scholarly journals 997 A Systematic Review of Hernia Repair Simulation Models

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
T Pelly ◽  
J Vance-Daniel ◽  
C Linder

Abstract Introduction There are barriers to education in both open and laparoscopic hernia repair technique, due to the laparoscopic learning curve, as well as reduced theatre time for junior surgical trainees. This is particularly evident during the current COVID-19 pandemic. Simulation models may provide further opportunities for training in hernia repair outside of the traditional surgical apprenticeship model. Method A systematic review was carried out following PRISMA guidelines to identify and evaluate simulation models in hernia repair. Of the 865 records screened, 26 were found to be relevant. These were assessed for face, content, and construct validity, as well as attempts to assess educational impact. Results Simulation models were identified comprising of animal tissues, synthetic materials, as well as VR technology. Models were designed for instruction in repair of inguinal, umbilical, incisional and diaphragmatic hernias. 4 of the 21 laparoscopic hernia repair models described demonstrated validity across several domains, and 3 of these 4 models were part of simulation-based courses demonstrating transferability of skills learnt in simulation to the operating room. Of the 5 open hernia repair simulation models, none were found to have demonstrated an educational impact in addition to assessing validity. Conclusions Few models individually were able to demonstrate validity and educational impact. Several novel assessment tools have been developed for assessment of progress when performing simulated and real laparoscopic inguinal hernia repair. More study is required, particularly for open hernia repair, including randomized controlled trials with large sample sizes to assess the transferability of skills.

2019 ◽  
Vol 7 (1) ◽  
pp. 24
Author(s):  
Waleed Yusif El Sherpiny

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.


2018 ◽  
Vol 7 (2) ◽  
pp. 30-34
Author(s):  
Rohit Prasad Yadav ◽  
Dipendra Thakur ◽  
Bashu Dev Baskota ◽  
Amit Kumar Shah ◽  
Kaushal Samsher Thapa ◽  
...  

 Background: Hernia is the abnormal exit of an organ or fatty tissue, such as the bowel, through the weak wall of the cavity in which it normally resides. Repair of inguinal hernia is common surgical  procedures. This study aims to compare between laparoscopic and open hernia repair. Method: Study is non randomized comparative study. Study includes 76 patients who had undergone surgery for hernioplasty. Among them 38 undergone laparoscopic hernioplasty and 38 undergone open hernioplasty from June 2016 to August 2018. Results: Mean hospital stay was 2.95 days in group 1 and 4.03 in group 2 .VAS was found to be 2.45 in group 1 and 5.71 in group 2 which is significantly low in group 1 patients with p<0.001. Duration of surgery is more in group 1 with mean duration of 94.08 minutes comparing to group 2 with mean duration of 43.55 minutes (with p<0.001). Conclusion: Laparoscopic hernia repair offers advantages over open repair in terms of less hospital stay and lower pain score for patient not contraindicated for general anesthesia and complicated hernia.


2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Medhat M. Ibrahim

Introduction. Several laparoscopic treatment techniques were designed for improving the outcome over the last decade. The various techniques differ in their approach to the inguinal internal ring, suturing and knotting techniques, number of ports used in the procedures, and mode of dissection of the hernia sac.Patients and Surgical Technique. 90 children were subjected to surgery and they undergone two-port laparoscopic repair of inguinal hernia in children. Technique feasibility in relation to other modalities of repair was the aim of this work. 90 children including 75 males and 15 females underwent surgery. Hernia in 55 cases was right-sided and in 15 left-sided. Two patients had recurrent hernia following open hernia repair. 70 (77.7%) cases were suffering unilateral hernia and 20 (22.2%) patients had bilateral hernia. Out of the 20 cases 5 cases were diagnosed by laparoscope (25%). The patients’ median age was 18 months. The mean operative time for unilateral repairs was 15 to 20 minutes and bilateral was 21 to 30 minutes. There was no conversion. The complications were as follows: one case was recurrent right inguinal hernia and the second was stitch sinus.Discussion. The results confirm the safety and efficacy of two ports laparoscopic hernia repair in congenital inguinal hernia in relation to other modalities of treatment.


Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 853
Author(s):  
Zenon Pogorelić ◽  
Sachit Anand ◽  
Zvonimir Križanac ◽  
Apoorv Singh

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.


2019 ◽  
Vol 6 (9) ◽  
pp. 3353
Author(s):  
Mahim Koshariya ◽  
Mayank Soni ◽  
Prateek Malpani ◽  
Bhupendra Parmar ◽  
Shikha Shukla

Background: Hernias of the abdominal wall constitute an important public health problem. Laparoscopic inguinal hernia repair (TEP) is a minimal access surgical procedure as compared to open hernia repair. The objective of the study was to compare open and laparoscopic hernia repair in terms of safety, complications, morbidity, recurrence, post-op pain and hospital stay.Methods: This was a prospective observational comparative study. Total 50 patients were taken in this study; out of them 25 patients subjected to group A (open repair of inguinal hernia) and 25 patients subjected to group B (laparoscopic repair of inguinal hernia). Postoperatively patients were observed for any complications and followed up one year.Results: Present study shows high incidence of inguinal hernia in males. Mean operative time for open hernia repair group was less than laparoscopic hernia repair group. Time to return to normal work, duration of hospital stay and postoperative pain were less in laparoscopic hernia repair group than open hernia repair group. Out of 25 patients in laparoscopic hernia repair (TEP) 1 patient had recurrence but in open hernia repair group there was no recurrence.Conclusions: Laparoscopic hernia repair is quite safe; it has definite advantages in bilateral and recurrent cases, postoperative pain, early return to normal activities, less postoperative hospital stay and better cosmetic results although it has its own disadvantages in terms of recurrence rate, operative time and cost effectiveness.


2016 ◽  
Vol 18 (3) ◽  
pp. 62
Author(s):  
SM Bhattarai ◽  
G Simkhada ◽  
T Shah ◽  
RK Gupta

Introduction: Inguinal hernia is one of the major problems at B.P. Koirala Institute of Health Sciences (BPKIHS), a tertiary referral center. We perform Laparoscopic hernia repair as a routine procedure for groin hernias. This technique is highly demanding and complex. In our country the development of laparoscopic technique is still in a developing phase.Aims and objective: To present technical tips and trick in LIHR, which we experienced, as lead to preventing intra/post operative complication.Results: We have performed a total of 129 groin hernia repairs in 105 patients with M: F= 26:1 and mean age 41.97±20 (16-85). The mean length of hospital stay was 1.14 ± 0.35 days. Eight patients were converted to TAPP and 1 converted to open hernia repair due to operative difficulty. The complications encountered are pain (20), seroma(8) and epididymitis(2).Conclusion: In our experience LIHR (TEP) is safe method for routine management of groin hernias.


2020 ◽  
Vol 7 (9) ◽  
pp. 2985
Author(s):  
Dinesh Prasad ◽  
Yash Patel

Background: Chronic groin pain (inguinodynia) following inguinal hernia repair is a significant, though under-reported problem. Mild pain lasting for a few days is common following mesh inguinal hernia repair. However, moderate to severe pain persisting more than 3 months after inguinal herniorrhaphy should be considered as pathological. The main aim of this study was to assess the incidence of inguinodynia in inguinal hernia repair patients at a tertiary centre.Methods: This non-randomized retrospective study was undertaken in the department of general surgery, SMIMER Hospital, Surat, Gujarat, India from August 2016 to July 2019. Total 940 patients were operated for inguinal hernia repair during this period. Out of these 940 patients, only 460 patients could be traced for clinical evaluation as Surat is an industrial city with very high percentage of migrant population and so only, they were included in the study.Results: In this study, total 460 patients were included, in which 310 patients were operated for open inguinal hernia repair and 150 patients were operated for laparoscopic hernia repair. Total 102 (22.17%) patients has developed inguinodynia out of 460 patients evaluated in this series. Incidence of inguinodynia is more in open inguinal hernia repair than laparoscopic inguinal hernia repair i.e., 24.83% versus 16.67%. Incidence of testicular complication in inguinodynia patients is more in open inguinal hernia repair and non in laparoscopic repair.Conclusions: Authors conclude that overall incidence of inguinodynia is 22.17% and incidence of inguinodynia is higher in open hernia repair in comparison to laparoscopic hernia repair (24.83% versus 16.67%). The incidence of mild inguinodynia is approximately eight times more common than severe inguinodynia.


2022 ◽  
Vol 11 (2) ◽  
pp. 321
Author(s):  
Fu-Huan Huang ◽  
Po-Lung Cheng ◽  
Wen-Hsuan Hou ◽  
Yih-Cherng Duh

Objective: This systematic review and meta-analysis investigated the feasibility and effectiveness of laparoscopic hernia repair with the extraperitoneal approach in pediatric inguinal hernias. Summary Background Data: Inguinal hernia repair is the most common operation in pediatric surgical practice. Although open hernia repair (OHR) is a well-established procedure with good outcomes, studies have reported acceptable or even better outcomes of laparoscopic hernia repair with the extraperitoneal approach (LHRE). However, a meta-analysis comparing LHRE with OHR is lacking. Methods: PubMed, EMBASE, and Cochrane Library databases were searched for randomized controlled trials (RCTs) and comparative studies (prospective or retrospective). Outcomes were metachronous contralateral inguinal hernia (MCIH), hernia recurrence, surgical site infection, operation time, and hospitalization length. A meta-analysis was performed, and risk ratios (RR), weighted mean difference (WMD), and 95% confidence intervals (CI) were calculated using random-effects models. Results: Five RCTs and 21 comparative studies involving 24,479 patients were included. Lower MCIH incidence (RR: 0.11, 95% CI: 0.07 to 0.17; p < 0.00001) and a trend of shorter operation time (WMD: −11.90 min, 95% CI: −16.63 to −7.44; p < 0.00001) were found in the LHRE group. No significant differences in ipsilateral recurrence hernias, surgical site infection, and length of hospitalization were found between the groups. Conclusions: LHRE presented lower MCIH incidence and shorter operation times, with no increase in hernia recurrence, surgical site infection, or length of hospitalization. As more surgeons are increasingly becoming familiar with LHRE, LHRE would be a feasible and effective choice for pediatric inguinal hernia repair.


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