SSKM Hospital and. CNMC&H, Kolkata, West Bengal. In SSKM Hospital-MARCH 2017 – SEPTEMBER 2018 and CNMC&H OCTOBER 2018- MARCH 2021, N=200 (n=100 in each group.) Randomized prospective parallel group study. RESULTS AND ANALYSIS: In proline darning, 8 patients had neuralgia Complications after hernia repair-( late>7 days) and 4 patients had scar tenderness Complications after hernia repair- (late >7 days) . In our study,72(72%) patients had Proline darning RIH Diagnosis, 4(4%) patients had Proline darning BLIH Diagnosis and 24(24%) patients had Proline darning LIH Diagnosis. SUMMARY: Thus the above study shows that there is no signicant difference between mesh/darn method of repair of primary inguinal hernia in terms of postoperative complications, duration of hospital stay, time of surgery, day off work provided necessary surgical skill, patient compliance, facilities are available. Though darning requires expertise in maintaining no tension during surgery, with little experience one can perform it with case and results similar to mesh repair. It is the cheaper and effective alternative to mesh repair in remote areas where availability of mesh and other facilities are difcult. CONCLUSION: So endogenous tissue is always superior to any foreign material once the mesh becomes infected it becomes resistant to healing and present with persistent sinus or stula or abscess. Source control is the applied histology of any inammatory process. Its foundation lies in the optimal harnessing off the process of inammation and tissue repair to expedite the resolution of infection. Endomesh created by using the endogenous tissue, internal oblique and transversusabdominis muscle and the use of redundanthernial sac is the future of herniorrhaphy operation.

Sign in / Sign up

Export Citation Format

Share Document