scholarly journals Outcome of laparoscopic total extraperitoneal approach with direct dissection and mesh hernioplasty in the treatment of inguinal hernias

2017 ◽  
Vol 5 (1) ◽  
pp. 248
Author(s):  
Yousef Hisham ◽  
Mannarakkal Ranjith ◽  
Thommil Padinjarenalakath Nabeel ◽  
Kummankandath Abbas Sidhic
Keyword(s):  
Inguinal Hernia ◽  
Indirect Inguinal Hernia ◽  
Tep Repair ◽  
Total Extraperitoneal ◽  
The Mean ◽  
Surgery Department ◽  
Mean Time ◽  
Laparoscopic Tep ◽  
Mesh Hernioplasty

Background: Laparoscopic inguinal hernia repair has become increasingly popular as an alternative to open surgery. Aim: To evaluate total extraperitoneal repair with direct telescopic dissection and mesh hernioplasty for inguinal hernias.Methods: This study was conducted at General Surgery department the period of 1 year on 30 patients having inguinal hernia.Results: This prospective study included 30 adult patients with primary unilateral inguinal hernia, all of them were males. Age of study patients ranged from 22 to 64 years old. Intraoperatively, 6 patients were presented to have direct inguinal hernia (20%) while 21 patients had indirect inguinal hernia (70%). In 3 patients, combined direct and indirect hernia defects were present (10%). Mean operative time was 99.30±25.13 min. Mean time for analgesia was 3.62±1.57 days. Hospital stay mean was 1.43±0.62 days. The mean time until return to work was 14.1±3.13 days, the mean time of follow up was 7.1±2.2 months. Intra operatively 5 (15%) and post operatively 8 (26.6%)complications were observed.Conclusions: Laparoscopic TEP repair is an excellent alternative to open preperitoneal repair of inguinal hernia. Complication rate was average with other studies while there was no hernia recurrence during the period of follow up.

scholarly journals Comparison of conventional balloon method and Dulucq method for extraperitoneal access for laparoscopic total extraperitoneal repair of inguinal hernia

2017 ◽  
Vol 4 (8) ◽  
pp. 2791
Author(s):  
Chirag B. Kakadiya ◽  
Dilip B. Choksi ◽  
Amul Bhedi ◽  
Sushil Damor
Keyword(s):  
Inguinal Hernia ◽  
Veress Needle ◽  
Tep Repair ◽  
Advantages And Disadvantages ◽  
Total Extraperitoneal ◽  
Peritoneal Space ◽  
The Mean ◽  
Time Required ◽  
Mean Time ◽  
Laparoscopic Tep

Background: Laparoscopic inguinal hernia repair has been shown to be slightly superior to open approaches. The aim of study is to compare advantages and disadvantages between two methods of extra peritoneal access for TEP repair of inguinal hernia using conventional balloon device method and using Dulucq method.Methods: This is a prospective study. It was conducted from June 2014 to November 2016 at SSG Hospital Vadodara. Total 50 patients of inguinal hernia taken for laparoscopic TEP repair among them patients were divided in two groups by envelop method of randomization, in 25 patients extra peritoneal space was created by balloon method and in 25 patients extra peritoneal space was created by veress needle or Dulucq method.Results: The mean time taken for extra peritoneal space creation by balloon method was 13.12 minutes and the mean time taken for extra peritoneal space creation by veress needle method was 9.32 minutes. The mean total operative time required for TEP by balloon method was 66.7 minutes and that for, TEP with veress needle method was 53 minutes.Conclusions: Total time for extraperitoneal space creation by Dulucq method is less as compared to balloon method of extraperitoneal space creation in laparoscopic TEP repair of inguinal hernia.

scholarly journals Laparoscopic total extraperitoneal (tep) repair of direct inguinal hernia using nonfixation of three-dimensional mesh: Long term follow up

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Đình Tuấn Dũng Phan ◽  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Three Dimensional ◽  
Mesh Migration ◽  
Direct Inguinal Hernia ◽  
Tep Repair ◽  
Total Extraperitoneal ◽  
Laparoscopic Tep

Tóm tắt Đặt vấn đề: Đến nay, phẫu thuật nội soi trong điều trị bệnh lý thoát vị bẹn được thực hiện ngày càng nhiều trên lâm sàng, trong đó phẫu thuật nội soi hoàn toàn ngoài phúc mạc đã được sử dụng rộng rãi cùng một tấm lưới nhân tạo được cố định vào thành bụng trước. Tuy nhiên, sự cố định này là một trong những nguyên nhân chủ yếu gây ra tình trạng đau sau mổ và ngược lại sự di chuyển của tấm lưới nhân tạo phẳng chính là nguyên nhân gây ra tình trạng thoát vị tái phát. Việc sử dụng tấm lưới nhân tạo 3D (3DMAX Mesh/Bard-Davol) có thể tránh được những vấn đề này. Mục tiêu của đề tài nhằm đánh giá kết quả lâu dài của phương pháp phẫu thuật đặt tấm nhân tạo 3D ngoài phúc mạc qua ngã nội soi trong điều trị bệnh lý thoát vị bẹn trực tiếp. Phương pháp nghiên cứu: Phương pháp nghiên cứu mô tả tiến cứu được thực hiện trên các người bệnh được chẩn đoán thoát vị bẹn trực tiếp và được điều trị phẫu thuật nội soi hoàn toàn ngoài phúc mạc (TEP) đặt tấm nhân tạo 3D (3D-Max - Davol) từ tháng 6 năm 2010 đến tháng 12 năm 2018. Nghiên cứu đánh giá về các đặc điểm chung, đặc điểm phẫu thuật, biến chứng, thời gian nằm viện và đánh giá tái khám sau phẫu thuật sau 36 tháng. Kết quả: Có 62 người bệnh (tổng số 67 trường hợp thoát vị trực tiếp) đã được phẫu thuật bằng phương pháp đặt tấm nhân tạo 3D ngoài phúc mạc bằng nội soi. Độ tuổi trung bình 54,7 ± 13,1 tuổi (nhỏ nhất 41 tuổi, lớn nhất 81 tuổi). 91,9% là thoát vị bẹn một bên. Đặc điểm phẫu thuật: thủng phúc mạc trong quá trình phẫu thuật chiếm tỷ lệ 4,5%, không có trường hợp nào tổn thương các mạch máu lớn trong phẫu thuật. Thời gian phẫu thuật trung bình là 47,2±11,9 phút (35-95 phút) đối với thoát vị bẹn một bên và 81,4±18,9 phút (65-120 phút) đối với thoát vị bẹn hai bên. Tái khám sau mổ: 3/67 (4,5%) trường hợp còn cảm giác đau khi tái khám vào tháng thứ 3, không có trường hợp tụ dịch ở vết mổ, không có trường hợp tái phát nào được ghi nhận lúc tái khám vào ở vết mổ, không có trường hợp tái phát nào được ghi nhận lúc tái khám vào tháng thứ 36. Kết luận: Phẫu thuật nội soi hoàn toàn ngoài phúc mạc với tấm nhân tạo 3D trong điều trị thoát vị bẹn trực tiếp có tính an toàn và hiệu quả cao. Kỹ thuật này có thể được áp dụng rộng rãi và nên được xem như là tiêu chuẩn vàng trong điều trị bệnh lý thoát vị bẹn. Abstract Introduction: Laparoscopic inguinal hernia repair is frequently performed using the mechanical fixation of a flat polypropylene mesh. This procedure is associated with pain issue and mesh migration that may occur without fixation of flat prothesis. An anatomically contoured mesh 3D-Max (3DMAX Mesh/Bard-Davol, France) using no fixation would prevent these problems. The objective of this study is to evaluate the effectiveness and safety of laparoscopic totally extraperitoneal (TEP) for inguinal hernia repair with nonfixation of three-dimensional mesh. Material and Methods: A retrospective analysis of patients, admitted for direct inguinal hernia and operated by laparoscopic TEP with nonfixation of 3-D mesh, performed between June 2010 and December 2018. Data were collected regarding general characteristics, complications, length of hospital stay and the recurrence rates. Results: 62 patients with 67 direct hernias underwent laparoscopic (TEP) to repair hernia with an average age of 54.7±13,1 years (range 41 – 81 years); peritoneal injury was noticed during dissection in 4.5%, there was no injury of the inferior epigastric vessels during dissection. Average operative time of unilateral hernia was 47.2±11.9 minutes (range 35 – 95 minutes). All patients in this series were followed, pain in 4.5% at 3 months after operation. There were no recurrences at 36 months postoperative follow up. Conclusion: The laparoscopic (TEP) repair of inguinal hernia is safe and effective. It is considered as the gold standard technique in treatment of direct hernia. Keyword: Inguinal hernia – Laparoscopic TEP, hernioplasty – laparoscopy.

Comparison of post-operative pain after laparoscopic total extraperitoneal mesh repair of indirect inguinal hernia with tacker

2021 ◽  
Vol 15 (10) ◽  
pp. 2733-2735
Author(s):  
Shahid Hussain ◽  
Asiya Shabbir ◽  
Muhammad Asif
Keyword(s):  
Inguinal Hernia ◽  
Mesh Repair ◽  
Indirect Inguinal Hernia ◽  
Satisfactory Outcome ◽  
Post Operative Pain ◽  
Total Extraperitoneal ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Laparoscopic Tep

Objectives: To compare the post-operative pain after laparoscopic total extraperitoneal mesh repair of indirect inguinal hernia with tacker and without tacker fixation. Materials & Methods: This comparative study was done at Surgical Department of Bahawal Victoria Hospital, Bahawalpur from May 2020 to November 2020 over the period of 6 months. Total 182 patients with indirect inguinal hernia, having age range from 20 to 60 either male or female were selected. In group A patients, laparoscopic TEP mesh repair of inguinal hernia without tacker fixation was done while in group B patients, laparoscopic TEP mesh repair of inguinal hernia with tacker fixation was done. Patients were assessed for post-operative pain and outcome (satisfactory/unsatisfactory) at 1 month follow up. Results: Average of patients was 41.33 ± 12.37 years and 40.83 ± 12.04 years in group A and group B. Out of 182 patients, 170 (93.41%) were males and 12 (6.59%) were females. Mean post-operative pain in Group A was 1.46 ± 1.50 while in Group B was 1.77 ± 2.08 (p-value=0.2505). Satisfactory outcome was noted in 84 (92.31%) patients and 67 (73.63%) patients of group A and B and the difference was significant (P = 0.001). Conclusion: Results of this study showed that there is a significant difference of satisfactory outcome (less post-operative pain) between the non-fixation and fixation group. Difference of satisfactory outcome was also significant between male patients, diabetics and obese patients of both groups. Keywords: Inguinal hernia, laparoscopic, mesh, tacker fixation

scholarly journals Laparoscopic treatment of inguinal hernia in female children – national experience

2021 ◽  
Vol 20 (1) ◽  
pp. 20-26
Author(s):  
Toni Risteski
Keyword(s):  
Inguinal Hernia ◽  
Open Repair ◽  
Average Length ◽  
Prospective Clinical Study ◽  
Indirect Inguinal Hernia ◽  
Group 4 ◽  
Repair Materials ◽  
Female Children ◽  
The Mean

Background. Although, laparoscopic inguinal hernia repair in children is gaining ground as a safe, feasible, and popular method, still many pediatric surgeons continue to debate its safety, efficacy, and cosmesis in comparison with conventional open repair. Materials and methods. This was a prospective clinical study, that elaborated 98 female children aged 1–14 with clinically diagnosed indirect inguinal hernia. Equal proportions of 49 children were treated via laparoscopic (PIRS) either conventional open repair (OR). Outpatient clinic follow up was performed regardless of the type of the intervention, on the 7th day and 6 weeks after discharge. Results. The mean age of children in PIRS vs. OR group was 5.3±2.7 vs. 5.9±3.3 years. There was no significant differences between the groups related to age (p = 0.4221), weight (p = 0.5482), family history (p = 0.5377), and residency rural/urban (p = 0.3161). The average length of unilateral vs. bilateral PIRS repair (29.5±6.8 vs. 43.6±7.2 min) was significantly shorter than OR (44±4.2 vs. 97±8.1 min) for consequently p = 0.0023 vs. p = 0.00001. The post-operative hospitalization after PIRS repair was 14.1±3.1 hours and was significantly shorter compared to OR – 44±4.2 hours (p = 0.00001). In OR group, 4 (8.2%) children had postoperative nausea compared to none in PIRS group. Significantly bigger cosmetic satisfaction was found in PIRS compared to OM group (p = 0.0001). Conclusion. With due respect to OR as a gold standard, the proven advantages of PIRS are motivation for further improvement of this technique for the purpose of treatment of inguinal hernia of female children.

LAPAROSCOPIC TOTAL EXTRAPERITONEAL REPAIR OF INGUINAL HERNIA DIRECT: NONFIXATION OF THREE-DIMENSIONAL MESH

2016 ◽  
pp. 21-27
Author(s):  
Dinh Tuan Dung Phan ◽  
Anh Vu Pham ◽  
Manh Ha Le
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Groin Hernia ◽  
Three Dimensional ◽  
Complication Rates ◽  
3D Mesh ◽  
Tep Repair ◽  
Totally Extraperitoneal ◽  
Laparoscopic Tep

Introduction: Laparoscopic inguinal hernia repair frequently is performed with mechanical fixation of a flat polypropylene mesh. Mechanical fixation is associated with pain syndromes and mesh migration may occur without fixation of flat protheses. An anatomically contoured mesh 3D-Max (3DMAX Mesh/Bard-Davol, France) using no fixation would avoid these problems. The objective of this study is to demonstrate the effectiveness and safeness of laparoscopic totally extraperitoneal (TEP) hernia repair with nonfixation of three-dimensional mesh. Materials and methods: A prospective analysis of patients, admitted for groin hernia type direct and operated by laparoscopic TEP hernia repair with nonfixation of 3D mesh (3DMAX Mesh), performed between June 2010 and June 2015. Data were collected regarding general characteristics, complication rates, length of hospital stay and the recurrence rate postoperative of this method. Results: 36 patients/42 hernias type direct underwent laparoscopic totally extraperitoneal (TEP) repair with nonfixation of 3D mesh. The results show with an average age of 59,5±13,2 years (range 36–85 years); peritoneal laceration was noticed during dissection in 7,1%, there was no injury of the inferior epigastric vessels during dissection. Unilateral hernia had an operative time of 54,5±18,1 minutes (range 30–115 minutes), bilateral hernia was 88,3±24,6 (range 65-120 minutes). All of these patients in the study were controlled with 2,4% had pain post-op at 3 months follow-up postoperative, but at 12 months and 24 months follow-up, there were no complication, no recurrences. Conclusions: The laparoscopic (TEP) repair of inguinal hernia with nonfixation of three-dimensional mesh is safe and effective. Keywords: groin hernia – TEP hernioplasty - laparoscopy

scholarly journals Feasibility of laparoscopic inguinal hernia repair (TEP) in rural centre in India

2017 ◽  
Vol 4 (7) ◽  
pp. 2336
Author(s):  
Prashant Sawarkar ◽  
Ranjana Zade ◽  
Suchine Dhamanaskar ◽  
Bhupendra Gathe ◽  
Pradip Sawardekar ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Return To Work ◽  
Inguinal Hernia Repair ◽  
Gold Standard ◽  
Lichtenstein Technique ◽  
Hernia Surgery ◽  
Tep Repair ◽  
The Mean ◽  
Laparoscopic Tep

Background: Inguinal hernia repair is one of the most frequently performed operations in general surgery worldwide. Routinely used gold standard Lichtenstein technique gives a long scar and more post-operative pain. TEP has demonstrated favourable short-term results, with regards to reduced postoperative stay, pain and earlier return to physical activity in comparison with open mesh repairs.Methods: This study was prospective observational study in which 75 patients were included for TEP repair and followed for the outcome measured as the time taken for operation, incidence of intra operative and post-operative complications, severity of pain at post-operative day 1, 1 week, 1 month and 6 months after operation, return to work and cost effectiveness of inguinal hernia repair.Results: We have enrolled the 75 patients from 16 to 80 years out of which 34 (45.3%) patients were from age group 50 to 70 years.  47 (62.7%) patients operated on right side and 58 (77.4%) were operated for indirect hernia. Mean time taken for TEP was 81.5 minutes with minimum of 45 minutes and maximum of 135 minutes. There was single most complications of Pneumoperitoneum in 24 (32.0%) which was benign and managed conservatively. Other complications include bleeding in 4 (5.3%) and vas injury in one (1.3%). the mean duration of time taken for return to work was 11 days. The mean cost of TEP was Rs. 5932 with minimum of Rs. 4327 and maximum of Rs. 7742.Conclusions: The laparoscopic (TEP) repair is well established surgery for primary hernia repair and the other open tension free Lichtenstein technique is still regarded as a gold standard for inguinal hernia repair. The laparoscopic hernia surgery attempting similar claims underwent controversies with conflicting results. Laparoscopic (TEP) inguinal hernia repair gives greater patient’s satisfaction and better cosmetic results than open (Lichtenstein) repair.

scholarly journals Total extraperitoneal approach in large inguino-scrotal hernias: an institutional approach

2016 ◽  
Vol 18 (3) ◽  
pp. 51 ◽  
Author(s):  
Tuhin Shah ◽  
S Shah ◽  
BR Joshi ◽  
RJ Karkee ◽  
RK Gupta
Keyword(s):  
Inguinal Hernia ◽  
Operating Time ◽  
Operation Time ◽  
Hernia Surgery ◽  
Recurrence Rates ◽  
Hernia Sac ◽  
Tep Repair ◽  
Inguinal Hernia Surgery ◽  
Total Extraperitoneal ◽  
The Mean

Introduction: Since 2 decades laparoscopichernia repair has gained key role in uncomplicated inguinal hernia surgery with advantages showed by several trials and guidelines. However, its role in complicated inguinal hernia such as incarcerated, obstructed and inguino-scrotal is debatable. Cases of large inguino-scrotal raises objection to laparoscopic procedure because of anticipated problems and complications in dissecting extended hernia sac even though posterior approach is advocated as repair of choice for complicated cases. Here, we reviewed our series of patients undergoing TEP in a limited time frame.Method: Between March 2013 and June 2014, 50 consecutive patients underwent TEP repair for inguinoscrotal hernia. Patient demographics, hernia characteristics, operating time, surgical technique, conversion rate, intraoperative, postoperative complications and recurrence was recorded and analyzed using MS Excel.Results: 50 patients were recorded, 26 had unilateral and 24 had bilateral hernias. Mean age was 52 (22-72) years. The mean operation time was 70 (50-140) min. Bilateral repairs took 45% (18 min) longer than for unilateral repairs (52 + 12 min). Two (12.5%) patients required combined open surgery to transect the incarcerated omentum. There was no mortality. Morbidity was limited to asymptomatic seroma formation in 2 (12.5%) patients; 1 patient of combined open-TEP approach had wound infection, both treated conservatively. Mean follow up was 6.3 months; we recorded 2 recurrences (12.5%). The mean length of hospital stay was 1.8 days.Conclusion: We conclude that TEP can be safely employed for complicated inguinal hernias repair. Surgical experience in mandatory with tailored technique to reduce morbidity and achieve good clinical outcome with acceptable recurrence rates.

LAPAROSCOPIC TRANS-ABDOMINAL PRE-PERITONEAL (TAPP) REPAIR FOR TREATMENT INGUINAL HERNIA DISEASE

2018 ◽  
Vol 8 (4) ◽  
pp. 76-80
Author(s):  
Thao Nguyen Minh ◽  
Vu Pham Anh ◽  
Tri Nguyen Huu ◽  
Phu Nguyen Doan Van ◽  
Phuc Nguyen Thanh ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Operative Time ◽  
Bilateral Hernia ◽  
Repair Method ◽  
Tapp Repair ◽  
Post Operation ◽  
Average Operative Time ◽  
The Mean

Background: Inguinal hernia is one of the commonest surgical diseases and there are many different techniques applied. The laparoscopic trans-abdominal pre-peritoneal (TAPP) repair allows a better view of the inguinal anatomy, evaluation of opposite side and resolve combined peritoneal diseases as well. Patient and method: The study included 60 cases with inguinal hernia that have been treated by laparoscopic transabdominal pre-peritoneal (TAPP) repair. Method: Description, prospective follow-up. Result: The mean age was 58±18.2. 96.7% were males. The average operative time was 45.6±15.1 minutes for one side hernia, 73±25.2 minutes for bilateral hernia. 02 cases have been post-operation inguinal seroma complication (3.3%), 02 cases with hydrocele (3.3%), 01 case with abdominal seroma (1.7%). 04 cases (6.7%) opposite inguinal hernia were detected and 05 cases (8.3%) with combined diseases were resolved. Duration of post-operative stay was 3.9±1.1 days. Conclusion: TAPP is a safe and feasible procedure, allows evaluation of opposite side and resolve combined peritoneal diseases.

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