Endovideogernioplasty in patients with inguinal hernias: advantages and disadvantages

2021 ◽  
Vol 23 (3) ◽  
pp. 93-100
Author(s):  
Pavel N. Romashchenko ◽  
Alexander A. Kurygin ◽  
Valery V. Semenov ◽  
Alexey A. Mamoshin

This study analyzed the results of treatment of patients with inguinal hernias, with an assessment of the advantages and disadvantages of endovideosurgical hernioplasty techniques. The clinical study used the data of 1317 patients with inguinal hernias. The results revealed that the totally extraperitoneal inguinal hernia repair had some advantages over laparoscopic hernioplasty, such as a shorter duration of surgery (43 15 min), mild pain on a visual analog scale, and an average bed-day after surgery. Complications were diagnosed in 16 (1.2%) patients, and most had ClavienDindo grade II complications. Relapses were detected in 7 (0.5%) cases. Thus, endoscopic hernioplasty (laparoscopic and totally extraperitoneal inguinal hernioplasty) was the preferred surgery for patients with bilateral inguinal hernia, recurrent hernia after traditional hernioplasty, and metabolic syndrome and young people of working age. The use of a modified technique of totally extraperitoneal inguinal hernioplasty with a clear understanding of the multifascial structure of the anterior abdominal wall may reduce the risks of both intraoperative and postoperative complications and increase the cost-effectiveness of treatment of patients with inguinal hernias, allowing us to obtain good results.

2018 ◽  
Vol 10 (1) ◽  
pp. 6-10
Author(s):  
Sami Ahmad ◽  
Nadim Ahmed ◽  
Jawher Lal Singha ◽  
Ferdoush Rayhan ◽  
ASM Farhad Ul Hassan ◽  
...  

Background: In a remote district city of Bangladesh, inguinal hernias were repaired by Maloney (Darning) method.Efficacy of Darning repair was compared in this study.Aims and Objectives: The aim of this study was to determine the feasibility of doing Maloney ( Darn ) repair for adult inguinal hernias by specialist surgeons at remote districts . Age of the patients in ourstudy were above 20 years.Study Design: A descriptive retrospective study.Materials and Methods:In our study we included 2000 patient of inguinal hernia surgery repairs from May 2012 through June 2017. In the patients of the study group we repaired inguinal hernia by Maloney ( Darning) technique. Number of patients were 2000 ( male 1990 [99.5%] female 10 [.5%] with a mean age of 45.7 years. There were 1002(50.1%) hernias on the right side, 890(44.5%) were on the left side and 108(5.4%) were bilateral. Among the hernias 1419 ( 70.9%) were indirect, 575 (28.7%) were direct and 4 (0.2%) were of both direct and indirect (Pantoolon type), 2 (0.1%) were of femoral hernia. All were of primary hernias, recurrent hernias and hernias in patients with apparently weak musculature were repaired by Lychtenistein method with prolein mesh and were not included in this stpudy. 60 (3%) patients had feature of incarceration and 20 (1%) patients presented with obstruction. Among the obstructed hernias 8 (.4%) had strangulation and in 2 (.1%) resection and anastomosis were required for gangrenous ileum. In rest of the cases of strangulation circulation returned after incising the constricting ring and hot mob compression. We used IV antibiotic for 24 hours stated with induction of anaesthesia followed by oral for next 6 days. We used Injection Ceftrixone followed by Cefixime and in some patients Flucloxacillin.Statistics Analysis Used: Simple frequencies, proportion and cross tabulation.Results: Average duration of surgery was 70 minutes. There was no perioperative mortality. 90 (4.5%) patients developed mild subcutaneous wound infection, haematoma occurred in 160 ( 8% ) patients and seroma found in 300 ( 15% ) patients. All haematoma and seroma subsided gradually. Only 1 patient needed secondary closure for infected wound gap. The average duration of hospitalization was 3 days. All patients in study group are still in contact with me. Three patients (0.15%) had recurrences. All the recurrent cases reported within 6 months of their operations. Among the three age of 2 patients was above 60 and one patient of age above 70 had Maloney hernia repair for obstructed hernia.Conclusion:In remote places where prolene mesh is not available or is costly we can repair inguinal hernia by Maloney operation with very simple antibiotics with good results in comparison with other methods.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 6-10


2017 ◽  
Vol 176 (3) ◽  
pp. 77-80 ◽  
Author(s):  
A. B. Guslev ◽  
D. F. Cherepanov ◽  
G. M. Rutenburg ◽  
S. S. Yeltsin

OBJECTIVE. The authors investigated different methods of hernioplasty. MATERIAL AND METHODS. Endovideosur gical inguinal hernioplasty was performed in 3900 patients at the period from 1994 to 2016. The article described the developed and implemented techniques, strategy of surgical treatment, the choice of the type and size of prostheses in patients with different variants and complex forms of inguinal hernias. RESULTS. Specific postoperative complications were analyzed and suggested the methods of their prevention. CONCLUSIONS. The analysis of results was made. The authors gave recommendations concerning the technique of operative intervention.


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.


2017 ◽  
Vol 4 (4) ◽  
pp. 1244
Author(s):  
Sudarshan P. B. ◽  
Sundaravadanan B. S. ◽  
Prabu Shankar S.

Background: The two common procedures which are nowadays commonly performed for laparoscopic repair of inguinal hernia are transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) mesh repair. This retrospective study was aimed to compare these two, TAPP and TEP laparoscopic approaches for inguinal hernia repair in terms of various outcomes.Methods: In this retrospective study, we included 50 cases of inguinal hernia who underwent laparoscopic approach of inguinal hernia repair at Saveetha medical college and hospital between 2014 and 2016 for a duration of 3 years. Various parameters including the age, sex of patient, type of hernia, preoperative and post-operative complications, duration of hospital stay was analysed.Results: Of the 50 patients who underwent laparoscopic repair, 26 patients underwent TEP and 24 patients under went TAPP procedure. 31 cases were indirect inguinal hernias and 30 cases were direct inguinal hernias, totalling 61 hernia repairs, as 11 patients had bilateral hernia. One female inguinal hernia and 4 cases of recurrent hernia were operated by TAPP method. Postoperative complications like seroma formation; subcutaneous emphysema was seen in TEP group. Two cases of TEP were converted to TAPP and open lichenstein procedure. Postoperative pain was less in both the group. Patients who underwent TEP procedure spent less time in the hospital compared to those who underwent TAPP procedure.Conclusions: There is no major difference in the outcome after TEP and TAPP surgeries except for some minor complications and the results are comparable in both techniques TAPP and TEP. Both the procedures can be practiced according to surgeon’s familiarity of the procedure.


2019 ◽  
Vol 21 (1) ◽  
pp. 113-117
Author(s):  
A A Polyakov ◽  
I V Mikhin ◽  
O A Kosivtcov ◽  
L A Ryaskov

Introduction. Inguinal hernia is one of the most common diseases and occurs mainly in men of working age. The development of surgery and endoscopic technology made it possible to look at this pathology from the other side and move on to pathogenetically substantiated minimally invasive methods of treatment. The aim of the study. To improve the results of the endohernioplasty in inguinal hernias by improving the techniques and determining the advantages and disadvantages of various options for positioning mesh. Materials and methods. The paper reflects the experience of 203 endovideosurgical allohernioplasty in 161 patients using transabdominal preperitoneal (TAPP) and extraperitoneal techniques (TEP, e-TEP). Results. Intraoperative damage to the sigmoid colon occurred twice with sliding inguinal hernias on the left at the beginning of TAPP, one injury required a laparotomy, the other was eliminated laparoscopically. When performing 55 extraperitoneal hernia repair, there were no complications. Long-term results were traced from 6 to 36 months; no relapses were identified. Conclusion. Due to its advantages, the endovideosurgical technique for the treatment of inguinal hernias is a priority, e-TEP access are easier to learn and can be used even in difficult cases, expanding the surgeon’s capabilities and is the first step to master extraperitoneal approaches to other abdominal hernias.


2012 ◽  
pp. 9-14
Author(s):  
Dinh Tuan Dung Phan ◽  
Nhu Hiep Pham ◽  
Loc Le

Objectives: Inguinal hernia is the most common hernia and inguinal hernia repair is the most frequently performed operation in gerenal surgery. Hernioplasty by laparoscopy was gradually the standard method for inguinal hernia repair all over the world. The objective of this study is to demonstrate the effectness and safeness of laparoscopic totally extraperitoneal (TEP) hernia repair. Materials and methods: A prospective analysis of patients, admitted for groin hernia and operated by laparoscopic TEP hernia repair, performed between June 2010 and December 2011. Data were collected regarding general characteristics, complication rates, length of hospital stay and the recurrence rate postoperative of this laparoscopic method. Results: 35 patients underwent laparoscopic totally extraperitoneal (TEP) hernia repair with an average age of 51.3±13.8 years (range 31 – 72 years); 5.7% of the inguinal hernias were operated bilaterally, peritoneal laceration was noticed during dissection in 14.3%, there was no injury of the inferior epigastric vessels during dissection. Unilateral hernia had an operative time of 66.52 ± 17.4 minutes (range 45 – 115 minutes) and bilateral hernia took 107.5 minutes (range 95 – 120 minutes). All of these patients in the study were controlled, 5.7% had seroma at the time 3 months postoperative, there were no recurrences during follow-up ranging from 3 – 18 months (average 9.6 months). Conclusions: The laparoscopic (TEP) repair of inguinal hernia is safe and effective. That laparoscopy method should be the gold standard technique in treatment for the repair of inguinal hernias. Keywords: groin hernia – TEP hernioplasty - laparoscopy


2014 ◽  
pp. 35-39
Author(s):  
Quoc Phong Le ◽  
Nhu Hiep Pham ◽  
Van Lieu Nguyen ◽  
Dinh Tuan Dung Phan ◽  
Loc Le

Background: Inguinal hernia is a common disease in general surgery, it is treated by total extraperitoneal (TEP) procedure. It is also applicated in the worldwide. Study objectives: The results of use polypropylene mesh by TEP for inguinal hernias. Materials and Method: Prospective study of 93 patients with 102 inguinal hernias hernioplasty by TEP from November 2010 to March 2013 in Hue Central Hospital. Results: The mean age 51.9 ± 19, primary hernia 94.1%, recurrent hernia 5.9%, hematoma 3.2%, seroma 9.5%, wound infection 0%, conversion 6.9%, recurrence rate 1.1%. Conclusions: Hernioplasty by TEP for inguinal hernias are valuable and effective, shorter surgical time, low complications post-operation and low recurrence rate. Keywords: inguinal hernia; TEP


2017 ◽  
Vol 74 (8) ◽  
pp. 773-777
Author(s):  
Miroslav Ilic ◽  
Srdjan Putnik ◽  
Ivan Kuhajda ◽  
Dejan Ivanov

Background/Aim. Despite a huge success in decrease rate of recurrences of inguinal hernia in mesh and ?plug in? techniques, a new problem appears such as chronic pain and other complications. The aim of this paper was to present the original modification of bilayer patch device (Prolene Hernia System?, Ethicon) insertion in ?non-plugged? fashion and 11-year experience with this open technique for the indirect hernia repair in a male. Methods. This retrospective study included 96 male patients with 103 indirect unilateral and bilateral inguinal hernias, operated due to a primary or recurrent hernia in an 11-year interval (2004?2015). In all operation an extended Prolene Hernia System? (PHS) bilayer patch device was inserted medially of inferior epigastric vessels through a small incision in Hasselbach's triangle, thus avoiding plug component of device connector into the internal ring. All data were taken from the medical records, operative protocols, and telephone questionnaire. Results. Non-plugged technique of bilayer patch device insertion was presented in details. Mean age of patients was 59 years. There were 3 (2.91%) patients with procedure-related complications, two patients with postoperative seroma and one with scrotal ecchymosis. There were 86 (89.6%) patients who answered on the questionnaire. During 11 years of following, recurrence of a hernia occurred in 1 patient, one had funiculocele and only one had chronic pain during 6 months. Almost all patients (97.68%) were satisfied with the procedure and results of hernia surgery. Conclusion. Nonplugged insertion of bilayer patch device is a safe technique for solving the primary and recurrent indirect inguinal hernias. The low incidence of the recurrence and chronic pain many years after the operation justifies this technique even in hospitals not specialized for the hernioplasty.


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