scholarly journals Chronic Pain after Laparoscopic Inguinal Hernia Repair Depends on Mesh Implant Features: A Clinical Randomised Trial

2017 ◽  
Vol 1 (1) ◽  
pp. 014-020
Author(s):  
MR Langenbach ◽  
A Berengolts
QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hazem AbdelSalam Mohamed ◽  
Karim Fahmy ◽  
Mohammad Ahmad Abd-erRazik ◽  
Shaimaa Atef Ismaeil Awwad Elkomy

Abstract Background The fundamental mechanism of abdominal wall hernia formation is the loss of structural integrity at the musculotendinous layer. The exact cause of inguinal hernia is still unknown but the factors contributing in its occurrence include; preformed congenital sac, chronic passive rise in the intra-abdominal pressure and weak abdominal wall. Aim of the Work To assess intra-operative difficulties of laparoscopic inguinal hernia repair using two different meshes: The conventional polyproline mesh and the three-dimensional (3D) mesh, as regard the operative time. And early post-operative complications including post-operative seroma, early postoperative pain, chronic pain and limitation of function. Patients and Methods In our study 30 patients were recruited according to our preset inclusion and exclusion criteria. They were divided randomly into two groups, a group in which the 3D mesh was used and a group in which the polypropylene mesh was used. The study was conducted in Ain Shams University hospitals for 6 months, in which patients where followed up from 3 to 6 months and compared in terms of intraoperative time, post-operative pain after one week, restriction of physical activity, seroma formation and presence of chronic pain. Results In our study the mean application time (minutes) in 3D group was found to be 7.07 ± 2.66 while in PP group it was found to be 12.53±3.66 with highly statistically significant difference between them at p < 0.001. We believe that this difference in fixation time in our present study is attributed to easy insertion through the port, easy intraoperative handling, and easy unfolding of 3D mesh. Conclusion The use of three-dimensional mesh (3D mesh) for laparoscopic inguinal hernia repair is a safe and viable option. It offers many advantages in terms of less fixation time, shorter hospital stays, early recovery with a better movement limitation score. Whereas chronic pain was found to be similar in both groups. Further, elimination of tacks for fixation and shorter hospital stay may reduce the cost of 3D mesh. Longer-term studies are recommended with a larger sample size and follow up duration for better assessment of chronic pain, also for following up on recurrence.


Surgery ◽  
2020 ◽  
Author(s):  
Beau Forester ◽  
Mikhail Attaar ◽  
Sebastian Chirayil ◽  
Kristine Kuchta ◽  
Woody Denham ◽  
...  

2018 ◽  
Vol 99 (4) ◽  
pp. 712-716
Author(s):  
S V Tarasenko ◽  
A Yu Bogomolov ◽  
A A Natal'skiy ◽  
O V Zaytsev ◽  
O D Peskov ◽  
...  

Aim. Comparison of the immediate and long-term results of laparoscopic inguinal hernia repair with and without mesh implant fixation. Methods. The study included 145 patients over 18 years of both genders with inguinal hernias, including those with relapse after auto-hernioplasty. Patients underwent transabdominal preperitoneal hernioplasty with the application of mesh implant. Patients were randomly divided into two groups matched by age, sex and the type of hernias. In group 1 (n=71) patients underwent laparoscopic hernia repair without fixation, which in case of a direct inguinal hernia was supplemented with transverse fascia endoloop plication; and in group 2 (n=74) - laparoscopic hernioplasty using hernia stapler and/or endocorporal suture. Results. The duration of surgical intervention in compared groups did not differ significantly (p=0.92), there was no recurrence of hernia in either group. The patients of group 1 had less pain syndrome in the early postoperative period, which was expressed in a significantly lower need for narcotic analgesics in terms of the equivalent amount of morphine (p=0.03) and shorter duration of hospital stay (p=0.5). Advantages of laparoscopic hernioplasty without fixation are the following: (1) intensity of pain syndrome in patients operated by this method is less than in patients operated by the traditional method, during both the first 24 hours after the surgery (p=0.45) and on day 5 (p=0.69); (2) there is no need to purchase foreign-made devices (hernia staplers) and self-locking endoprostheses. Conclusion. The long-term and immediate results of laparoscopic inguinal hernia repair without mesh implant fixation are not inferior to the traditional methods of implant application; besides, the studied method has a raw of advantages.


2020 ◽  
Vol 24 (5) ◽  
Author(s):  
Carla Hipólito ◽  
Vicente Vieira ◽  
Virginia Antunes ◽  
Petra Alves ◽  
Adriana Rodrigues ◽  
...  

Background: Inguinal hernia is one of the most common conditions presented for surgical repair in children and laparoscopic approaches are increasingly performed. Previous studies have shown safety and efficacy in the use of supraglottic devices (SGD) as an alternative to tracheal intubation, which fits particularly well with outpatient anesthesia. Methodology: we conduct a retrospective observational study, collecting data from the electronic anesthetic form, from all patients aged 0 to 17 y who underwent ambulatory laparoscopic percutaneous internal ring suturing between February 2015 and August 2019, if I-gelTM was used to airway management. Results: We found 230 patients meeting the inclusion criteria. The mean age was 5.2 y old, mean weight 20.1 kg. All patients were ASA I (n=203) or ASA II (n=27). The mean surgery duration was 38 minutes. We found 4 respiratory adverse events, three bronchospasms, and one laryngospasm, managed in the operating room. Ninety percent of the surgeries were performed without neuromuscular blockade. Conclusion: I-gelTM was a safe, effective, and convenient alternative to airway management to laparoscopic inguinal hernia repair in the ambulatory setting. According to available literature, our practice did not represent an increased risk for the studied respiratory events. SGD obviates the need for neuromuscular blockade. Key words: I-gel; Supraglottic devices; Laparoscopy; Inguinal hernia repair; Pediatrics; Anesthesia, ambulatory Citation: Hipólito C, Vieira V, Antunes V, Alves P, Rodrigues A, Santos MJ. Airway management with I-gelTM for ambulatory laparoscopic inguinal hernia repair in children; a retrospective review of 230 cases. Anaesth. pain intensive care 2020;24(5): Received: 18 February 2020, Reviewed: 5 August, 6 September 2020, Accepted: 11 September 2020


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