scholarly journals A study of outcome and complications of emergency inguinal hernias repair

2020 ◽  
Vol 7 (2) ◽  
pp. 419
Author(s):  
Dinesh Prasad ◽  
Yash Patel
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Length Of Hospital Stay ◽  
Seroma Formation ◽  
Site Infection ◽  
Wound Site ◽  
Inguinal Hernias ◽  
Mesh Hernioplasty

Background: Mesh hernioplasty in patients undergoing emergency inguinal hernia repair is considered practically, irrespective of complications. The main aim of this study was to assess the morbidity of Lichtenstein mesh hernioplasty in treating obstructed inguinal hernias. Primary outcome measures were post-operative wound site infection, seroma formation, length of hospital stay, hanging testis, testicular infarct, inguinodynia and recurrence.Methods: This study was undertaken in the department of General Surgery, SMIMER, Surat, Gujarat, India from August 2016 to July 2019. Fifteen patients were operated and included in the study. All patients underwent standard Lichtenstein mesh hernioplasty for obstracted inguinal hernia repair in emergency operating room.Results: 5 patients (33%) developed wound site infection, 4 patients (27%) developed inguinodynia, 2 patient (13%) developed seroma formation, 1 patient (6%) developed hanging testis. 1 patient (6%) developed testicular infarct. Average postoperative hospital stay was 5.6 days (range =2-18 days).Conclusions: Mesh repairs can be safely performed in emergency inguinal hernia repair with acceptable morbidity.

scholarly journals Using inferior epigastric vascular anatomical landmarks for anterior inguinal hernia repair

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Weiming Li ◽  
Yijun Li ◽  
Lili Ding ◽  
Xiongzhi Chen ◽  
Qingwen Xu ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Foreign Bodies ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Complication Rates ◽  
Anatomical Landmarks ◽  
Post Operative Pain

Abstract Background Inferior epigastric vascular anatomical landmarks for anterior inguinal hernia repair is an alternative surgical procedure. We present our experience and outcome of the way. Methods We performed a retrospective analysis of 230 patients who received anterior tension-free hernia repair between May 2016 to May 2017. Among these cases, 120 were performed using the traditional transinguinal preperitoneal (TTIPP) technique while 100 were performed using the vascular anatomic landmark transinguinal preperitoneal (VALTIPP) technique. Between these two groups, we compared the operation time, length of hospital stay, complication rates, and the visual analog scale (VAS) for pain at 2 days, 3 months, and 6 months after surgery. Results Surgery was well-tolerated in both groups with no significant hemorrhage or complications. The operation times for the VALTIPP and TTIPP groups were 42.52 ± 9.15 and 53.84 ± 10.64 min (P < 0.05), respectively. Ten patients in the VALTIPP group and 17 patients in the TTIPP group reported sensations of foreign bodies (P < 0.05). The VAS pain score in VALTIPP patients at 2 days (4.0 ± 0.5), 3 months (1.0 ± 0.3), and 6 months (0.9 ± 0.3) were significantly lower when compared with those of TTIPP patients (5.3 ± 0.9 at 2 days, 1.8 ± 0.4 at 3 months, and 1.1 ± 0.1 at 6 months, p < 0.05). No statistically significant differences were found in age, gender, BMI, hernia type and location, follow-up period, incidence of post-operative seromas, recurrence rate, or length of hospital stay. Conclusion Anterior inguinal hernia repair using inferior epigastric vascular anatomical landmarks may lead to reduced operation times, reduced sensations of foreign bodies, and reduced post-operative pain. This technique is simple, practical, and effective in the management of inguinal hernias.

scholarly journals A COMPARATIVE AND RANDOMIZED STUDY BETWEEN TRANS ABDOMINAL PRE-PERITONEAL VERSUS TOTALLY EXTRA-PERITONEAL LAPAROSCOPIC TECHNIQUES OF INGUINAL HERNIA REPAIR

2020 ◽  
pp. 26-29
Author(s):  
Nikhil Agrawal ◽  
Swapnil Sen
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Statistical Hypothesis ◽  
Categorical Variables ◽  
Chi Squared

A hernia, an abnormal protrusion of an organ or tissue through a defect in its surrounding wall is a very common surgical problem. Approximately 75% of all hernias are usually groin hernias, among which 95% are inguinal region hernias. Various methods of repair have been employed which have progressed from open repair to various laparoscopic approaches. There is insufficient data to draw conclusions about the relative effectiveness of the two laparoscopic methods. Overall superiority of the two laparoscopic methods has not been demonstrated in available literature. AIM: The purpose of this study is to compare the clinical effectiveness and relative efficiency of laparoscopic TAPP and laparoscopic TEP for inguinal hernia repair. MATERIALS AND METHODS: Hospital based comparative randomised study on 100 patients admitted in General Surgical wards with Inguinal hernia at a tertiary care centre of Eastern India. Randomization in two groups was done by lottery system. A well designed proforma containing various parameters under study was used for data collection. Baseline information were collected via structured interview using predesigned questionnaire. For statistical analysis data were entered into a Microsoft excel spreadsheet and then analyzed by SPSS version 24 and GraphPad Prism version 5. Data had been summarized as mean and standard deviation for numerical variables and count and percentages for categorical variables. Two-sample t-tests for a difference in mean involved independent samples or unpaired samples. Paired t-tests were a form of blocking and had greater power than unpaired tests. A chi-squared test (χ2 test) was any statistical hypothesis test wherein the sampling distribution of the test statistic is a chi-squared distribution when the null hypothesis is true. Unpaired proportions were compared by Chi-square test or Fischer’s exact test, as appropriate. RESULTS: TAPP was associated with significantly higher incidence of haematoma, length of hospital stay, early postoperative pain and longer operative time as compared to TEP. Visceral injury and vascular injury were found more in TAPP as compared to TEP but this was not statistically significant. Seroma, port site hernia, persisting numbness and mesh/deep infection was higher in group-A (TAPP) as compared to group-B (TEP) but this was not statistically significant. Conversion to open procedure and persistent pain were comparable among the two methods. Hernia recurrence rates were higher in the TEP group in this study although it was statistically insignificant. CONCLUSION: TAPP was associated with significantly higher incidence of haematoma, length of hospital stay, early postoperative pain and longer operative time as compared to TEP.

scholarly journals Managing bilateral inguinal hernia laparoscopically: is it gold standard?

2016 ◽  
Vol 4 (1) ◽  
pp. 296
Author(s):  
Kalpesh H. Patel ◽  
Jayesh B. Gohel ◽  
Bhumika J. Patel
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Bilateral Inguinal Hernia ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background:Even after many studies done in recent years, no consensus has been achieved on the surgical technique of inguinal hernia repair. It was believed that in bilateral inguinal hernia cases laparoscopic surgery is very much advantageous as it can be done through same incisions as unilateral laparoscopic inguinal hernia repair (no additional incision required), whereas in open surgery for bilateral case separate groin incision for each side required. Aim of this study is to evaluate and compare results of bilateral inguinal hernia patients operated by laparoscopic (transabdominal preperitoneal) or open (lichenstein) repair.Methods: A prospective comparative study was conducted in a tertiary care teaching hospital over the period of two years. 60 patients with bilateral inguinal hernia were taken up and randomly divided into two groups. Group I (study group) includes patients operated by bilateral laparoscopic hernia repair (TAPP) and Group II (control group) includes patients operated by open hernia repair (lichenstein tension free hernioplasty). All patients were followed up for 18 months post-operatively. All patients of both groups were monitored for operative time, conversion rate, length hospital stay, post-operative complications and recurrence, time to return to work.Results:Statistically there was significant difference between both groups in terms of length of hospital stay and time to return to work. Group I patients where TAPP surgery performed, 22 patients (73.33%) were discharged within 36 hours of surgery, whereas in Group II patients - control group where open surgery performed, only 4 patients (13.33%) discharged within 36 hours. All 30 patients (100%) in group I had joined their routine work within 10 days of surgery; whereas in Group II patients only 4 cases (13.33%) joined duties on or before 10 days and most of the patients 26 (86.67%) had taken more than 10 days to resume their duties. But there was no significant difference between operative time, complication rates and recurrence rates. All cases in group I were completed laparoscopically (no conversion to open repair).Conclusions:Simultaneous bilateral inguinal hernia repair laparoscopically does not increase the risk for the patient and has an equal morbidity compared with unilateral repair, length of hospital stay, and return to normal work and over all recovery after laparoscopic repair is faster than after open bilateral simultaneous repair. Laparoscopic inguinal hernia repair of bilateral hernias should be recommended as the gold standard.

scholarly journals Laparoscopic totally extra peritoneal (TEP) inguinal hernia repair: A series of 47 cases

2017 ◽  
Vol 5 (4) ◽  
pp. 120-123
Author(s):  
Suman Kumar Shrestha
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
College Teaching ◽  
Operation Time ◽  
Medical College ◽  
Inguinal Hernias ◽  
Total Extraperitoneal ◽  
The Mean

Background: Over the past years, several surgical techniques have been evolved, among which total extraperitoneal inguinal hernia repair is the laparoscopic technique which is more popular now.Objective: To evaluate the outcome of totally extra peritoneal laparoscopic hernioplasty in terms of operation time, hospital stay and complications.Methods: The prospectively designed descriptive study was carried out at Department of Surgery Unit III, Kathmandu Medical College Teaching Hospital from February 2014 to April 2015. Forty seven consecutive patients above 15 years of age underwent totally extra peritoneal repairs for inguinal hernias. The selection criteria were reducible primary or recurrent, unilateral, direct and indirect inguinal hernias. All the relevant details of each patient were noted subsequently and analyzed statistically using Statistical Program for Social Sciences (SPSS) version 15.Results: The mean age of patient was 49±2.5 years. The mean operation time was 65±5.3 minutes. There were no serious complications except four (8.5%) cases of groin seroma which resolved after single time aspiration. Three (6.3%) cases had developed recurrence, two (4.2%) had developed hydrocele in a median follow up period of 6±1.5 (range, 3-9months). The mean inpatient hospital stay was 1.7±0.2 (range, 1-2.4days).Conclusion: Total extra peritoneal hernioplasty is safe and feasible with acceptable complications and recurrence rates.Journal of Kathmandu Medical College, Vol. 5, No. 4, Issue 18, Oct.-Dec., 2016, page: 120-123

scholarly journals Comparative study between laparoscopic trans-abdominal preperitoneal and open mesh hernioplasty in repair of non-complicated inguinal hernia

2019 ◽  
Vol 7 (1) ◽  
pp. 24
Author(s):  
Waleed Yusif El Sherpiny
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Group ◽  
Routine Activities ◽  
Group A ◽  
Group B ◽  
Open Hernia Repair ◽  
Mesh Hernioplasty

Background: Inguinal mesh hernioplasty is one of the common procedures performed all over the world. It can be done either through open or laparoscopic techniques. The aim of this study was to compare the outcomes of Lichtenstein tension free hernioplasty versus laparoscopic transabdominal pre-peritoneal (TAPP) mesh repair considering, duration of the surgery, hospital stay, and duration to resume normal activity, degree of postoperative pain, wound infection, recurrence and complications.Methods: Adult patients presented to the general surgical OPD, with the diagnosis of inguinal hernia underwent either Lichtenstein repair or laparoscopic repair by TAPP.Results: Patients in Group A (open-repair) had significantly greater level of local pain during rest and during routine activities than those within Group B (laparoscopic group) during the postoperative period assessed on the visual-analogue scale. Mean operative time for open hernia repair was 43.7 minutes and for laparoscopic hernia repair was 59.03 minutes and the difference were statistically significant (p=0.0001). The mean duration of hospital stay for open hernia repair was 2.16 days and that for laparoscopic hernia repair was 1.08 days with a (p=0.00001) which was statistically significant. The time to resume routine activities was much shorter among Group B patients than patients in Group A. Only one recurrence (3.3%) was seen in Group B after 6 months follow up.Conclusions: It is concluded that laparoscopic TAPP repair of inguinal hernia in adults is safe and preferred operation as compared to open inguinal hernia repair.

scholarly journals Postoperative condition of patients as a result of treatment of inguinal hernias by laparoscopic and open methods

2021 ◽  
pp. 30-35
Author(s):  
V.V. Skyba ◽  
◽  
A.V. Ivanko ◽  
N.V. Voytyuk ◽  
V.V. Lysytsia ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Open Access ◽  
Hospital Stay ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Lower Percentage ◽  
Hernia Surgery ◽  
Inguinal Hernias ◽  
Inguinal Hernia Surgery

Purpose – to analyze condition of patients after surgical treatment of inguinal hernias by laparoscopic and open methods. Materials and methods. A retrospective review of medical histories and outpatient charts of all patients who underwent inguinal hernia surgery at the Kyiv City Clinical Hospital No. 1 from January 2018 to July 2020 was conducted. Results. During the above period of time in our hospital open hernioplasty was performed in 86 patients, laparoscopic hernioplasty – 138 patients. With open hernioplasty, the average duration of surgical treatment was 40±12 minutes. The laparoscopic technique was 35±12 minutes. The length of hospital stay was significantly longer in the group of patients with the open method (48±12 hours) than in the group of laparoscopic plastic surgery (12±3 hours). From the group of patients who underwent open hernioplasty, 62 patients complained of long-term pain syndrome, from the group of laparoscopy – 12 patients. The cosmetic appearance was dissatisfied with 34 patients in the open access group and only 2 patients in the laparoscopic plastic group. Postoperative complications were observed in 34 patients who underwent surgical treatment through open access, and in 15 patients – by laparoscopy. Conclusions. The laparoscopic approach of inguinal hernia surgery is superior to open access, as it reduces the length of hospital stay, postoperative recovery, improves the aesthetic effect of the operation, reduces the frequency of infection of incisions. According to the results of the study, this technique gives a better result in the early postoperative period, a lower percentage of chronic pain and a higher degree of patient satisfaction compared to open access with the same low recurrence rate. Therefore, in our opinion, laparoscopic access to hernioplasty is the optimal method of treatment and can be recommended as a method of choosing inguinal hernia surgery. Postoperative assessment of the quality of life of patients after treatment of inguinal hernia by laparoscopic and open methods. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: inguinal hernia, laparoscopy, open access surgery, analysis of methods, operation.

scholarly journals A comparative study of Desarda’s mesh free inguinal hernia repair with modified Bassini’s repair

2021 ◽  
Vol 6 (2) ◽  
pp. 104-115
Author(s):  
Hosni Mubarak Khan ◽  
◽  
Tirumal Rao Patwari
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Open Approach ◽  
Medical College ◽  
Inguinal Hernias ◽  
Mesh Free ◽  
Hospital Stays ◽  
A Prospective Study ◽  
Repair Techniques

Objective. This is a prospective study of 50 cases of inguinal hernias which were treated through open inguinal hernia repair techniques. The study was conducted with the objective of comparing the effectiveness of these procedures and complications. Materials and Methods. A number of 50 cases of inguinal hernias admitted to Dr. BR Ambedkar Medical College and Hospital were selected on the basis of the non-probability (purposive) sampling method. All the patients with direct and indirect uncomplicated hernias treated by means of an open approach were included. After the preoperative preparation, they were randomly chosen either for Desarda’s or Modified Bassini’s repair techniques. Results. In the postoperative period, moderate pain was experienced by 19 patients included in the Desarda group and 17 patients included in the Modified Bassini’s repair group on day 1. The postoperative wound infection developed in 2 cases of Desarda and 3 cases of Modified Bassini’s, erythema was observed in 2 cases of Desarda and 3 cases of Modified Bassini’s, 3 cases reported the occurrence of seroma in the Desarda group and 4 cases of seroma were recorded in the Modified Bassini’s group. Conclusions. The patients who underwent Desarda repair complained of a higher intensity of pain, which could probably be attributed to the extensive dissection involved. The duration of Desarda repair was longer due to the learning curve of the surgeons in our hospital. The return to normal gait and normal activities was significantly lower in the Desarda group. The duration of hospital stays and the postoperative complications was not significantly different in the two groups. There were no recurrences in either of the groups until the current study.

scholarly journals Contralateral exploration and repair of occult inguinal hernias during laparoscopic inguinal hernia repair: systematic review and Markov decision process

BJS Open ◽  
2020 ◽  
Vol 5 (2) ◽  
Author(s):  
N H Dhanani ◽  
O A Olavarria ◽  
S Wootton ◽  
M Petsalis ◽  
N B Lyons ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Markov Decision Process ◽  
Decision Process ◽  
Expectant Management ◽  
Contralateral Exploration ◽  
Unilateral Inguinal Hernia ◽  
Inguinal Hernias ◽  
Markov Decision

Abstract Background Contralateral clinically occult hernias are frequently noted at the time of laparoscopic unilateral inguinal hernia repair. There is no consensus on the role of contralateral exploration and repair. This systematic review assessed the safety and efficacy of operative repair of occult contralateral inguinal hernias found during unilateral repair. Methods PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception to February 2020. Adults diagnosed with a unilateral inguinal hernia undergoing laparoscopic repair were included. The primary outcome was the incidence of occult contralateral hernias. Summative outcomes of operative and expectant management were reported along with development of a Markov decision process. Results Thirteen studies (1 randomized trial, 12 observational cohorts) with 5000 patients were included. The incidence of occult contralateral inguinal hernias was 14.6 (range 7.3–50.1) per cent. Among patients who underwent repair, 10.5 (4.3–17.0) per cent experienced a postoperative complication. Of patients managed expectantly, 29 per cent later required elective repair for symptoms. Mean follow-up was 36 (range 2–218) months. Using a Markov decision process, it was calculated that, for every 1000 patients undergoing unilateral inguinal hernia repair, contralateral exploration would identify 150 patients with an occult hernia. Repair would result in 15 patients developing a postoperative complication and 105 undergoing unnecessary repair. Alternatively, expectant management would result in 45 patients requiring subsequent repair. Conclusion Contralateral repair is not warranted in patients with occult hernias diagnosed at the time of elective hernia repair. The evidence is largely based on observational studies at high risk of bias.

scholarly journals P035 EMERGENCY BILATERAL GORIN HERNIA REPAIR IN UNILATERAL COMPLICATED INGUINAL HERNIA REAPIR WITH CONCOMITNAT CONTRALATERAL HERNIA. COHORTS COMPARATIVE OUTCOMES ANALYSIS USING PROPENSITY SCORE MATCHING

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Alejandro Bravo-Salva ◽  
Francisco Rómulo Ochoa-Segarra ◽  
Ana María Gonzálz-Castillo ◽  
Joan Sancho-Insenser ◽  
Miguel Pera-Roman ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Propensity Score ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Propensity Score Matching ◽  
Inguinal Hernia Repair ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Bilateral Inguinal Hernia ◽  
Bilateral Hernia

Abstract Aim Aim of our study was to analyze outcomes and safety of bilateral inguinal hernia repair in unilateral groin complicated hernia with contralateral groin hernia. Material and Methods Retrospective cohorts study following STROBE statements on a prospective Emergency Surgery Department database. Inclusion criteria were: patients with emergency hernia repair from 2008 to 2018, 18 years old. Unilateral or bilateral inguinal hernia repair without other abdominal wall hernia repairs. Comparative analysis between two group unilateral hernia repair (UH) vs bilateral hernia repair (BH) those patients with unilateral complicated inguinal hernia with contralateral inguinal hernia. Propensity score matching (PSM) between groups was performed to eliminate statistically groups differences. Outcomes between groups were analyzed with special attention to postoperative morbimortality and hernia recurrence. Results 341 patients were included, 38(11.1%) were performed bilateral hernia repair. Groups differences were: higher rate of inguinoscrotal inguinal hernia (36.8 vs 22.8), prophylactic antibiotics use (94.7 vs 81.8) and general Anesthesia use (52.6% vs 50.2%). General high rates of morbidity and mortality were observed (5.9% and 41.9) and 22 (6.5%) hernia repair recurrence were detected. After PSM no differences between surgery outcomes groups were observed with similar morbidity, recurrence or hospital stay. Conclusions Emergency inguinal hernia repair has high morbidity and mortality rates in our experience. Emergency Bilateral inguinal hernia repair in context of hernia complication seems safe without recurrence or hospital stay increase.

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