Lower Incidence of Postoperative Pain after Open Inguinal Hernia Surgery with the Usage of Synthetic Glue-Coated Mesh (Adhesix®)

2018 ◽  
Vol 84 (12) ◽  
pp. 1932-1937
Author(s):  
Anna-Maria ThÖLix ◽  
Jyrki Kössi ◽  
Veikko Remes ◽  
Tom Scheinin ◽  
Jukka Harju
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Demographic Data ◽  
Mesh Fixation ◽  
University Hospital ◽  
Chronic Groin Pain ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery ◽  
Anchoring System

Chronic groin pain after inguinal hernia mesh repair is a common problem. Mesh fixation without sutures has been suggested to have several advantages over the traditional suture fixation. The aim of this study was to compare two self-adhering meshes, the glued Adhesix® (AH) and the gripping Parietene ProGrip® (PP), and evaluate their impact on postoperative chronic pain and overall recovery. Two consultant surgeons performed altogether 393 open inguinal hernia operations at the Helsinki University Hospital during 2014 to 2015. The two groups, AH (n = 169) and PP (n = 224) were similar and comparable in terms of demographic data. The data were collected and analyzed from the patients’ medical records in the hospital's register. The patients were followed up for a period of 19 months (5-31 months). The number of patient contacts due to postoperative pain was significantly less common in the AH group than in the PP group, 4/169 (2.4%) versus 19/224 (8.5%) patients, respectively ( P = 0.011). The duration of pain was under three months for most patients, only two patients in the PP group had pain for over one year. The pain was treated most patients with anti-inflammatory painkillers, whereas injections of a local anesthetic and corticosteroid, and chronic pain medication was needed in some cases. It seems that the use of glue-coated mesh (Adhesix®) was associated with less postoperative visits due to pain compared with the self-fixating mesh with absorbable anchoring system (ProGrip®). Further studies with long-term follow-up are needed to confirm these results.

SNP in TNFα T308G is predictive for persistent postoperative pain following inguinal hernia surgery

2012 ◽  
Vol 3 (3) ◽  
pp. 188-188
Author(s):  
Maija Kalliomäki ◽  
Anne-Li Lind ◽  
Alfhild Grönbladh ◽  
Ulf Gunnarsson ◽  
Gabriel Sandblom ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Significant Risk ◽  
Taqman Assay ◽  
Control Group ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery ◽  
Increased Risk ◽  
Persistent Postoperative Pain

Abstract Aim of investigation Persistent postoperative pain of some extent is seen in about 20% of patients after surgical operations, while 80% heal without chronic pain. The type of chronic pain that arises is mainly neuropathic, and is suggested to be in part regulated by genetic factors. In order to study the possible involvement of some candidate genes suggested to be involved in the processing of pain (BDNF, CACNA2D2, ORPM1, GRIK 3, GCH1 and TNF-α ), we performed a genetic association study in a well characterized clinical material of patients that had undergone surgery for inguinal hernia (n = 189). Of those 94 had developed a persistent postoperative pain state when investigated 2–3 years following the operation. The control group (n = 95) had undergone the same surgical procedure, and were pain free at follow up. Methods Genomic DNA was extracted from blood samples and genotyped by the Handy Bio-strand method and the TaqMan assay. Results The patients with persistent postoperative pain that had homozygous SNP in the TNF-α gene displayed increased risk of persistent postoperative pain with an odds risk of 2.42, compared the pain free controls. None of the other of the investigated genes were associated with significant risk of development of chronic pain following surgery. Conclusion The expression of TNF-α shows a significant impact on the risk of developing chronic pain after surgery. Further experimental and clinical studies are needed in order to fine map the TNF-α effect and to address underlying mechanisms.

Mesh fixation methods and chronic pain after transabdominal preperitoneal (TAPP) inguinal hernia surgery: a comparison between fibrin sealant and tacks

2017 ◽  
Vol 31 (10) ◽  
pp. 4077-4084 ◽  
Author(s):  
Kristoffer Andresen ◽  
Andreas Q. Fenger ◽  
Jakob Burcharth ◽  
Hans-Christian Pommergaard ◽  
Jacob Rosenberg
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Fibrin Sealant ◽  
Mesh Fixation ◽  
Hernia Surgery ◽  
Fixation Methods ◽  
Transabdominal Preperitoneal ◽  
Inguinal Hernia Surgery

scholarly journals Efficacy of Transversus Abdominis Plane Block and Rectus Sheath Block in Laparoscopic Inguinal Hernia Surgery

2015 ◽  
Vol 100 (4) ◽  
pp. 666-671 ◽  
Author(s):  
Katsushi Takebayashi ◽  
Masakata Matsumura ◽  
Yasuhiro Kawai ◽  
Takahiko Hoashi ◽  
Nagato Katsura ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Rectus Sheath ◽  
Transversus Abdominis ◽  
Block Group ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Hernia Surgery ◽  
Laparoscopic Inguinal Hernia ◽  
Inguinal Hernia Surgery

We aimed to assess the efficacy of transversus abdominis plane (TAP) block and rectus sheath (RS) block in patients undergoing laparoscopic inguinal hernia surgery. Few studies have addressed the efficacy and safety associated with TAP block and RS block for laparoscopic surgery. Thirty-two patients underwent laparoscopic inguinal hernia surgery, either with TAP and RS block (Block+ group, n = 18) or without peripheral nerve block (Block− group, n = 14). Preoperatively, TAP and RS block were performed through ultrasound guidance. We evaluated postoperative pain control and patient outcomes. The mean postoperative hospital stays were 1.56 days (Block+ group) and 2.07 days (Block− group; range, 1–3 days in both groups; P = 0.0038). A total of 11 patients and 1 patient underwent day surgery in the Block+ and Block− groups, respectively (P = 0.0012). Good postoperative pain control was more commonly observed in the Block+ group than in the Block− group (P = 0.011). TAP and RS block was effective in reducing postoperative pain and was associated with a fast recovery in patients undergoing laparoscopic inguinal hernia surgery.

Absorbable Meshes in Inguinal Hernia Surgery: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 24 (3) ◽  
pp. 289-298 ◽  
Author(s):  
Stina Öberg ◽  
Kristoffer Andresen ◽  
Jacob Rosenberg
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hernia Surgery ◽  
Absorbable Mesh ◽  
Inguinal Hernia Surgery ◽  
Increased Risk ◽  
Meta Analyses

Purpose. Absorbable meshes used in inguinal hernia repair are believed to result in less chronic pain than permanent meshes, but concerns remain whether absorbable meshes result in an increased risk of recurrence. The aim of this study was to present an overview of the advantages and limitations of fully absorbable meshes for the repair of inguinal hernias, focusing mainly on postoperative pain and recurrence. Methods. This systematic review with meta-analyses is based on searches in PubMed, Embase, Cochrane, and Psychinfo. Included study designs were case series, cohort studies, randomized controlled trials (RCTs), and non-RCTs. Studies had to include adult patients undergoing an inguinal hernia repair with a fully absorbable mesh. Results. The meta-analyses showed no difference in recurrence rates (median 18 months follow-up) and chronic pain rates (1 year follow-up) between absorbable- and permanent meshes. Crude chronic pain rates for the RCTs were 2.1% for the absorbable meshes and 7.6% for the permanent meshes. For the absorbable meshes, medial hernias were more susceptible for recurrence compared with lateral hernias ( P < .0005). None of the studies reported allergic reactions or other serious adverse events related to the absorbable mesh. Conclusions. Patients with an absorbable mesh seem to have less chronic pain following inguinal hernia surgery compared with permanent meshes, without increased risk of recurrence.

scholarly journals Chronic Pain after Inguinal Hernia Repair

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Mallikarjuna Manangi ◽  
Santhosh Shivashankar ◽  
Abhishek Vijayakumar
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Nerve Injury ◽  
Statistical Significance ◽  
Preemptive Analgesia ◽  
Preoperative Pain ◽  
Hernia Surgery

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.

A PROSPECTIVE STUDY OF N-BUTYL CYANO ACRYLATE GLUE FIXATION VERSUS SUTURE FIXATION OF MESH IN OPEN REPAIR OF INGUINAL HERNIA

2021 ◽  
pp. 21-24
Author(s):  
Shiv Kumar Bunkar ◽  
Anushree Jhunjhunwala ◽  
Kalpana Agrawal
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Controlled Study ◽  
Cyanoacrylate Glue ◽  
Hernia Surgery ◽  
Post Operative Period ◽  
Inguinal Hernia Surgery ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
Suture Group

BACKGROUND: The face of inguinal hernia surgery has been under constant evolution with improvements in surgical technique; together with the development of new prosthetic materials and a better understanding of how to use them. Till date, prevention of recurrence was the primary goal of any hernia surgery. With the advent of newer techniques the current focus has shifted to minimizing post-operative pain while continuing to ensure that the primary goal is met. The objective of our study was to compare suture xation of the mesh with non-mechanical xation using nbutyl cyanoacrylate (NBCA) glue for open inguinal hernia repair. METHODS: A prospective randomized controlled study was carried out at the General surgery department of J.L.N. Hospital, Ajmer between January 2019 and January 2020 consisting of 120 patients with uncomplicated inguinal hernia undergoing standard Lichenstein's mesh hernioplasty. Endpoints studied were postoperative acute and chronic pain, analgesic requirement in the post-operative period, duration of surgery and complications in the post operative period. RESULTS: Operative time was signicantly lesser in glue group as compare to suture group. There was no signicant difference in the post-operative pain during the entire timeline except at 24 hrs post procedure. However, 2 patients in suture group had chronic pain and complained of mild pain at 6 months follow up and even beyond. Post-operative complications were comparable in both groups. CONCLUSION: Our study help us to conclude that mesh xation with N butyl 2 cyanoacrylate glue is superior to sutures in several aspects.

scholarly journals Lessons Learned from the Student’s Surgery Academic League: Is It Worth It?

2020 ◽  
Vol 44 (1) ◽  
Author(s):  
Luiz Eduardo Correia Miranda ◽  
Ana Clara Galindo Miranda ◽  
Diego Laurentino de Lima ◽  
Ana Karla Alves Arraes
Keyword(s):  
Inguinal Hernia ◽  
Medical Students ◽  
General Surgery ◽  
Surgical Techniques ◽  
Surgical Care ◽  
Lessons Learned ◽  
University Hospital ◽  
Undergraduate Medical Students ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery

Abstract: Introduction: One of the great challenges of a medical school curriculum is to offer training in basic surgical techniques, which allows graduates to develop competences to take care of simple cases presented in the primary care level of SUS. In order to approach the problem of the technical-surgical qualification of medical students and taking advantage of the interest raised by students’ leagues, a surgical care project directed at patients with inguinal hernia was proposed and carried out, based on the students’ academic leagues. The aim of this study is to disclose and discuss the results and the academic experience learned from a students’ league in surgical learning. Methods: This report encompasses the three-year experience of an academic league aiming to approach the problem of the technical-surgical qualification of medical students and which takes advantage of the academic leagues among undergraduate medical students. The participants comprised one general surgery professor, one anesthesiologist, and undergraduate medical students interested in the surgical clinic, from the School of Medicine, University of Pernambuco, Recife (PE), Brazil. Results: Twenty-four students were included. Ninety-six patients were submitted to surgery. Two seminars with nine lectures and one workshop on surgical skills were held. One paper entitled “League of Inguinal Hernia Surgery” was presented. We did not observe hernia recurrences; the surgical complications were minimum and small in number. The students showed fast development of surgical, interpersonal, and communication skills. However, this education model included a small number of students and offered heavy competition to the general surgery residents in their first year at the University Hospital. Conclusion: The academic league in surgery allows a rich pedagogical experience, offering the opportunity for human and technical qualification. However, the proposed model has limitations. In our opinion, it does not represent a solution for the flaws and omissions observed in the school’s curricular grid.

Laparoscopic inguinal hernia repair in children via PIRS (percutaneous internal ring suturing)

2020 ◽  
Vol 99 (6) ◽  
pp. 277-281
Keyword(s):  
Inguinal Hernia ◽  
Pediatric Surgery ◽  
Inguinal Canal ◽  
Operating Time ◽  
Initial Study ◽  
University Hospital ◽  
Internal Ring ◽  
Hernia Surgery ◽  
Safe Alternative ◽  
Inguinal Hernia Surgery

Introduction: The miniinvasive approach is a trend in pediatric surgery nowadays. The new surgical technique called percutaneous internal ring suturing (PIRS) is a promising method bringing all the benefits of miniinvasive surgery. Methods: Prospective study of patients operated on using the PIRS technique from 01 January 2018 to 01 January 2020 at the Department of Pediatric Surgery, 2nd Faculty of Medicine, Charles University, University Hospital Motol. Results: 73 patients (25 boys and 48 girls) were operated on using PIRS. The median age was 68 months. 90 % of operations were performed by the same team of surgeons. During the procedure there were found 53 right-sided and 38 left-sided inguinal hernias. In 18 cases the hernia was bilateral, but only in 13 cases was this diagnosis made before the operation. A non-absorbable stitch was used in 57 cases to close the internal ring of the inguinal canal, and a non-absorbable monofilament in 16. The median operating time was 34 minutes. There were 3 recurrences (3.3 %) in our study. Conclusion: In our initial study, the PIRS technique proved to be a safe alternative method to the open inguinal hernia surgery. This method provides the benefit of allowing to revise the contralateral inguinal canal as a prevention of a metachronous inguinal hernia. The cosmetic results were excellent.

Evaluation of Chronic Groin Pain Rates After TEP Hernioplasty – A Single-Center Study

2019 ◽  
Vol 12 (2) ◽  
pp. 153-156
Author(s):  
Dobromir D. Dimitrov
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Groin Pain ◽  
Mesh Fixation ◽  
University Hospital ◽  
Chronic Groin Pain ◽  
Minimal Risk ◽  
Preoperative Pain ◽  
Total Extraperitoneal

Summary Total extraperitoneal hernioplasty (TEP) has become increasingly used by surgeons. The TEP procedure is technically more challenging due to space constraints and has a higher learning curve. Chronic groin pain after inguinal hernia repair has become the dominant outcome investigated rather than recurrence. We aimed to evaluate the rate of chronic groin pain after TEP inguinal hernia repair performed at the Department of Surgical Oncology in G. Stranski University Hospital – Pleven. The procedures performed totaled 36. There was one conversion, and the patient was excluded from the study because the procedure performed was not laparoscopic. Distribution according to inguinal hernia type was: 41.7% - indirect hernia (15), 36.1% - direct hernia (13), 13.9% combined (5), and 8.3% femoral (3). Twenty-eight of the patients (80%) had preoperative pain. Two of the patients with chronic groin pain had had their meshes fixed with tacks (14.3% from the tack group with p=0.7). Our study showed that the TEP procedure is a safe, feasible operation with minimal risk for complications. Using tacks for mesh fixation is associated with higher rates of chronic groin pain, but it does not affect the recurrence rate, which correlates with the literature review data.

Sign in / Sign up

Export Citation Format

Share Document