scholarly journals The role of laparoscopic approach in bilaterality assessment in patients with unilateral inguinal hernia

2017 ◽  
Vol 4 (6) ◽  
pp. 2047
Author(s):  
Ahmed M. S. M. Marzouk ◽  
Haitham S. E. Omar ◽  
Heba O. E. Ali
Keyword(s):  
Inguinal Hernia ◽  
Operative Time ◽  
Laparoscopic Approach ◽  
Unilateral Inguinal Hernia ◽  
Frequent Finding ◽  
Ultrasound Assessment ◽  
Group 3 ◽  
The Right ◽  
Unilateral Group

Background: Patients presented with unilateral inguinal hernia are at risk for the possibility of contra-lateral occult hernias; small early-developed hernias may be difficult to be elicited by clinical, imaging assessment and during open repair. This study to evaluate laparoscopic identification of contra-lateral occult hernia with regard to the pre-operative clinical and imaging study.Methods: Retrospective analysis of patients presented in the period of March to December 2015 with unilateral inguinal hernia for which medical and ultrasound imaging assessment were done. Laparoscopic trans abdominal pre-peritoneal (TAPP) approach was done with intraoperative evaluation of the presence of contra-lateral occult hernias.Results: During the study period (27) patients (25 Males and 2 females) presented with unilateral inguinal hernia were clinically evaluated, 18 (66.6%) patients had right sided hernia, 9 (33.33%) had left sided, In all the studied patients routine ultrasound assessment was done and no documented cases of presence of contra-lateral hernia, Intraoperative abdominal exploration successfully Identifies bilateral inguinal hernias in 7 cases (25.9%) with mean age (44.14 years, SD 10.99) compared to (34.97 years, SD 10.51) in the Unilateral group, 3 cases on the left side (16.6% of total right side patients) and 4 cases on the right side (44.4% of total left side patients). operative time for unilateral repair was (Mean 85.8 minutes, SD 18.8), and for discovered bilateral cases (Mean 145.9 minutes, SD 46.8).Conclusions: The presence of occult inguinal hernia is a frequent finding specially in older age group of patients, also in our study we found the percentage of occult hernias are more in patients presented with left side disease. Laparoscopic (TAPP) approach is a useful tool for assessment of the presence of such hernias, and gives the privilege of simultaneous repair in same operation with the advantage of avoiding the patient’s later surgery together with the laparoscopic surgery benefits of less pain, rapid recovery and shorter hospital stay.

Ultrasound Assessment of the contralateral groin in infants with unilateral inguinal hernia

1994 ◽  
Vol 49 (8) ◽  
pp. 546-548 ◽  
Author(s):  
K. Lawrenz ◽  
A.S. Hollman ◽  
R. Carachi ◽  
S. Cacciaguerra
Keyword(s):  
Inguinal Hernia ◽  
Unilateral Inguinal Hernia ◽  
Ultrasound Assessment

scholarly journals Laparoscopic herniorrhaphy in children

2015 ◽  
Vol 37 (2) ◽  
Author(s):  
Mirko Bertozzi ◽  
Laura Marchesini ◽  
Simonetta Tesoro ◽  
Antonino Appignani
Keyword(s):  
Inguinal Hernia ◽  
Abdominal Wall ◽  
Laparoscopic Repair ◽  
Umbilical Hernia ◽  
Operative Time ◽  
Abdominal Wall Defect ◽  
Laparoscopic Herniorrhaphy ◽  
Internal Inguinal Ring ◽  
Unilateral Inguinal Hernia ◽  
The Mean

The authors report their experience in laparoscopic repair of inguinal hernias in children. From May 2010 to November 2013, 122 patients with inguinal hernia underwent laparoscopic herniorrhaphy (92 males and 30 females). Telescope used was 5 mm, while trocars for the operative instruments were 3 or 2 mm. After introducing the camera at the umbilical level and trocars in triangulation, a 4-0 nonabsorbable monofilament suture was inserted directly through the abdominal wall. The internal inguinal ring was then closed by N or double N suture. All operations were performed in one-day surgery setting. In the case of association of inguinal and umbilical hernia an original technique was performed for positioning and fixing the umbilical trocar and for the primary closure of the abdominal wall defect. The postoperative follow-up consisted of outpatient visits at 1 week and 1, 3, and 6 months. The mean age of patients was 38.5 months. Of all patients, 26 were also suffering from umbilical hernia (19 males and 7 females). A total of 160 herniorrhaphies were performed; 84 were unilateral (66 inguinal hernia, 18 inguinal hernia associated with umbilical hernia), 38 bilateral (30 inguinal hernia, 8 inguinal hernia associated with umbilical hernia). Nine of 122 patients (6 males and 3 females) were operated in emergency for incarcerated hernia. A pre-operative diagnosis of unilateral inguinal hernia was performed in 106 cases. Of these patients, laparoscopy revealed a controlateral open internal inguinal ring in 22 cases (20.7%). The mean operative time was 29.9±15.9 min for the monolateral herniorrhaphies, while in case of bilateral repair the mean operative time was 41.5±10.4 min. The mean operative time for the repair of unilateral inguinal hernia associated with umbilical hernia was 30.1±7.4 while for the correction of bilateral inguinal hernia associated with umbilical hernia 39.5±10.6 min. There were 3 recurrences (1.8%): 2 cases in unilateral repair and 1 case a unilateral recurrence in a bilateral repair. No other complications were seen. Laparoscopic repair of inguinal hernia in children performed in this experience resulted a safe and effective procedure.

scholarly journals Role of the Laparoscopic Approach for Complex Urologic Surgery in the Era of Robotics

2021 ◽  
Vol 10 (9) ◽  
pp. 1812
Author(s):  
Iulia Andras ◽  
Angelo Territo ◽  
Teodora Telecan ◽  
Paul Medan ◽  
Ion Perciuleac ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Operative Time ◽  
Vena Cava ◽  
Laparoscopic Approach ◽  
Hepatic Veins ◽  
Combined Approach ◽  
Urological Procedures ◽  
The Mean ◽  
Complications Rate

(1) Introduction: The advent of robotic surgery led to the assumption that laparoscopic surgery would be replaced entirely. However, the high costs of robotic surgery limit its availability. The aim of the current study was to assess the feasibility of the 3D laparoscopic approach for the most complex urological procedures. (2) Materials and methods: We included in the current study all patients who had undergone complex 3D laparoscopic procedures in our department since January 2017, including radical nephrectomy (LRN) using a dual combined approach (19 patients), radical nephroureterectomy (LRNU) with bladder cuff excision (13 patients), and radical cystectomy (LRC) with intracorporeal urinary diversion (ICUD) (21 patients). (3) Results: The mean operative time was 345/230/478 min, the complications rate was 26%/30.76%/23.8% and positive surgical margins were encountered in 3/1/1 patients for the combined approach of LRN/LRNU/LRC with ICUD, respectively. A single patient was converted to open surgery during LRN due to extension of the vena cava thrombus above the hepatic veins. After LRC, sepsis was the most common complication and 8 patients were readmitted at a mean of 15.5 days after discharge. (4) Conclusions: In the era of robotic surgery, laparoscopy remains a plausible alternative for most complex oncological cases.

scholarly journals Comparison of Laparoscope-Assisted Single-Needle Laparoscopic Percutaneous Extraperitoneal Closure versus Open Repair for Pediatric Inguinal Hernia

2021 ◽  
Author(s):  
Shaofeng Wu ◽  
Xiaoyu Xing ◽  
Rong He ◽  
Haiteng Zhao ◽  
Liang Zhong ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Operative Time ◽  
Open Repair ◽  
Operating Time ◽  
Laparoscopic Approach ◽  
Bilateral Hernia ◽  
Pediatric Inguinal Hernia ◽  
The Past ◽  
Attractive Option ◽  
Contralateral Inguinal Hernia

Abstract Background: Laparoscopic repairs have gained gradual acceptance in pediatric inguinal hernia over the past decade. However, consensus about the optimal management is still lacking. The aim of this study is to present a modified single-needle laparoscopic approach with the assistance of a laparoscope and to evaluate the surgical outcomes in comparison with traditional open repair method. Materials and Methods: We retrospectively reviewed the medical data of children who underwent laparoscope-assisted single-needle laparoscopic percutaneous extraperitoneal closure (LPEC) and open repair (OR) for inguinal hernia from 2014 to 2019. Data were reviewed and analyzed with respect to the operating time, the incidence of metachronous contralateral inguinal hernia (MCIH), recurrence, and other complications. Results: In our cohort, 961 patients in the OR group and 1098 patients in the LPEC group were analyzed retrospectively. Mean operative time was significantly shorter in the LPEC group (22.3±3.5 min) than in the OR group (27.8±5.9 min) for bilateral hernia repair (p<0.001). Iatrogenic cryptorchidism occurred statistically more frequently in the OR group than in the LPEC group (0.4% vs. 0%, p=0.013). In addition, the incidence of MCIH was 3.7% (33/887) in the OR group and 0.3% (3/1014) in the LPEC group (p<0.01). Conclusion: Based on the current outcomes, laparoscope-assisted single-needle LPEC provides a simple and attractive option for the administration of pediatric patients with inguinal hernia/hydrocele to reduce the MCIH.

Laparoscopic Inguinal Hernia Repair—TAPP versus TEP: Results of 301 Consecutive Patients

2021 ◽  
Vol 39 ◽  
Author(s):  
Beslen Goksoy ◽  
◽  
Gokhan Yilmaz ◽  
Ibrahim Azamat ◽  
Ibrahim Ozata ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Operative Time ◽  
Laparoscopic Inguinal Hernia Repair ◽  
Secondary Outcome ◽  
Unilateral Inguinal Hernia ◽  
Laparoscopic Inguinal Hernia ◽  
The Mean

Introduction: Transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) hernia repair are the two most commonly used techniques in laparoscopic inguinal hernia repair, and the results of comparative studies are conflicting. The objective of this study is to compare the two methods in unilateral inguinal hernia repair. Materials and Methods: The data of consecutive patients who underwent TEP and TAPP due to unilateral inguinal hernia between December 7, 2017, and March 15, 2020, were analyzed retrospectively. The primary outcome was to compare the clinical outcomes of the two techniques in terms of complications, conversion, pain, and operative time. The secondary outcome was recurrence rates. Results: A total of 301 (TEP n=234, TAPP n=67) patients were included in the study. The mean age was 43 years, and the follow-up period was two years. The groups were similar in terms of demographic characteristics and hernia type. The mean operative time was longer in the TAPP group than in the TEP group (67 min and 58 min, p=0.007). The recurrence rate was 4.3% in the TEP group and 5.9% in the TAPP group (p>0.05). The conversion rate was 6% in both groups. In total, 19 (6.3%) patients had intraoperative complications (TEP n=16, TAPP n=3), and 23 (7.6%) patients had postoperative complications (TEP n=16, TAPP n=7). Both intraoperative and postoperative complication rates were similar between the groups (p=0.31 and p=0.051, respectively). The early postoperative pain was less in the TEP group (p=0.004). Conclusion: Less early postoperative pain and shorter operative time were detected in patients who underwent TEP.

scholarly journals The Operative Time for Unilateral Inguinal Hernia Repair in Children Performed with Percutaneous Internal Ring Suturing (PIRS) or Open Approach Method

2021 ◽  
Vol 10 (6) ◽  
pp. 1293
Author(s):  
Przemyslaw Karol Wolak ◽  
Agnieszka Strzelecka ◽  
Aneta Piotrowska ◽  
Katarzyna Dąbrowska ◽  
Piotr Przemysław Wolak ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Operative Time ◽  
Retrospective Chart Review ◽  
Open Approach ◽  
Internal Ring ◽  
Patients Âgés ◽  
Unilateral Inguinal Hernia ◽  
Approach Method

In this study, we compared the operative time for unilateral inguinal hernia repair in children performed with either an open approach (OA) or the Percutaneous Internal Ring Suturing (PIRS) method. It was a retrospective chart review of all patients ages 0 to 18 who underwent unilateral inguinal hernia repair in the Department of Pediatric Surgery, Urology and Traumatology of the Regional Hospital in Kielce between January 2011 and December 2018. Patients with bilateral hernias or additional problems were excluded. Of 878 patients qualified for the study, 701 were in the OA group and 177 in the PIRS group. Overall, the time needed to complete the procedure was significantly longer for the OA method. The operative time was longer if the hernia was left-sided (p = 0.024). Analysis by gender showed that operative time was generally longer in males. For both genders, surgery was shorter if the PIRS method was used. For males in the PIRS group the operative time was affected by the location of the hernia, and it was longer for a left-sided hernia. The take-home message is that the PIRS procedure is faster than the OA for inguinal hernia repair in children and it might be considered as a preferred method, especially in females.

scholarly journals Self-retaining Freedom Proflor vs. Lichtenstein Mesh Repair for the Reduction of Postoperative pain in Inguinal Hernia: A 1-year Randomized Controlled Study

2019 ◽  
Vol 6 ◽  
Author(s):  
Kannikanti Nageswara Rao ◽  
A. S. Gogate
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Mesh Repair ◽  
Operative Time ◽  
Demographic Data ◽  
Clinical Findings ◽  
Controlled Study ◽  
Group A ◽  
Group B ◽  
The Right

Introduction : Lichtenstein tension-free mesh repair (LMR), surgical procedure for inguinal hernia, associated with postoperative pain. The study was aimed to compare self-retaining Freedom ProFlor versus LMR for the reduction of postoperative pain in inguinal hernia.Methodology : A total of 60 patients with inguinal hernia undergoing mesh repair were randomized into two groups of 30 each: group A (Freedom ProFlor mesh repair) and group B (LMR). Demographic data and clinical findings of all the patients including duration of pain, lump size, cough impulse, and the position of hernia were noted. Recorded findings such as postoperative pain and operative time were subjected to statistical analysis.Results : Most (31) of the patients had hernia on the right side. The operative time was significantly less in group A when compared to group B (P < 0.05). Significantly lower pain scores were observed in group A than in group B (P < 0.05). The mean post-operative pain was significantly lower in group A compared with group B during the fifth follow-up visit (0.2 ± 0.41 vs. 1.07 ± 1.28; P < 0.0001). Conclusion : The Freedom ProFlor mesh repair was better than the LMR regarding postoperative pain. Moreover, the dose of the analgesic needed in Freedom ProFlor mesh repair group was less and for a shorter time when compared to LMR group. However, further long-term studies are required for documenting hernia recurrences.

Robotic Inguinal Hernia Repair: Technique and Early Experience

2016 ◽  
Vol 82 (10) ◽  
pp. 1014-1017 ◽  
Author(s):  
Massimo Arcerito ◽  
Eric Changchien ◽  
Oscar Bernal ◽  
Adam Konkoly-Thege ◽  
John Moon
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Operative Time ◽  
Open Repair ◽  
Laparoscopic Approach ◽  
Recurrence Rates ◽  
Robotic Inguinal Hernia Repair

Laparoscopic inguinal hernia repair has been shown to have multiple advantages compared with open repair such as less postoperative pain and earlier resume of daily activities with a comparable recurrence rate. We speculate robotic inguinal hernia repair may yield equivalent benefits, while providing the surgeon added dexterity. One hundred consecutive robotic inguinal hernia repairs with mesh were performed with a mean age of 56 years (25–96). Fifty-six unilateral hernias and 22 bilateral hernias were repaired amongst 62 males and 16 females. Polypropylene mesh was used for reconstruction. All but, two patients were completed robotically. Mean operative time was 52 minutes per hernia repair (45–67). Five patients were admitted overnight based on their advanced age. Regular diet was resumed immediately. Postoperative pain was minimal and regular activity was achieved after an average of four days. One patient recurred after three months in our earlier experience and he was repaired robotically. Mean follow-up time was 12 months. These data, compared with laparoscopic approach, suggest similar recurrence rates and postoperative pain. We believe comparative studies with laparoscopic approach need to be performed to assess the role robotic surgery has in the treatment of inguinal hernia repair.

scholarly journals Ex-vivo nephron-sparing surgery and autotransplantation for renal tumours: Revisited

2014 ◽  
Vol 8 (9-10) ◽  
pp. 728 ◽  
Author(s):  
George P Abraham ◽  
Avinash T Siddaiah ◽  
Krishnamohan Ramaswami ◽  
Datson George ◽  
Krishanu Das
Keyword(s):  
Operative Time ◽  
Ex Vivo ◽  
Laparoscopic Approach ◽  
Nephron Sparing Surgery ◽  
Study Patient ◽  
Renal Tumours ◽  
Nephron Sparing ◽  
Renal Autotransplantation ◽  
Patient Profiles

Introduction: We studied the feasibility of ex-vivo nephron-sparing surgery and autotransplantation for complex renal tumours. We also studied the role of laparoscopy in these situations.Methods: All patients who underwent renal autotransplantation for renal tumour at our centre were included in this retrospective study. Patient profiles were recorded in detail. Operative and postoperative details were also recorded.Results: Our series includes 3 patients. Two patients had complex renal cell carcinoma and 1 patient had bilateral large angiomyolipoma. In the first 2 patients, laparoscopic approach was used for nephrectomy. Operative time for case 1, 2 and 3 was 5.5, 4.5, 8 (right side) and 6 (left side) hours, respectively. Cold ischemia time was 110, 90, 150 and 125 minutes, respectively. One patient required temporary postoperative hemodialysis.Conclusion: Ex-vivo nephron-sparing surgery and autotransplantation still remain a viable option for complex renal tumours. It offers satisfactory renal functional outcome with acceptable morbidity. The laparoscopic approach should be used whenever possible to reduce morbidity.

scholarly journals TAPP technique for congenital inguinal hernia

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Dan Dumitrescu ◽  
Costel Savlovschi ◽  
Victor Dumitrescu
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Surgical Intervention ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Approach ◽  
Surgical Team ◽  
Hernia Surgery ◽  
New Era ◽  
Recommended Treatment ◽  
The Right

Laparoscopic hernia repair has opened a new era in hernia surgery shifting paradigms from anterior to posterior approaches. This has exposed surgeons to new anatomical perspective, tehnical challenges and clinical implication. We present the case of a 53-year-old patient admitted to surgery in outpatient conditions with the diagnosis of bulky inguinal-scrotum hernia. Transabdominal pre-peritoneal (TAPP) repair was our option to solve the inguinal parietal defect. Intraoperatively, in the peritoneal cavity, lateral to the epigastric vessels, the parietal flaccid defect was revealed, communicating with the right scrotum cavity, with clear evidence of testicle, suggestive of external congenital oblique hernia. Peritoneal sectioning and take-off, with Cooper's, spermatic vessels and the relevant channel, were the precursors of the dissection and 360-degree take-off of the herniated sac, with the support of the herniated suture ligament, followed by in-line, and the abandonment of the distal, open, unbounded end. The application of the 3D-MAX mesh, fixed with Capsure at the Cooper ligament, preperitoneal drainage and closure of the resorbable thread peritoneum were the endpoints of surgical intervention. The postoperative progression was favorable with discharge on the 2nd postoperative day. Control at 30 days postoperatively did not identify possible complications, it presented without painful accusations, without suggestive elements for hydrocele and without signs of relapse. The laparoscopic approach, even in the case of bulky parietal defects, remains a recommended treatment option with the best results, but largely depending on the surgical team experience.

Sign in / Sign up

Export Citation Format

Share Document