Inguinal Hernia Repair Using Self-adhering Sutureless Mesh: Adhesix™: A 3-Year Follow-up with Low Chronic Pain and Recurrence Rate

2016 ◽  
Vol 82 (2) ◽  
pp. 112-116 ◽  
Author(s):  
Malek Tabbara ◽  
Laurent Genser ◽  
Manuela Bossi ◽  
Maxime Barat ◽  
Claude Polliand ◽  
...  

To review our experience and outcomes after inguinal hernia repair using the lightweight self-adhering sutureless mesh “Adhesix™” and demonstrate the safety and efficacy of this mesh. This is a 3-year retrospective study that included 143 consecutive patients who underwent 149 inguinal hernia repairs at our department of surgery. All hernias were repaired using a modified Lichtenstein technique. Preoperative, perioperative, and postoperative data were prospectively collected. Incidence of chronic pain, postoperative complications, recurrence, and patient satisfaction were assessed three years postoperatively by conducting a telephone survey. We had 143 patients with a mean age of 58 years (17–84), who underwent 149 hernia repairs using the Adhesix™ mesh. Ninety-two per cent (131 patients) were males. Only 10 patients (7%) had a postoperative pain for more than three years. In our series, neither age nor gender was predictive of postoperative pain. Only one patient had a hematoma lasting for more than one month and only four patients (2.8%) had a recurrence of their hernia within three years of their initial surgery. Ninety per cent of the patient expressed their satisfaction when surveyed three years after their surgery. In conclusion, the use of the self-adhering sutureless mesh for inguinal hernia repair has been proving itself as effective as the traditional mesh. Adhesix™ is associated with low chronic pain rate, recurrence rate, and postoperative complications rate, and can be safely adopted as the sole technique for inguinal hernia repair.

2010 ◽  
Vol 76 (10) ◽  
pp. 1115-1118 ◽  
Author(s):  
Kristin Masukawa ◽  
Samuel E. Wilson

Chronic postoperative pain has been associated with mesh repair in meta-analysis of clinical trials. We compared the incidence of early complications, recurrence, and chronic pain syndrome in anatomic and mesh repairs in 200 patients. We defined chronic pain syndrome as pain in the inguinal area more than 3 months after inguinal hernia repair, patient referral to pain management, or necessity of a secondary procedure for pain control. The mean follow-up time was 4 years and 2 months for anatomic repair and 3 years and 7 months for mesh repair. The clinical outcomes did not reveal a significant disparity between the 100 consecutive patients who had mesh repair versus the 100 patients who had anatomic repair with regard to the incidence of superficial wound infection (0 vs 2%, P = 0.497), testicular swelling (12 vs 7%, P = 0.335), hematoma (1 vs 0%, P = 0.99), recurrence (3 vs 2%, P = 0.99), or chronic postoperative pain (4 vs 1%, P = 0.369). The anatomic procedure without mesh should continue to be offered to patients who have an initial inguinal hernia repair.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Mallikarjuna Manangi ◽  
Santhosh Shivashankar ◽  
Abhishek Vijayakumar

Background. Chronic postherniorrhaphy groin pain is defined as pain lasting >6 months after surgery, which is one of the most important complications occurring after inguinal hernia repair, which occurs with greater frequency than previously thought. Material and Methods. Patients undergoing elective inguinal hernioplasty in Victoria Hospital from November 2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for followup at end of six months. Detailed preoperative, intraoperative, and postoperative details of cases were recorded according to proforma. The postoperative pain and pain at days two and seven and at end of six months were recorded on a VAS scale. Results. Chronic pain at six-month followup was present in 89 patients constituting 39.4% of all patients undergoing hernia repair. It was seen that 26.9% without preoperative pain developed chronic pain whereas 76.7% of patients with preoperative pain developed chronic pain. Preemptive analgesia failed to show statistical significance in development of chronic pain (P=0.079). Nerve injury was present in 22 of cases; it was found that nerve injury significantly affected development of chronic pain (P=0.001). On multivariate analysis, it was found that development of chronic pain following hernia surgery was dependent upon factors like preoperative pain, type of anesthesia, nerve injury, postoperative local infiltration, postoperative complication, and most importantly the early postoperative pain. Conclusions. In the present study, we found that chronic pain following inguinal hernia repair causes significant morbidity to patients and should not be ignored. Preemptive analgesia and operation under local anesthesia significantly affect pain. Intraoperative identification and preservation of all inguinal nerves are very important. Early diagnosis and management of chronic pain can remove suffering of the patient.


2020 ◽  
Vol 7 (7) ◽  
pp. 2147
Author(s):  
Pinak Pani Dhar ◽  
Upasana Mohanty ◽  
Raman Kumar Shankar

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. 


2018 ◽  
Vol 5 (11) ◽  
pp. 3719
Author(s):  
Komal B. Gurung ◽  
Niroj Banepali ◽  
Rakesh R. Sthapit ◽  
Baikuntha Adhikari

Background: Laparoscopic inguinal hernia repair has been proven to be a safe and effective procedure for groin hernias. In recent years, many of the tertiary centers in Nepal have started performing laparoscopic hernia repair. With the availability of resources and the facilities, the laparoscopic repairs for inguinal hernias are going to be more accessible in near future in Nepal. The aim of this study was to compare the intraoperative events and postoperative complications of transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) techniques of laparoscopic inguinal hernia repairs.Methods: Out of 56 patients, 30 underwent TAPP and 26 TEP repairs for primary unilateral inguinal hernias and were prospectively analyzed. Patient demographics, past medical and surgical history, intraoperative, and postoperative events were recorded. Patients were followed-up for two years.Results: Demographic parameters were comparable in both the groups. The difference in mean operating time was statistically significant (longer in the TAPP group). Intraoperative events such as port-site bleeding and peritoneal tear were comparable in both groups. The immediate postoperative complications like skin ecchymosis, cord hematoma, and scrotal edema were comparable in both repairs.  Immediate postoperative pain was significantly lesser in TEP repair whereas the hospital stays and time to return to the normal physical activity were comparable in both groups.Conclusions: Both TAPP and TEP laparoscopic techniques are safe and effective for inguinal hernia repair. However, there are few advantages of TEP repair such as shorter duration of surgery and less postoperative pain.


2018 ◽  
Vol 5 (8) ◽  
pp. 2904
Author(s):  
Jenish Yogeshkumar Sheth ◽  
Foram Arvindbhai Modh

Background: Inguinal hernias have been treated traditionally with open methods of hernioplasty. But the trends have changed in last 2 decades with the introduction of laparoscopic inguinal hernia repair by transabdominal preperitoneal (TAPP) and total extra preperitoneal (TEP) surgery.Methods: The study was prospective type conducted from January 2010 to April 2018. 130 patients, who underwent laparoscopic inguinal hernia repair. 60 patients for TAPP and 60 patients for TEP. Preoperative, intraoperative, postoperative and follow up data was analysed.Results: From 130 patients,10 patient underwent open hernia repair due to anaesthetics reason. 93.3% primary hernias and 6.7% recurrent hernias. 50% was repaired by TEP and 50% by TAPP. Mean time taken for surgeries was 60-90 min. The intraoperative, postoperative complications rates were 1.2% and 7.4% respectively. Mean hospital stay was 1-5 days.Conclusions: laparoscopic inguinal hernia repair could be contemplated safely both via totally extra peritoneal as well as transperitoneal route even in our setup of developing country with modifications.


2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
M. R. Berndsen ◽  
Tomas Gudbjartsson ◽  
Fritz Hendrik Berndsen

Background and Aims. The aim of this prospective single-center study was to evaluate the outcome of inguinal hernia repair. Materials and Methods. A total of 485 inguinal hernias (452 patients and 33 patients with bilateral hernias) were operated between January 2004 and December 2010. Mean age was 56 years, and 93% were male. Patient demographics and operative data were collected, and the operating surgeon assessed the technical difficulty of the operation. Five years after surgery, a questionnaire evaluated recurrence and chronic discomfort according to the Cunningham scale. 372 responded (82%), and mean follow-up was 5.5 years. Results. There were 390 repairs for a primary and 62 for a recurrent hernia. Totally extraperitoneal (TEP) operation was most frequently performed (56%), transabdominal preperitoneal (TAPP) operation in 31%, and Lichtenstein and Shouldice in 12% and 2%, respectively. At 5-year follow-up, the primary outcome of chronic discomfort was 19.5%. The independent positive predictors were young age and operation for a recurrent hernia (OR: 3.7), with TEP operation reducing the risk of chronic discomfort (OR: 0.5). The secondary outcome was the recurrence rate of 2.5%. Risk factors were strenuous work (OR: 13.7), technically difficult repairs (OR: 7.2), and chronic discomfort (OR: 6.7). Conclusions. Every fifth patient had chronic discomfort in long-term follow-up. The recurrence rate was 2.5%, and a technically difficult procedure was a risk factor.


2021 ◽  
Vol 108 (Supplement_3) ◽  
Author(s):  
A Arango Bravo ◽  
V Sosa Rodríguez ◽  
E Pérez Prudencio ◽  
M Soto Dopazo ◽  
C Nuño Iglesias ◽  
...  

Abstract INTRODUCTION Chronic postoperative pain after inguinal hernia repair is one of the most prevalent sequel after inguinal hernioplasty. MATERIAL AND METHODS A retrospective descriptive study was done, studying 414 patients who underwent programmed anterior inguinal hernioplasty in our centre between 01/01/18 and 12/31/19. Laterality, the type of mesh used and fixation method are studied, as well as the appearance of early postoperative pain, at one month and after the third month. P < 0.05 is considered a statistically significant value. RESULTS Of 414 patients, 90.6% were male, with a mean age of 65.5 years. In 89.1% the surgery was unilateral and 8.7% was hernia recurrence. 46.1% presented pre-surgical pain. 10.4% presented pain in the first check-up and 1.9% chronic pain. In 81.4%, flat mesh was placed, fixing it with suture in 83.6%. Greater pain was observed in the first review in patients operated on for bilateral hernia (22%, p 0.006). No differences were found regarding age, sex or recurrent hernias. In bilateral hernias, recurrent hernias and hernioplasty with plug, more postoperative complications were observed with a p < 0.05. In those patients who present complications, postoperative pain was observed in the first review in 16% (p < 0,05). CONCLUSIONS Patients who underwent bilateral hernioplasty present more complications and greater postoperative pain in the first revision, but not after the third postoperative month. No differences were observed in chronic pain in primary vs recurrent hernias. Post-surgical complications are related to greater initial postoperative pain but not to chronic pain.


2020 ◽  
Vol 4 (2) ◽  
pp. 695-698
Author(s):  
Nuhi ARSLANI

Background: In this study we investigated the differences between tension free versus not tension free inguinal hernia repair in occurrence of various postoperative complications. Methods: The study included 65 male patients with direct or indirect inguinal hernia operated at the Department of Abdominal and General Surgery,  between March 2012 and March 2014. The patients were divided into two groups. Evaluated were postoperative complications.. Results: No statistically significant differences in incidences of postoperative complications between two groups (p<0.05). Conclusion: Obtained results show that tension-free mesh repair is equivalent to the not tension free hernia repair method with regards of postoperative complications, severity of postoperative pain and ambulance.


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