EP.TH.444Long-term recurrence and complication rates in patients with self gripping mesh hernia repair

Abstract Aim Assessment of long term complications of self gripping mesh used in different types of hernia repair procedures more than 4 years ago aiming to compare the results with sutured prolene mesh with regards to safety and efficacy. Methods 70 patients (3 emergency & 67 elective) ventral hernia repair procedures, done in 2016 using self gripping mesh, were followed for recurrence and complications on the long term. Results There were 2 right (6.45%) and 1 left (3.44%) inguinal hernia recurrences. There were no cases of chronic groin pain or foreign body sensation. As compared to the meta-analysis of postoperative pain using non-sutured or sutured single-layer open mesh repair for inguinal hernia, where 19 studies including 4531 patients analysed recurrence, no significant difference was found in recurrence rates between the 2 mesh repair groups after 1 year of follow-up. With regards to the incidence of chronic pain at 12 months, there was no significant difference between Self gripping and suture fixation. Conclusions The self-gripping mesh in this study has better results as compared with a sutured mesh regarding the incidence of chronic postoperative inguinal pain and foreign body sensation. Recurrence rates are comparable to most studies, however, long-term results still are based on relatively small patients numbers.

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Persistent foreign body sensation and pharyngeal pain due to retention of staples: an interesting sequelae of endoscopic stapling procedure

The Journal of Laryngology & Otology ◽

10.1258/0022215011907839 ◽

2001 ◽

Vol 115 (5) ◽

pp. 425-427 ◽

Cited By ~ 8

Author(s):

P. S. Arunachalam ◽

D. S. Cameron

Keyword(s):

Surgical Treatment ◽

Foreign Body ◽

Foreign Body Sensation ◽

Long Term Results ◽

Barium Swallow ◽

Pharyngeal Pouch ◽

X Ray ◽

Repeat Endoscopy ◽

Body Sensation

The surgical treatment of a pharyngeal pouch with endoscopic stapling diverticulotomy is a relatively new concept. Long-term results and complications are yet to be fully studied. We describe a patient who developed persistent pharyngeal pain and foreign body sensation due to retention of a clump of staples at the cricopharyngeal sphincter. This complication has not been reported before. This case highlights the need for repeat endoscopy rather than a barium swallow X-ray if the patients are symptomatic after stapling procedures.

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Desarda versus Lichenstein technique for primary inguinal hernia treatment: one year results of a randomised clinical trial

International Surgery Journal ◽

10.18203/2349-2902.isj20202578 ◽

2020 ◽

Vol 7 (7) ◽

pp. 2147

Author(s):

Pinak Pani Dhar ◽

Upasana Mohanty ◽

Raman Kumar Shankar

Keyword(s):

Chronic Pain ◽

Inguinal Hernia ◽

Foreign Body ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Operative Time ◽

Foreign Body Sensation ◽

Primary Inguinal Hernia ◽

Body Sensation

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.

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Comparison of tension free Desarda technique with Lichtenstein for inguinal hernia repair

International Surgery Journal ◽

10.18203/2349-2902.isj20191558 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1528

Author(s):

Abhishek Gupta ◽

Subash Chandra Sharma ◽

Janmejai Prasad Sharma ◽

Pradeep Singhal

Keyword(s):

Inguinal Hernia ◽

Foreign Body ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Cost Effective ◽

Foreign Body Sensation ◽

Everyday Activity ◽

Post Operative Pain ◽

Body Sensation

Background: Inguinal hernia is common surgical problem for which mesh based technique, particularly Lichtenstein repair is considered gold standard. However it has its own limitation such as foreign body sensation, wound infection, cord fibrosis, chronic pain, etc. Desarda technique for hernia repair is emerging technique for inguinal hernia repair known for its low cost procedure, less recurrence rate and feasibility of the procedure. The objective of the study was to compare treatment of primary inguinal hernia repair with these methods in terms of various operative and post-operative parameters.Methods: 64 patients included in the study and operated after randomization. Intra-operative time, local complication, return to everyday activity, post-operative pain, foreign body sensation and early recurrence were analysed.Results: 51 patients were analysed with a minimum follow up period of 3 months and rest were lost on follow up. Operative time was less in Desarda’s repair (28.24 vs. 30.88 min). Desarda repair was cost effective, return to everyday activity was early in Desarda group, there was significantly (p<0.001) less post-operative pain measured on VAS on 2nd POD, 7th POD and 1 month. No recurrence observed.Conclusions: Desarda repair is easy to perform and takes less time to perform, it is also cost effective. Desarda repair when compared with Lichtenstein was superior in terms of postoperative pain, return to everyday activity and no foreign body sensation. Desarda repair is superior to mesh based technique in terms of outcome.

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A comparative study between light and heavy polypropylene mesh in lichtenstein repair of inguinal hernia

International Surgery Journal ◽

10.18203/2349-2902.isj20175122 ◽

2017 ◽

Vol 4 (12) ◽

pp. 3933

Author(s):

Syed Nasiruddin ◽

Sridhar Suresh ◽

Jayanth D. H.

Keyword(s):

Inguinal Hernia ◽

Foreign Body ◽

Comparative Study ◽

General Surgery ◽

Polypropylene Mesh ◽

Mesh Repair ◽

Foreign Body Sensation ◽

Lichtenstein Repair ◽

Mesh Group ◽

Body Sensation

Background: Inguinal hernia repair is one of the most common surgical procedures performed in practice. Although numerous techniques have been described, currently tension free mesh repair is the standard of care in the treatment of hernias because of the low recurrence rates.Methods: A comparative study between Light and Heavy Polypropylene mesh in Lichtenstein repair of inguinal hernia was conducted at Department of General Surgery in MVJ Medical college and Research Hospital, Hoskote, Bangalore on patients admitted in Department of General Surgery between November 2014 to July 2016 undergoing Lichtenstein tension free mesh repair for inguinal hernia. The study is a prospective study. 30 Patients were in Light mesh group and 30 were in Heavy mesh group.Results: Age group of 31-40 yrs had highest incidence of inguinal hernia. Males outnumber Females in incidence of Inguinal Hernia. Foreign body sensation in Heavy mesh group is significantly high. Average of 26.7% of the patients had foreign body sensation in Heavy mesh group. Whereas in Light group average was 10%. Chronic pain also showed significant readings in Heavy mesh group. Stiffness over abdominal wall was complained by 10% of patients overall in the light mesh group whereas no patients had this complaint in light mesh group. Recurrence was high in light mesh group where total of 5 patients had recurrence and in heavy there were only 2 patients with recurrence.Conclusions: In my study light mesh has been proved to be better than heavy mesh in treatment of inguinal hernia.

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Desarda’s versus Lichtenstein technique of inguinal hernia repair: a comparative study

International Surgery Journal ◽

10.18203/2349-2902.isj20194431 ◽

2019 ◽

Vol 6 (10) ◽

pp. 3719

Author(s):

Mohammad Sadik Akhtar ◽

Suraj Kant Mani ◽

Yasir Alvi ◽

Parveg Alam ◽

Syed Amzad Ali Rizvi ◽

...

Keyword(s):

Physical Activity ◽

Inguinal Hernia ◽

Foreign Body ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Groin Pain ◽

Foreign Body Sensation ◽

Chronic Groin Pain ◽

Body Sensation

Background: Inguinal hernias rank among the commonest of all hernias and surgery is the only definitive treatment. We analyzed the outcomes of desarda tissue based repair in comparison with the standard Lichtenstein tension free mesh repair of primary inguinal hernia.Methods: A total of 164 patients were randomly allocated into two groups, Desarda (group D) or Lichtenstein (group L) (80 VS 84, respectively). The primary outcome measures were chronic groin pain and recurrence during the follow up period. Secondary outcome measures included operating time, post-operative pain scores, duration of post-operative hospital stay, time to return to basic physical activity and to work, foreign body sensation, and post-operative complications.Results: During two year follow up, no recurrence was detected in each group. Operative time was significantly less in the Desarda group (28.91±5.82 min as compared to 34.07±8.63 min in the Lichtenstein group). Postoperative day 1, day 3 and day 7 groin pain was more in the Desarda as compared to the Lichtenstein group. Basic physical activity, chronic groin pain, cost, seroma formation, foreign body sensation, were also significantly less in the Desarda group.Conclusions: The successful primary inguinal hernia repair without mesh implantation can be achieved using Desarda tissue based repair, as it is effective as the standard Lichtenstein tension free mesh repair. Shorter operative time, early return to basic physical activity, lower cost, less chronic groin pain, less foreign body sensation are potential benefits of Desarda repair and can be preferred for inguinal hernia repair.

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Slowly resorbable biosynthetic mesh: 2-year results in VHWG grade 3 hernia repair

Hernia ◽

10.1007/s10029-021-02453-1 ◽

2021 ◽

Author(s):

M. M. J. Van Rooijen ◽

T. Tollens ◽

L. N. Jørgensen ◽

T. S. de Vries Reilingh ◽

G. Piessen ◽

...

Keyword(s):

Quality Of Life ◽

Hernia Repair ◽

Hernia Recurrence ◽

Recurrence Rates ◽

Elective Repair ◽

Significant Difference ◽

Grade 3

Abstract Introduction Information on the long-term performance of biosynthetic meshes is scarce. This study analyses the performance of biosynthetic mesh (Phasix™) over 24 months. Methods A prospective, international European multi-center trial is described. Adult patients with a Ventral Hernia Working Group (VHWG) grade 3 incisional hernia larger than 10 cm2, scheduled for elective repair, were included. Biosynthetic mesh was placed in sublay position. Short-term outcomes included 3-month surgical site occurrences (SSO), and long-term outcomes comprised hernia recurrence, reoperation, and quality of life assessments until 24 months. Results Eighty-four patients were treated with biosynthetic mesh. Twenty-two patients (26.2%) developed 34 SSOs, of which 32 occurred within 3 months (primary endpoint). Eight patients (11.0%) developed a hernia recurrence. In 13 patients (15.5%), 14 reoperations took place, of which 6 were performed for hernia recurrence (42.9%), 3 for mesh infection (21.4%), and in 7 of which the mesh was explanted (50%). Compared to baseline, quality of life outcomes showed no significant difference after 24 months. Despite theoretical resorption, 10.7% of patients reported presence of mesh sensation in daily life 24 months after surgery. Conclusion After 2 years of follow-up, hernia repair with biosynthetic mesh shows manageable SSO rates and favorable recurrence rates in VHWG grade 3 patients. No statistically significant improvement in quality of life or reduction of pain was observed. Few patients report lasting presence of mesh sensation. Results of biosynthetic mesh after longer periods of follow-up on recurrences and remodeling will provide further valuable information to make clear recommendations. Trial registration Registered on clinicaltrials.gov (NCT02720042), March 25, 2016.

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O12 OPEN PREPERITONEAL INGUINAL HERNIA REPAIR, TREPP VERSUS TIPP IN A RANDOMIZED CLINICAL TRIAL

British Journal of Surgery ◽

10.1093/bjs/znab396.011 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Willem Bökkerink ◽

Giel Koning ◽

Patrick Vriens ◽

Roland Mollen ◽

Willem Akkersdijk ◽

...

Keyword(s):

Clinical Trial ◽

Inguinal Hernia ◽

Hernia Repair ◽

Learning Curve ◽

Randomized Clinical Trial ◽

Inguinal Hernia Repair ◽

Recurrence Rates ◽

Significant Difference ◽

Related Quality

Abstract Aim The preperitoneal mesh position for inguinal hernia repair showed beneficial results regarding Chronic Postoperative Inguinal Pain (CPIP) with low recurrence rates. Two open preperitoneal techniques, the TransREctus Sheath PrePeritoneal (TREPP) and the TransInguinal PrePeritoneal (TIPP) technique, were compared in a randomized clinical trial with the hypothesis of less patients with CPIP after TREPP due to complete avoidance of nerve contact. Materials and Methods Adult patients with a primary unilateral inguinal hernia were randomized to either TREPP or TIPP in four hospitals. Prior to the trial’s start the study protocol was ethically approved and published. Outcomes included CPIP after 1 year (primary outcome) and recurrence rates, adverse events and Health related Quality of Life (secondary outcomes). Follow-up was performed at 2 weeks, 6 months and 1 year. Results Baseline characteristics were comparable in both groups. Pain was less often present after TREPP at 2 weeks and 6 months, but the CPIP at rest at 1 year was comparable 1.9% after TREPP vs 1.4% after TIPP, p = 0.535). The overall recurrence rate was higher in the TREPP group, 8.9% vs 4.6%, p = 0.022). Corrected for a learning curve for TREPP, no significant difference could be assessed (TREPP 5.7% and TIPP 4.8%, p = 0.591). Conclusions both the TREPP and TIPP technique resulted in a low incidence of CPIP after 1 year follow-up. The TREPP method can be considered a solid method for inguinal hernia repair if expertise is present. The learning curve of the TREPP techniques needs further evaluation.

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A STUDY OF COMPARISON OF PURE TISSUE REPAIR (DESERDA) AND PROSTHETIC REPAIR (LICHTENSTEIN) METHODS FOR INGUINAL HERNIA REPAIR-A COMPARATIVE STUDY

10.36106/ijsr/9605824 ◽

2021 ◽

pp. 1-4

Author(s):

Harish Chauhan ◽

Daxesh Patel ◽

Nishan Gaudani

Keyword(s):

Chronic Pain ◽

Foreign Body ◽

Hernia Repair ◽

Operative Time ◽

Late Complication ◽

Normal Activity ◽

Foreign Body Sensation ◽

Prosthetic Repair ◽

Body Sensation

INTRODUCTION: An ideal hernia repair should be tension free, tissue based, with no potential damage to vital structures, no long term pain or complications and no recurrence. Although Lichtenstein's prosthetic repair is simple and safe, but it is also correlated with risk of infections, recurrence, chronic pain, testicular atrophy and infertility, foreign body sensations and chronic groin sepsis. Desarda hernia repair does not require mesh and provide more physiological support. It is simple, easy to learn. AIMS AND OBJECTIVES: a) To compare the operative time, postoperative stay and time required to return normal activity between two groups. b) To compare early complication rate and late complication rate between two groups. MATERIALAND METHODS: This observational study was conducted among patients admitted with the diagnosis of primary inguinal hernia in SMIMER, Surat. The patients were randomly allocated to either Lichtenstein or Desarda method of hernia repair. Operating time, post operative stay and duration of return to normal activity were recorded. Early complications were noted and the patients were followed up to 12 months for late complications (chronic pain, foreign body sensation, and recurrence). RESULTS: The mean operative time and postoperative stay did not show signicant differ for both groups. Patients operated by Desarda technique returned to normal activity signicantly early by 12.2 ± 2.54 days as compared to patients operated by Lichtenstein techniques (14.0 ± 2.76 days, p = 0.01). Most common early complication in both groups was pain (D group; 40.0%, Lgroup: 45.2%) followed by wound infection (D group; 8.0%, Lgroup: 6.5%) and seroma (D group; 0.0%, Lgroup: 3.2%). Occurrence of chronic pain was more in Lgroup (58.1%) as compared to D group (16.0%, p=0.001). None of the patients from D group had foreign body sensation. Foreign body sensation was observed only in ve patients of Lgroup (16.1%). Recurrence rate during one year in Lgroup (6.5%) was higher than D group (4.0%). CONCLUSION: Early return to work was potential benet of Desarda repair. Early complications were similar in both procedures. Desarda repair has lower incidence of chronic pain and foreign body sensation. However, there is no signicant difference for chronic pain in Desarda group when compared in same patients operated bilaterally with different technique. This study was conducted with small sample size with short follow up. Therefore, result of late complication in the present study may insufcient to conclude the probability of occurrence as longer follow up and larger sample size is required.

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