scholarly journals A comparative study of postoperative chronic pain after tension free inguinal hernia repair using absorbable versus non absorbable sutures for mesh fixation

2018 ◽  
Vol 5 (4) ◽  
pp. 1378 ◽  
Author(s):  
Laxmi Narayan Meena ◽  
Somendra Bansal ◽  
Pradeep Verma ◽  
Rohit Rai
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Groin Pain ◽  
Mesh Fixation ◽  
Absorbable Suture ◽  
Tension Free ◽  
Vas Score ◽  
Absorbable Sutures ◽  
Common Diagnosis

Background: Inguinal hernia is a one of common diagnosis which is frequently encountered in routine clinical practice. The Lichtenstein technique (tension free mesh repair) is currently the gold standard in open inguinal hernia repair. Currently chronic groin pain (Inguinodynia) is one of the common complications after hernia repair and it may affect quality of life and it has been reported in 16% to 62% of the patients.Methods: This prospective, randomized study was conducted in the department of general surgery in S.M.S. Medical College and attached group of hospitals, Jaipur from May 2014 to December 2015. All patients of 18-80 years old, who were admitted for elective inguinal hernia repair, were included for the study. Patients with bilateral, recurrent, irreducible or incarcerated hernia, pregnant patients and patients with co morbid conditions, were excluded from the study.Results: Mean age was 46.5 years in absorbable group and 45.4 years in non absorbable group. Male to female ratio was 142:13 in absorbable group and 143:12 in non absorbable group. Post operative pain was measured by VAS score. Mean postoperative pain (VAS score) was lower in absorbable sutures group as compared to non absorbable group at 3 months (0.92±0.879 vs. 1.23±1.2; p=0.013) and at 6 months (0.48±0.57 vs. 0.77±0.65; p≤0.001), which was significant.Conclusions: Patients with absorbable suture for mesh fixation has less groin pain as compared to non-absorbable suture in hernia repair during 6 months follow up period.

scholarly journals Endoscopic Techniques in the Treatment of Inguinal Hernias

2020 ◽  
Vol 13 (2) ◽  
pp. 138-145
Author(s):  
Wadim Trukhalev ◽  
Alexander Vlasov ◽  
Аleksandra Kalinina ◽  
Elena Krivenkova
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Fixation ◽  
Safe Procedure ◽  
Recurrence Rates ◽  
Tension Free ◽  
Inguinal Hernias ◽  
Total Extraperitoneal ◽  
Endoscopic Methods

The review is devoted to the treatment methods of inguinal hernia. Inguinal hernia repair is one of the most common operations in the world and is performed on more than 20 million patients per year. Recurrence rates of inguinal hernias after different types of surgical interventions range from 10 to 15%. The use of synthetic materials reduced the rates of hernia recurrence on average to 1-5%. Currently there are traditional tissue-based techniques, open tension-free mesh hernia repair, and laparoscopic mesh hernioplasty. Nowadays tension-free repair with synthetic mesh is a technique of choice for inguinal hernia repair. The emphasis has been placed on endoscopic methods of inguinal hernia prosthetic repair. According to the literature, laparoscopic repair is associated with low rates of wound infection and fewer haematomas, which leads to early resumption of everyday activities compared with Lichtenstein hernia repair. The paper discusses two standardized endoscopic methods for inguinal hernia treatment, namely laparoscopic transabdominal preperitoneal patch (TAPP) and total extraperitoneal (TEP) repair. Analysis of the literature has shown that criteria of necessity and method of mesh fixation during TAPP procedure were not completely identified. However, a number of researches have demonstrated that TAPP technique without mesh fixation proved to be a safe procedure which can be used in most patients with unilateral and bilateral inguinal hernia showing no increase in postoperative complications and low recurrence rates.

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.

scholarly journals Comparative study of mean operating time and hospital stay in sutures and cyanoacrylate glue mesh fixation in inguinal hernia repair

2018 ◽  
Vol 5 (4) ◽  
pp. 1271
Author(s):  
Ashrith Iyanahally ◽  
Abhilash Gautham Ramesh
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Mesh Fixation ◽  
Operating Time ◽  
Suture Fixation ◽  
Cyanoacrylate Glue ◽  
Tension Free ◽  
Medical College

Background: Hernia is a protrusion of a viscus or part of a viscus through an abnormal opening in the walls of its containing cavity. A hernia is the bulging of part of contents of the abdominal cavity through a weakness in the abdominal wall. Inguinal hernia repair is the most frequently performed operation in any general surgical unit. To compare the mean operating time and total duration of hospital stay between sutures and cyanoacrylate glue mesh fixation in inguinal hernia repair in a medical college setup.Methods: All patients presenting to B.L.D. E. U’s Shri B. M. Patil Medical College Hospital and Research Centre Bijapur and admitted patients in whom the diagnosis of primary inguinal hernia is considered from October 2013 to June 2015.Results: Operating time was significantly less that is 36.52 min in cyanoacrylate group and 48.32 in suture fixation group. Hospital stay in cyanoacrylate group was 4.82 days and in suture fixation group was 6.48 days. Two days is considered as preoperative work up period in both the groups as it is a medical college setup.Conclusions: Lichtenstein tension free hernioplasty is always better option if mesh fixation done with N-butyl cyanoacrylate when compared with Lichtenstein’s tension free hernia repair with standard prolene suture fixation. 

scholarly journals Audit of Patient Outcomes after Lichtenstein Hernioplasty for the Repair of Adult Inguinal Hernia

2019 ◽  
Vol 16 (2) ◽  
pp. 54-58
Author(s):  
Md Ibrahim Siddique ◽  
Samia Mubin ◽  
Krisna Rani Majumder ◽  
Muhammad Ali Siddiquee
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Repair ◽  
Groin Pain ◽  
General Surgeon ◽  
Chronic Groin Pain ◽  
Tension Free ◽  
Lichtenstein Hernioplasty

Background: Inguinal hernia repair is one of the most commonly performed surgeries worldwide. While numerous surgical approaches exist to treat inguinal hernias, the Lichtenstein tension-free mesh repair remains the gold standard. This retrospective study is carried out to evaluate the short and long term outcomes of Lichtenstein hernioplasty in the hand of a general surgeon. Patients and Methods: A retrospective analysis of all adult inguinal hernia repair by Lichtenstein method between January .2003 and December 2009 was carried out. The outcome measures were early post-operative complications, incidence of chronic groin pain and recurrence rate. Results: A total of 526 procedures were carried out in 445 adult male patients during the study period. The median age of the patients was 49 years (range, 21-73 years). All patients underwent Lichtenstein hernioplasty under spinal anesthesia. Length of hospital stay was median 2.4 days (range, 1-4 days). Median time to the resumption of normal activities was 8 days (range, 5-1 0 days). Urinary retention was the most frequent early post-operative complication (5.1 6%). Rate of wound infection was acceptable (0.44%). Chronic groin pain was experienced by three patients (0.67%). There was no recurrence observed among the 291 (65.4% of the total) patients who were available after two years of the procedure. Conclusion: The Lichtenstein open tension-free mesh repair of adult inguinal hernia is a safe procedure with least post-operative morbidity and least chance for recurrence. It is a simple technique, quick and. easy to perform without compromising the patient's care and long-term outcome in the hand of an experienced general surgeon. Journal of Surgical Sciences (2012) Vol. 16 (2) : 54-58

scholarly journals P114 ROBOTIC INGUINAL HERNIA REPAIR (RTAPP): ANATOMY LESSONS AND RESULTS OF A CASUISTIC OF 302 OPERATED HERNIAS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Ulrich Dietz
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Fibrin Glue ◽  
Inguinal Canal ◽  
Mesh Fixation ◽  
Mesh Size ◽  
Control Group ◽  
Nerve Lesion ◽  
Absorbable Suture

Abstract Aim The purpose of this study is to apply the resources of robotics to inguinal hernia repair (r-TAPP) and to investigate where specific optimizations to the surgical technique of can be achieved. Material and Methods The results of 302 consecutive r-TAPP surgeries performed over an 18-month period are presented. It is a cohort study without a control group. The study was approved by the ethics committee (Ref. No. 2019-02046). Decisions on interventions (suturing of the transverse fascia or fibrin glue sealing of the inguinal canal) and mesh size were made intraoperatively. Patients were followed up six weeks postoperatively. Results In every fourth patient, a femoral, obturator, or Spieghel hernia was diagnosed in addition to symptomatic inguinal hernia. Mesh fixation with absorbable suture at 4 points was matured. The operative time averaged 71 minutes for unilateral, 103 minutes for bilateral and 95 minutes for unilateral recurrent hernias. 48% of procedures were performed by residents. Seroma incidence decreased from 15.0% in the first period to 5.1% in the third study period. None of the patients experienced pain symptoms due to nerve lesion. The study provided new clarity about the blood supply patterns of the lipoma, the course of the genital branch and the constitution iliac fascia. Conclusions Suturing of the transversal fascia, fibrin glue sealing of the inguinal canal, and suture fixation of the mesh are steps who must be validated in future studies. Robotics provides optimal conditions for residents training, without learning curve on the patient and with predictable OR times. Postoperative seroma formation and complication rate of r-TAPP are low.

Mesh fixation with human fibrin glue (Tissucol) in open tension-free inguinal hernia repair: a preliminary report

Hernia ◽  
2005 ◽  
Vol 9 (4) ◽  
pp. 330-333 ◽  
Author(s):  
S. Canonico ◽  
A. Santoriello ◽  
F. Campitiello ◽  
A. Fattopace ◽  
A. Della Corte ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Fibrin Glue ◽  
Preliminary Report ◽  
Mesh Fixation ◽  
Tension Free ◽  
Human Fibrin Glue

Outcome of tension free open mesh repair of inguinal hernia

2020 ◽  
Vol 22 (1) ◽  
pp. 21-24
Author(s):  
Mohammad Masum ◽  
Md Aminul Islam ◽  
Masflque Ahmed Bhuiyan ◽  
Kazi Mazharul Lslam ◽  
Md Selim Morshed ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Repair ◽  
Groin Hernia ◽  
Synthetic Mesh ◽  
Indirect Inguinal Hernia ◽  
Prolene Mesh ◽  
Tension Free ◽  
Open Mesh Repair

Background: In the practice of General Surgery, hernia repair is the second most common procedure after appendectomy. Several methods have been developed over the years to try to improve hernia repair. Good result can be expected using Bassini's, McVay's, Shouldice's techniques provided the exact nature of hernia is recognized and the repair is done without tension using healthy tissue. The introduction of synthetic mesh started a new era in hernia surgery. The use of synthetic mesh repair of primary and recurrent hernias has gradually gained acceptance among surgeons. Objective: To find out the outcome and complications of open inguinal hernia repair with prolene mesh. Methods: This is a prospective cross sectional study conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from December, 2011 to May, 2012. One hundred patients of inguinal hernia admitted in different surgical units of BSMMU, Dhaka for elective surgery were studied. We have given 1 gm ijv Cephradine per operatively and then 500 gm cephradine ijv 6 hourly for 24 hours followed by oral form of Cephradine for next 5 days. Polypropylene mesh of 11 cm x 7 cm size was used in all cases. All the operations were done by open tension free prolene mesh repair technique. Patients were followed for one year to see the outcome. Results: Out of 100 cases of inguinal hernia, 71 patients (71%) had indirect inguinal hernia and 29 cases (29%) had direct inguinal hernia; 90 cases (90%) were primary hernia and only 10 cases (10%) were recurrent hernia; 58 cases were right sided, 34 cases (34%) were left sided and 8 cases (8%) were bilateral. Complications of mesh repair of groin hernia in this study included wound infection (5%), scrotal oedema (2%), mesh infection (0%), scrotal hematoma (2%), echymoces of peri-incisional skin (5%), early wound and groin pain (7%), chronic inguinodynia (2%), hernia recurrence (1%). Conclusion: In the present study an attempt is made to evaluate the outcome of patients undergoing inguinal hernia repair by prolene mesh. The results confirm that Lichtenstein tension free mesh repair of inguinal hernia is safe and reliable for both primary and recurrent groin hernia, with less recurrence rate. Patient's compliance was good with minimum morbidity. Journal of Surgical Sciences (2018) Vol. 22 (1): 21-24

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