scholarly journals TP9.2.13Outcomes of Emergency Groin hernia repair: 30-months experience of a tertiary care hospital

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Dileep Kumar ◽  
Brandon Tan ◽  
Michael Guilbert ◽  
Mohamed Elsllabi ◽  
Girivasan Muthukumarasamy
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Femoral Hernia ◽  
Mesh Repair ◽  
Groin Hernia ◽  
Bowel Resection ◽  
Wound Complications ◽  
Suture Repair ◽  
Mesh Infection ◽  
Groin Hernia Repair

Abstract Aims Repair of Emergency groin hernia is variable across different regions and even within same units. Mesh is increasingly used these days. We aim to evaluate peri-operative and long-term outcomes over last 30-months. Methods Retrospective analysis of all emergency groin hernia repairs from January 2018- July 2020 in a tertiary Centre. Case notes and electronic patient records (clinical portal, PACS system etc.) used for data collection. Results Of 89 emergency groin hernia repairs 62(69.7%) males, 32/89 (35.9%) indirect inguinal hernia and 29 (32.5%) femoral hernia. Median age 72 years (range 20-95), 74(83.1%) primary hernia and 15(16.9%) recurrent hernias. Femoral hernia was most common in females 25/27 (92.5%) in contrast 58/62 males (93.5%) had inguinal hernia. All patients, except 1(1.1%) laparoscopic, had open repair, 11/89 cases (12.3%) required bowel resection, of those 10 (90.9%) had suture repair. Additionally, 6/89 cases (6.7%) needed laparotomy. Of 68/89 (76.4%) cases who had mesh repair, 52(76.4%) were inguinal and 23.5% (16/68) femoral hernia. Only 55% femoral hernias repaired with mesh. Median LOS was 3 days (range 0-54), 6/89 cases (6.74%) had wound complications (3 wound infections, 2 haematoma and 1 fluid collection). With median 19 months (range 6-36 months) follow-up, 1(1.1%) recurrence each in both mesh and suture repair groups, no mesh infection and 2/89 (2.2%) 30-day mortality recorded. Conclusion Mesh repair is increasingly used in emergency groin hernia repair without increased risk of mesh infection, although suture repair is still preferred in groin hernias requiring bowel resection.

Outcome of tension free open mesh repair of inguinal hernia

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

Laparoscopic repair of inguinal hernia: Prospective evaluation at a tertiary care center

2020 ◽  
Vol 23 (2) ◽  
pp. 54-58
Author(s):  
ABM Mahbubur Rahman ◽  
Tamjeed Alam ◽  
AHM Shamsul Alam ◽  
Fahim Ferdaus ◽  
Gazi Gias Uddin
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Groin Hernia ◽  
Tertiary Care ◽  
Groin Hernia Repair ◽  
Groin Hernias ◽  
Laparoscopic Groin Hernia Repair ◽  
Repair Techniques

Background: Treatment of groin hernias continues to evolve. The emergence of laparoscopic inguinal hernia surgery has challenged the conventional gold standard Lichtenstein’s tension free mesh repair. Laparoscopic technique to achieve surgical correction over groin hernia is increasingly being practiced in our country, and it is imperative to test the overall outcome of this technique in a tertiary care setting. Objectives: Current study was aimed at evaluating the per-operative events, early and late outcomes of laparoscopic groin hernia repair techniques. End points of evaluation were postoperative pain, hospital stay, resumption of normal activities, chronic pain and recurrence. Methods: Within a 2-year period, 45 patients of groin hernias of different clinical types underwent laparoscopic inguinal hernia repair in Bangladesh Medical College Hospital were recruited in this prospective observational study. Preoperative findings, intraoperative course, postoperative and follow-up data were analyzed to evaluate the outcomes. Observations were made regarding operating time, operative hazards, postoperative pain, incidence of early post-operative morbidities, hospital stay, resumption of activities. Total 24 months follow-up was carried out with regards to normal activity, late complications notably chronic groin pain and recurrence. Results: The mean age of 38.1±11.1 years, 27(60%) patients underwent TEP repair whereas, TAPP procedure was carried out in 18 patients (40%). For unilateral hernia repair using TEP technique, mean operative time was 50.3±4.2 mints and 61.7±5.3 mints for direct and indirect variety (D/I), with the corresponding rates for TAPP repair being 65.0±2.2 mints and 72.8±3.2 mints (D/I) respectively. Conversion rate to other operative procedure was 6.67%. The overall surgery related early post-operative morbidity was 7.4% (TEP) and 16.8% (TAPP). 3 out of 45 patients (6.67%) experienced chronic pain in the groin in the study. However, there was no single incidence of recurrence observed during the follow up period. Conclusion: Laparoscopic groin hernia repair techniques are safe and feasible, offers the benefits of minimally invasive surgery and becoming the procedure of choice specially for bilateral and recurrent inguinal hernias. Journal of Surgical Sciences (2019) Vol. 23(2): 54-58

scholarly journals Laparoscopic total extraperioneal mesh hernioplasty is a novel approach for inguinal hernia: our experience over 7 years

2019 ◽  
Vol 6 (11) ◽  
pp. 3982
Author(s):  
Dheer Singh Kalwaniya ◽  
Ranjith Mahadevan ◽  
Satya V. Arya ◽  
Jaspreet Singh Bajwa ◽  
Gowtham K. Gowda ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Mesh Repair ◽  
Wound Complications ◽  
Indirect Inguinal Hernia ◽  
Bilateral Inguinal Hernia ◽  
Hernia Surgery ◽  
Early Recovery ◽  
Inguinal Hernia Surgery ◽  
Laparoscopic Tep

Background: Inguinal hernia surgery is the most common performed surgery all over the world. Among them laparoscopic totally extra-peritoneal (TEP) mesh repair fulfils all the requirements with better clinical outcomes than other procedures.Methods: Data was collected from the inpatient and out-patient records of 60 patients who underwent laparoscopic TEP for unilateral or bilateral inguinal hernia in a single unit in the Department of General Surgery during May 2012-June 2019 including the two years of follow-up. 3D mesh was used for application and was fixed with tackers. Then patients were followed up in outpatient department after 1 week, 2 week, and 3 months, 6 months and yearly up to two years. In every visit post-operative pain (assessed by visual analogue scale), local wound complication (hematoma, seroma, wound infection) and recurrence were noted. The data was collected and evaluated and the results shown.Results: All patients were men, with average age of 36.5 years (range 32-58). On categorization 53 (88.3%) of them had unilateral inguinal hernia and 7 (11.6%) of them had bilateral inguinal hernia. Intra operatively 12 (20%) of them had direct inguinal hernia and 48 (80%) of them had indirect inguinal hernia. Haematoma was seen in 1 patients, surgical emphysema in 3, seroma in 5 and recurrence in 2 patients.Conclusions: Laparoscopic TEP mesh repair was effective and safe tool for hernia repair, in terms of lesser postoperative painless number of hospital days, early recovery and lesser wound complications. However recurrence rates are comparable with other methods of hernia repair.

scholarly journals Trends in Emergent Groin Hernia Repair—An Analysis From the Herniamed Registry

2021 ◽  
Vol 8 ◽  
Author(s):  
Ferdinand Köckerling ◽  
Till Heine ◽  
Daniela Adolf ◽  
Konstaninos Zarras ◽  
Dirk Weyhe ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Hernia Repair ◽  
Groin Hernia ◽  
Bowel Resection ◽  
Emergency Admission ◽  
Female Gender ◽  
Developed Countries ◽  
Perioperative Outcomes ◽  
Groin Hernia Repair ◽  
Gender And Age

Introduction: While the proportion of emergency groin hernia repairs in developed countries is 2.5–7.7%, the percentage in developing countries can be as high as 76.9%. The mortality rate for emergency groin hernia repair in developed countries is 1.7–7.0% and can rise to 6–25% if bowel resection is needed. In this present analysis of data from the Herniamed Registry, patients with emergency admission and operation within 24 h are analyzed.Methods: Between 2010 and 2019 a total of 13,028 patients with emergency admission and groin hernia repairs within 24 h were enrolled in the Herniamed Registry. The outcome results were assigned to the year of repair and summarized as curves. The total patient collective is broken down into the subgroups with pre-operative manual reduction (taxis) of the hernia content, operative reduction of the hernia content without bowel resection and with bowel resection. The explorative Fisher's exact test was used for statistical assessment of significant differences with Bonferroni adjustment for multiple testing.Results: The proportion of emergency admissions with groin hernia repair within 24 h was 2.7%. The percentage of women across the years was consistently 33%. The part of femoral hernias was 16%. The proportion of patients with pre-operative reduction (taxis) remained unchanged at around 21% and the share needing bowel resection was around 10%. The proportion of TAPP repairs rose from 21.9% in 2013 to 38.0% in 2019 (p < 0.001). Between the three groups with pre-operative taxis, without bowel resection and with bowel resection, highly significant differences were identified between the patients with regard to the rates of post-operative complications (4% vs. 6.5% vs. 22.7%; p < 0.0001), complication-related reoperations (1.9% vs. 3.8% vs. 17.7%; p < 0.0001), and mortality rate (0.3% vs. 0.9% vs. 7.5%; p < 0.001). In addition to emergency groin hernia repair subgroups female gender and age ≥66 years are unfavorable influencing factors for perioperative outcomes.Conclusion: For patients with emergency groin hernia repair the need for surgical reduction or bowel resection, female gender and age ≥66 years have a highly significantly unfavorable influence on the perioperative outcomes.

scholarly journals Late Ps. aeruginosa Inguinal Mesh Infection 12 Years after the Initial Operation: Report of the Case and Short Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Dimitrios Filippou
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Groin Hernia ◽  
Short Review ◽  
Mesh Infection ◽  
Initial Operation ◽  
E Coli ◽  
Open Inguinal Hernia Repair ◽  
Hernia Mesh Repair

Inguinal hernia mesh repair is one of the most frequent operations performed worldwide. The Lichtenstein technique and its various modifications are the most popular operations for groin hernia repair. The rate of surgical site infection (SSI) following inguinal hernia repair ranges between 0 and 14% in various series. Most of these infections developed early postoperatively. The incidence of late mesh infection following open inguinal hernia repair still remains unclear and highly variable. Late deep mesh infections are relatively rare specially after more than 10 years. The most common pathogens reported in the literature are E. coli and St. aureus. The infection is treated by conservative means initially but in case of failure then the mesh should be removed surgically. A unique case of a patient with very late (chronic) mesh infection is presented. The infection was due to Pseudomonas aeruginosa, which occurred 14 years after the initial operation and presented as subcutaneous fistula.

scholarly journals Current options in local anesthesia for groin hernia repairs

2011 ◽  
Vol 58 (3) ◽  
pp. 25-35 ◽  
Author(s):  
Hakan Kulacoglu ◽  
Alp Alptekin
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Local Anesthesia ◽  
Regional Anesthesia ◽  
Local Anaesthesia ◽  
Groin Hernia ◽  
Local Anaesthetics ◽  
Health Care Economics ◽  
Groin Hernia Repair ◽  
Solid Foods

Inguinal hernia repair is one of the most common procedures in general surgery. All anesthetic methods can be used in inguinal hernia repairs. Local anesthesia for groin hernia repair had been introduced at the very beginning of the last century, and gained popularity following the success reports from the Shouldice Hospital, and the Lichtenstein Hernia Institute. Today, local anesthesia is routinely used in specialized hernia clinics, whereas its use is still not a common practice in general hospitals, in spite of its proven advantages and recommendations by current hernia repair guidelines. In this review, the technical options for local anaesthesia in groin hernia repairs, commonly used local anaesthetics and their doses, potential complications related to the technique are evaluated. A comparison of local, general and regional anesthesia methods is also presented. Local anaesthesia technique has a short learning curve requiring simple training. It is easy to learn and apply, and its use is in open anterior repairs a nice way for health care economics. Local anesthesia has been shown to have certain advantages over general and regional anesthesia in inguinal hernia repairs. It is more economic and requires a shorter time in the operating room and shorter stay in the institution. It causes less postoperative pain, requires less analgesic consumption; avoids nausea, vomiting, and urinary retention. Patients can mobilize and take oral liquids and solid foods much earlier. Most importantly, local anesthesia is the most suitable type of anesthesia in elder, fragile patients and patients with ASA II-IV scores.

Case Report: Incarcerated femoral hernia containing ovary, unusual presentation of uncommon groin hernia

POCUS Journal ◽  
2016 ◽  
Vol 1 (3) ◽  
pp. 15-16 ◽  
Author(s):  
Priyank Gupta, MD, FRCR ◽  
Hadiel Kaiyasah, MRCS Glasgow ◽  
Mahra AlSuwaidi, MRCS Glasgow
Keyword(s):  
Case Report ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Femoral Hernia ◽  
Groin Hernia ◽  
Adult Population ◽  
Unusual Presentation ◽  
Peak Incidence ◽  
Groin Hernias

Of all groin hernias, femoral hernias account for around 2–8%. They occur four to five times more commonly in females than males and have a peak incidence in those between 30 and 60 years old [1,2]. In adult population, femoral hernias are more commonly found in patients with previous inguinal hernia repair [3].

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