scholarly journals Should a laparoscopic repair be the first choice in incarcerated inguinal hernia

2020 ◽  
Vol 7 (4) ◽  
pp. 961
Author(s):  
Tamer Akay ◽  
Murat Akici

Background: An important part of the procedures for admission to emergency surgery is incarcerated inguinal hernia repair. Minimally invasive surgical procedures have led surgeons to perform these operations laparoscopically. The aim of this study was to demonstrate the safety of laparoscopic inguinal hernia repair in patients admitted to the emergency department with incarcerated inguinal hernia.Methods: The files of patients who underwent laparoscopic surgery for incarcerated inguinal hernia between January 2015 and June 2019 in Bandirma State Hospital General Surgery Clinic was retrospectively reviewed. Pearson Chi-Square test was used as statistical method. Version 18 of the SPSS program was used. P<0.05 was considered significant as it should be.Results: A total of 63 patients were included in the study. The mean age was 52.8 years. A total of 64 repairs were performed on the right side in 41 (65%) cases, on the left side in 21 (33.3%) cases and on both sides in one (1.58%) case. Four (6.25%) of 63 patients had strangulation. Three of these patients (4.68%) had strangulated hernia, and one (1.56%) had strangulated and incarcerated hernia. Four patients (6.25%) presented with ileus. The mean operation time was 65 minutes (35-110 minutes). Mean duration of hospitalization was 2.4 days. The rate of minor complications was 4.68%. Only one (1.56%) major complication was iatrogenic small intestinal perforation. The mean follow-up time was 25.2 months. There was no early recurrence in patients.Conclusions: We suggest that laparoscopic transabdominal preperitoneal hernia repair can be performed safely in emergency procedures in patients with incarcerated inguinal hernia.

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Thanh Xuân Nguyễn ◽  
Đức Anh Lê

Tóm tắt Đặt vấn đề: Thoát vị bẹn là bệnh lý phổ biến trong ngoại khoa, đặc biệt lĩnh vực ngoại tiêu hóa. Từ khi phẫu thuật nội soi ra đời và ứng dụng tấm nhân tạo trong điều trị thoát vị bẹn, đã có những thay đổi trên thế giới về điều trị cho người bệnh thoát vị bẹn. Phương pháp phẫu thuật nội soi đặt tấm nhân tạo đường xuyên phúc mạc TAPP (Trans-Abdominal Pre-Peritoneal) có nhiều ưu điểm như đường cong huấn luyện ngắn, phát hiện thoát vị bẹn đối bên và điều trị cả trường hợp có biến chứng, nên được nhiều phẫu thuật viên trẻ lựa chọn. Phương pháp nghiên cứu: Nghiên cứu tiến cứu, lâm sàng mô tả, theo dõi dọc 19 người bệnh với 21 trường hợp thoát vị bẹn được phẫu thuật TAPP tại Bệnh viện Trung ương Huế - Cơ sở 2 từ tháng 12/2018 đến 3/2019. Kết quả: Tuổi trung bình 66,8 ± 14,35. Thoát vị bẹn nghẹt 4,8%. Thoát vị bẹn cầm tù 9,5%. Thời gian phẫu thuật trung bình một bên 65,3 ± 19,6 phút, hai bên 102,5 ± 12,5 phút. Thời gian hậu phẫu trung bình 4,1 ± 1,6 ngày. Phát hiện 2 trường hợp thoát vị bẹn đối bên. Sau 3 tháng không có trường hợp nào tái phát. Kết luận: Phẫu thuật TAPP là một phẫu thuật an toàn, hiệu quả có thể ứng dụng rộng rãi. Abstract Introduction: Inguinal hernia repair is one of the most common operation performed in general surgery, especially in digestive field. Since the introduction of laparoscopic repair and application of synthetic mesh to treatment, the trends have changed in the last decade in treatment for inguinal hernia. The laparascopic trans-abdominal pre-peritoneal (TAPP) has a short learning cure. TAPP has many advantages, such as wide dissection, contralateral side checkup, treatment strangulated hernia and incarcerated hernia, a short learning cure has been the first choice for surgeons. Materials and Methods: Study subjects included 19 patients with 21 inguinal hernia cases treated by laparoscopic trans-abdominal pre-peritoneal (TAPP) technique at the Hue Central Hospital - Base 2 from 12/2018 though 3/2019. Descriptive and prospective follow-up study. Results: The mean age was 66,8 ± 14,35 years old. Strangulated hernia and incarcerated hernia respectively accounted for 4,8% and 9.5% of cases. The mean durations of unilateral inguinal hernia repair and bilateral inguinal repair were 65,3 ± 19,6 mins and 102,5 ± 12,5 mins, respectively. Mean duration of postoperative stay was 4,1 ± 1,6 days. 2 case (3.2%) with contralateral inguinal hernia were detected. At 3-months evaluation, there was no recurrence. Conclusion: TAPP is a safe and effective surgical technique; should be encouraged and widely applied in different levels hospitals. Keyword: inguinal hernia, TAPP, laparoscopic surgery, mesh.


2017 ◽  
Vol 5 (4) ◽  
pp. 120-123
Author(s):  
Suman Kumar Shrestha

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


2020 ◽  
Vol 24 (5) ◽  
Author(s):  
Carla Hipólito ◽  
Vicente Vieira ◽  
Virginia Antunes ◽  
Petra Alves ◽  
Adriana Rodrigues ◽  
...  

Background: Inguinal hernia is one of the most common conditions presented for surgical repair in children and laparoscopic approaches are increasingly performed. Previous studies have shown safety and efficacy in the use of supraglottic devices (SGD) as an alternative to tracheal intubation, which fits particularly well with outpatient anesthesia. Methodology: we conduct a retrospective observational study, collecting data from the electronic anesthetic form, from all patients aged 0 to 17 y who underwent ambulatory laparoscopic percutaneous internal ring suturing between February 2015 and August 2019, if I-gelTM was used to airway management. Results: We found 230 patients meeting the inclusion criteria. The mean age was 5.2 y old, mean weight 20.1 kg. All patients were ASA I (n=203) or ASA II (n=27). The mean surgery duration was 38 minutes. We found 4 respiratory adverse events, three bronchospasms, and one laryngospasm, managed in the operating room. Ninety percent of the surgeries were performed without neuromuscular blockade. Conclusion: I-gelTM was a safe, effective, and convenient alternative to airway management to laparoscopic inguinal hernia repair in the ambulatory setting. According to available literature, our practice did not represent an increased risk for the studied respiratory events. SGD obviates the need for neuromuscular blockade. Key words: I-gel; Supraglottic devices; Laparoscopy; Inguinal hernia repair; Pediatrics; Anesthesia, ambulatory Citation: Hipólito C, Vieira V, Antunes V, Alves P, Rodrigues A, Santos MJ. Airway management with I-gelTM for ambulatory laparoscopic inguinal hernia repair in children; a retrospective review of 230 cases. Anaesth. pain intensive care 2020;24(5): Received: 18 February 2020, Reviewed: 5 August, 6 September 2020, Accepted: 11 September 2020


Author(s):  
Anthony Ferrantella ◽  
Juan E. Sola ◽  
Hallie J. Quiroz ◽  
Brent A. Willobee ◽  
Chad M. Thorson ◽  
...  

Author(s):  
Sabriye Dayı

INTRODUCTION: Inguinal hernia repair is one of the most common surgical procedures in pediatric surgery. In parallel with the advances in the field of medicine, various laparoscopic techniques have been developed in inguinal hernia repair. The Burnia technique is one of the latest published techniques and it is the cauterization of the inguinal hernia sac laparoscopically without using sutures in girls. The aim of this study is the investigation of the use of Burnia technique in clinical practice, and its postoperative outcomes. Any article concerning the use of this technique in Turkey has not been encountered. METHODS: The demographic features of patients, preoperative, peroperative, postoperative and follow-up results of 41 patients who had been operated with Burnia technique by a single surgeon within 2 years were reviewed retrospectively. Laparoscopically, the camera was first placed at an inclination of 30 degrees to the umbilical region using Hasson technique, and then, a single port was used for cauterization of the hernia sac. The Hernia sac was pulled into the abdominal cavity and cauterized. RESULTS: Burnia technique was applied to 62 inguinal hernia sacs in 41 girls. Their ages ranged from 1.5 to 16 years (median 36 months) with body weights ranging between 3.5 kg-40 kg (median 12 kg). Preoperatively 15 patients had right (37%), 19 patients left (46%), 7 patients bilateral inguinal hernias (17%). During surgery, 14 of the unilateral inguinal hernias were found to have a hernia sac on the contralateral side, and the rate of bilateral hernia increased to 51 percent. In one patient ovary was in the inguinal canal, and after its reduction, we proceeded with the operation Unexpectedly. in one patient, right ovarian torsion was detected which was detorsioned, and hernia surgery was performed in the same session. The duration of the operation was 5-35 min (median 15 min) for unilateral and 8-45 min (median 20 minutes) for bilateral hernias. None of these patients developed peroperative and postoperative complications. Follow-up time was minimum 10 months, and maximum 3 years. Recurrence was not detected. DISCUSSION AND CONCLUSION: Burnia technique seems to be effective and safe. The contralateral side and other intra-abdominal pathologies are explored. The cosmetic appearance is its another advantage. The operation time is very short due to the fact that only the hernia sac is cauterized. Comparison of this technique with other laparoscopic techniques is planned in the future study.


Author(s):  
Ergun Ergün ◽  
Ufuk Ateş ◽  
Kutay Bahadır ◽  
Fırat Serttürk ◽  
Bahtiyar Mehdi ◽  
...  

Objective: Laparoscopic inguinal hernia surgery has recently been a preferred surgical approach among pediatric surgeons. The aim of this study is to compare open and laparoscopic inguinal hernia repair techniques in terms of complications and recurrences in children. Method: Patients whose inguinal hernias were operated with laparoscopic percutaneous internal ring suturing technique and open high ligation technique were included in the study. Dermographic data, surgical details and postoperative complications of the patients were reviewed retrospectively. Results: A total of 246 patients were included in the study. Among them 113 patients underwent laparoscopic inguinal hernia repair and 133 patients open inguinal hernia repair. The mean age of patients in the laparoscopic group was 27.7 months (1-192 months) and the mean age of patients in the open surgery group was 27.5 months (1-156 months). Diagnostic laparoscopy was performed in 104 patients who underwent open surgery, and the contralateral inguinal hernia repair was performed in 33 of the patients after hernia was detected on the contralateral side. Recurrence was observed in 2.6% (n=3) of the patients who underwent laparoscopic surgery and 3.7%(n=5) of the patients undergoing open surgery. In 2 of the patients who underwent laparos- copic surgery had hematomas that resolved without intervention and 1 had hydrocele. On the other hand 4 of the patients who underwent open surgery had iatrogenic undescended testis and 1 had hydrocele. The follow-up periods of the patients who underwent laparoscopic or open surgery were 13.2, and 74 months, respectively. Conclusion: Laparoscopic inguinal hernia repair has results comparable to open repair in terms of recurrence and complications. The advantage of the laparoscopic method can be considered as the ability to evaluate the contralateral side in all cases without increase in the risk of recur- rence and complications, and the ability to operate without scarring , but with good cosmetic results.


Medicine ◽  
2016 ◽  
Vol 95 (52) ◽  
pp. e5686 ◽  
Author(s):  
Shuo Yang ◽  
Guangyong Zhang ◽  
Cuihong Jin ◽  
Jinxin Cao ◽  
Yilin Zhu ◽  
...  

2017 ◽  
Vol 99 (8) ◽  
pp. 614-616 ◽  
Author(s):  
D Light ◽  
S Bawa ◽  
P Gallagher ◽  
L Horgan

Introduction The Ethicon™ laparoscopic inguinal groin hernia training (LIGHT) course is an educational course based on three days of teaching on laparoscopic hernia surgery. The first day involves didactic lectures with tutorials. The second day involves practical cadaveric procedures in laparoscopic hernia surgery. The third day involves direct supervision by a consultant surgeon during laparoscopic hernia surgery on a real patient. We reviewed our outcomes for procedures performed on real patients on the final day of the course for early complications and outcomes. Methods A retrospective study was undertaken of patients who had laparoscopic hernia surgery as part of the LIGHT course from 2013 to 2015. A matched control cohort of patients who had elective laparoscopic hernia surgery over the study period was identified. These patients had their surgery performed by the same consultant general surgeons involved in delivering the course. All patients were followed up at 6 weeks postoperatively. Results A total of 60 patients had a laparoscopic inguinal hernia repair and 23 patients had a laparoscopic ventral hernia repair during the course. The mean operative time for laparoscopic inguinal hernia repair was 48 minutes for trainees (range 22–90 minutes) and 35 minutes for consultant surgeons (range 18–80 minutes). There were no intraoperative injuries or returns to theatre in either group. All the patients operated on during the course were successfully performed as daycase procedures. The mean operative time for laparoscopic ventral hernia repair was 64 minutes for trainees (range 40–120 minutes) and 51 minutes for consultant surgeons (range 30–130 minutes). Conclusions The outcomes of patients operated on during the LIGHT course are comparable to procedures performed by a consultant. Supervised operating by trainees is a safe and effective educational model in hernia surgery.


2020 ◽  
Author(s):  
Kai Wang ◽  
Sarah Siyin Tan ◽  
Yue Xiao ◽  
Zengmeng Wang ◽  
Chunhui Peng ◽  
...  

Abstract Background: Congenital primary inguinal hernia is a common condition among children. Although much literature regarding inguinal hernia is available, large scale analysis are few, and rarely do they expand on gender difference or incarcerated hernias. Methods: Patients with unilateral or bilateral inguinal hernia who were admitted to our hospital and received open inguinal hernia repair (OIHR) or laparoscopic inguinal hernia repair (LIHR) under general anesthesia were included. Medical records were retrospectively collected and analyzed.Results: A total of 12190 patients were included in this study. The ratio of male to female was 4.8:1. There was a total of 10646 unilateral hernias (87.3%) and 1544 bilateral hernias (12.7%), with a corresponding ratio of 6.9:1. 12444 hernia repair surgeries, 11083 (89.1%) OIHR and 1361 (10.9%) LIHR, were held. OIHR had a shorter operative time than LIHR for all unilateral and female bilateral repair, unlike for bilateral male repair. There was no difference between OIHR and LIHR for ipsilateral recurrent hernia in males. There was a difference between OIHR and LIHR for metachronous contralateral hernia.Incarcerated inguinal hernia was associated with longer operative time, hospital stay and higher hospital costs. Females and patients under 1 year were more likely to present with incarcerated hernia.Conclusions: OIHR should be considered for male patients, especially for unilateral and complete inguinal hernia. LIHR is highly recommended for female patients. For incarcerated hernia, attention should be paid to patients under 1 year old, as they can be 60 times more susceptible, and females. Surgeons should also be aware of ovary hernias in females.


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