The technical characteristics and immediate results of laparoscopy trans-peritoneal and total extra-peritoneal hernioplasty

2016 ◽  
Vol 22 (3) ◽  
pp. 125-129 ◽  
Author(s):  
Aleksandr V. Sazhin ◽  
A. D Klimiashvili ◽  
E. Kochiay
Keyword(s):  
Inguinal Hernia ◽  
Average Duration ◽  
Inguinal Hernioplasty ◽  
Internal Organs ◽  
Gerontological Research ◽  
Operational Characteristics ◽  
Post Operative Pain ◽  
Clinical Center ◽  
Laparoscopic Hernioplasty ◽  
Duration Of Operation

Over the time of recent years, in surgical treatment of inguinal hernia such revolutionary changes occurred as implementation of Lichtenstein's nonstrain prosthetic inguinal hernioplasty (1986) into surgical practice and application of laparoscopic hernioplasty (Arregui M.E., 1992; McKernan and Ferzli, 1993). The study was carried out to evaluate reliability and effectiveness of application of trans-peritoneal and total extra-peritoneal hernioplasty in case of inguinal hernia. During 2012-2015, in the municipal clinical hospital №4 and the Russian gerontological research clinical center (Moscow) 12 patients underwent 12 hernioplasties using technique of total extra-peritoneal hernioplasty and 65 patients underwent 73 hernioplasties using technique of trans-peritoneal hernioplasty (in 8 cases herniae were bilateral). The technical intra-operational characteristics of procedures were analyzed. The evaluation of intra-operational and post-operational complications during earlier post-operational period and in a year after operation was carried out. The single patient in the group of total extra-peritoneal hernioplasty inguinal hernia was relapsing after herniotomy with plasty with local tissues. All herniae were one-sided. The average duration of operation made up to 62.5 minutes. The conversion was never required. In the group of trans-peritoneal hernioplasty average duration of operation made up to 58.5 minutes. The conversion was never required too. The rate of intra-operational complications in both groups was low. The most of the patients in main group (total extra-peritoneal hernioplasty) were ready to be discharged from the hospital at second day after operation. The total rate of post-operative complications made up to 20.6%. Only in the group of trans-peritoneal hernioplasty single relapse was observed after three months after operation. According to results of study, the laparoscopic inguinal hernioplasty is the most preferable and rational treatment of most of the types of inguinal herniae. The total extra-peritoneal hernioplasty is more preferable than trans-peritoneal hernioplasty because of number of reasons i.e. the post-operative pain is less expressed; operation is performed in retroperitoneal way; the risk of damaging of internal organs and development of peritoneal commissures is minimized.

scholarly journals The laparoscopic trans-abdominal pre-peritoneal hernioplasty in case of inguino-scrotal hernia

2016 ◽  
Vol 22 (4) ◽  
pp. 177-179
Author(s):  
Aleksandr V. Sazhin ◽  
A. D Klimiashvili ◽  
G. B Ivakhov ◽  
E. Kotchiay
Keyword(s):  
Chronic Pain ◽  
Average Duration ◽  
Total Rate ◽  
Effective Technique ◽  
Scrotal Hernia ◽  
Results Of Treatment ◽  
Operational Characteristics ◽  
Operative Complications ◽  
Duration Of Operation ◽  
Considerable Experience

The laparoscopic trans-abdominal pre-peritoneal hernioplasty is an effective technique of treatment of uncomplicated hernia. However, application of this technique at complicated forms (inguinal-scrotal, repeatedly relapsing, strangulated hernias) continues to be a point at issue. The treatment of inguinal-scrotal hernia requires from surgeon availability of considerable experience independently of selected technique. The study was carried out to evaluate reliability and effectiveness of application of trans-abdominal pre-peritoneal hernioplasty under inguinal-scrotal hernia. In municipal clinical hospital № 4 8 operations of hernioplasty was implemented using trans-abdominal pre-peritoneal hernioplasty from 2014 to 2015. The technical intra-operational characteristics of techniques were analyzed. The evaluation of intra-operational and post-operational complications in early post-operational period and after 3 and 6 months after operation was implemented. All hernias were primary and onesided ones and were operated by the same surgeon. The average duration of operation made up to 93.5 min. In no cases the conversion was needed. No severe intra-operational complications were detected. In no case chronic pain and relapsing were detected. The total rate of post-operative complications made up to 12.5%. All patients were satisfied with operation in 3 and 6 months after discharge from the hospital. According the results of study, trans-abdominal pre-peritoneal hernioplasty is an effective technique of treatment of inguinal-scrotal hernias comparative with results of treatment of primary uncomplicated hernias.

Advantages and faults of laparoscopic operations in treatment of ventral hernias

2020 ◽  
Vol 87 (3-4) ◽  
pp. 35-39
Author(s):  
V. V. Grubnik ◽  
R. P. Nikitenko ◽  
O. M. Stepanovichus ◽  
K. O. Vorotyntseva
Keyword(s):  
Average Duration ◽  
Comparison Analysis ◽  
Hernia Defect ◽  
Method Choice ◽  
Clinical Hospital ◽  
Laparoscopic Procedures ◽  
Laparoscopic Hernioplasty ◽  
Operation Duration ◽  
Duration Of Operation ◽  
Ventral Hernias

Objective. To conduct a comparison analysis of modern open, classic laparoscopic and separation laparoscopic hernioplastic procedures in treatment of ventral and postoperative ventral hernias. Materials and methods. During 2009 - 2019 yrs on the base of Odessa Regional Clinical Hospital 193 patients, suffering ventral and postoperative ventral hernias were operated. Depending on the hernioplasty method applied all the patients were divided on two groups. In the first one 100 patients were exposed to laparoscopic hernioplasty, including 91 patients - the standard laparoscopic operations. In the second group in 93 patients open hernioplasty was performed. Results. In the first group while using a standard laparoscopic procedures of hernioplasty the average duration of operation have constituted (114.0 ± 7.4) min, recurrence was revealed in 7 patients with large hernias (W3). In the second group the operation duration have constituted (130.0 ± 6.1) min, and recurrence was revealed in 8 patients. Conclusion. The operation method choice ought to be individually adjusted, taking into account the patient general status and age, presence of concurrent pathology, as well as the hernia defect dimensions and localization, in particular.

scholarly journals Minimal Accesss (TEP) versus Open Inguinal Hernioplasty: A Pragmatic Randomized Control Trial

2021 ◽  
Vol 7 (1) ◽  
pp. 75-78
Author(s):  
Ratna Rani Roy ◽  
Pankaj Kumar Saha ◽  
Md Abdulla Yusuf ◽  
Haridas Saha ◽  
Md Ibnul Hasan ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Laparoscopic Technique ◽  
Minimal Access ◽  
Post Operative Pain ◽  
Group A ◽  
Randomized Control ◽  
Group B ◽  
Duration Of Operation

Background: Inguinal hernia repair is the most frequently performed operation in general surgery. The standard method for inguinal hernia repair had changed little over a hundred years until the introduction of synthetic mesh. This mesh can be placed by either using an open approach or by using a minimal access laparoscopic technique. Objectives: The purpose of the present study was to compare minimal access laparoscopic mesh techniques with open techniques in hernioplasty. Methodology: This pragmatic randomized control trial was conducted in the Department of Surgery at Shaheed Suhrawardy Medical College & Hospital, Dhaka from January 2014 to December 2015 for a period of two years. Patients at any age with both sexes who were presented with inguinal hernia were selected as study population. These patients were divided into two group designated as group A and group B. In group A inguinal hernia repair was performed by laparoscopic technique and in group B open technique was used to repair the inguinal hernia. The comparison was done between open and laparoscopic technique of inguinal hernia repair in terms of duration of operation, per-operative complication, immediate post-operative pain, numbness, duration of hospital stay and time of return to normal activities. Follow up was done from 6 months to 2 years. Results: A total number of 200 patients were recruited for repairing of inguinal hernia. Duration of operation was longer initially in the laparoscopic groups (Laparoscopic approach 90 min vs. Lichtenstein approach 60 min). Post-operative pain was another important outcome to consider when choosing between laparoscopic and open repair of inguinal hernia. Laparoscopic repair had been associated with less post-operative pain than open repair. Operative complications were uncommon for both methods. Length of hospital stay was little shorter in laparoscopic group (laparoscopic 1-2 days vs. open technique 3-4 days); however, return to usual activity was earlier for laparoscopic groups (7 days) where open group: 20-30 days. The data available showed less persisting pain (Overall 8/80 versus 12/100) and less persisting numbness (Overall 3/80 versus 7/100) in the laparoscopic groups. Conclusions: In conclusion, minimal access laparoscopic mesh technique is better than open techniques in inguinal hernia repair. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 75-78

scholarly journals Open Maloney Repair for Adult Inguinal Hernia, 5 Years Experience in A Remote District

2018 ◽  
Vol 10 (1) ◽  
pp. 6-10
Author(s):  
Sami Ahmad ◽  
Nadim Ahmed ◽  
Jawher Lal Singha ◽  
Ferdoush Rayhan ◽  
ASM Farhad Ul Hassan ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Average Duration ◽  
Study Group ◽  
Hernia Surgery ◽  
Inguinal Hernias ◽  
Inguinal Hernia Surgery ◽  
Number Of Patients ◽  
Duration Of Surgery ◽  
Secondary Closure ◽  
The Right

Background: In a remote district city of Bangladesh, inguinal hernias were repaired by Maloney (Darning) method.Efficacy of Darning repair was compared in this study.Aims and Objectives: The aim of this study was to determine the feasibility of doing Maloney ( Darn ) repair for adult inguinal hernias by specialist surgeons at remote districts . Age of the patients in ourstudy were above 20 years.Study Design: A descriptive retrospective study.Materials and Methods:In our study we included 2000 patient of inguinal hernia surgery repairs from May 2012 through June 2017. In the patients of the study group we repaired inguinal hernia by Maloney ( Darning) technique. Number of patients were 2000 ( male 1990 [99.5%] female 10 [.5%] with a mean age of 45.7 years. There were 1002(50.1%) hernias on the right side, 890(44.5%) were on the left side and 108(5.4%) were bilateral. Among the hernias 1419 ( 70.9%) were indirect, 575 (28.7%) were direct and 4 (0.2%) were of both direct and indirect (Pantoolon type), 2 (0.1%) were of femoral hernia. All were of primary hernias, recurrent hernias and hernias in patients with apparently weak musculature were repaired by Lychtenistein method with prolein mesh and were not included in this stpudy. 60 (3%) patients had feature of incarceration and 20 (1%) patients presented with obstruction. Among the obstructed hernias 8 (.4%) had strangulation and in 2 (.1%) resection and anastomosis were required for gangrenous ileum. In rest of the cases of strangulation circulation returned after incising the constricting ring and hot mob compression. We used IV antibiotic for 24 hours stated with induction of anaesthesia followed by oral for next 6 days. We used Injection Ceftrixone followed by Cefixime and in some patients Flucloxacillin.Statistics Analysis Used: Simple frequencies, proportion and cross tabulation.Results: Average duration of surgery was 70 minutes. There was no perioperative mortality. 90 (4.5%) patients developed mild subcutaneous wound infection, haematoma occurred in 160 ( 8% ) patients and seroma found in 300 ( 15% ) patients. All haematoma and seroma subsided gradually. Only 1 patient needed secondary closure for infected wound gap. The average duration of hospitalization was 3 days. All patients in study group are still in contact with me. Three patients (0.15%) had recurrences. All the recurrent cases reported within 6 months of their operations. Among the three age of 2 patients was above 60 and one patient of age above 70 had Maloney hernia repair for obstructed hernia.Conclusion:In remote places where prolene mesh is not available or is costly we can repair inguinal hernia by Maloney operation with very simple antibiotics with good results in comparison with other methods.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 6-10

scholarly journals Transabdominal Pre-peritoneal Mesh Repair versus Lichtenstein’s Hernioplasty

2017 ◽  
Vol 15 (2) ◽  
pp. 135-140 ◽  
Author(s):  
Rajan Koju ◽  
Ram Bhakta Koju ◽  
Balaram Malla ◽  
Yashad Dongol ◽  
Lok Bikram Thapa
Keyword(s):  
Quality Of Life ◽  
Minimal Invasive ◽  
Laparoscopic Technique ◽  
P Value ◽  
Early Return ◽  
Post Operative Pain ◽  
Study Results ◽  
Ethical Committee Approval ◽  
Duration Of Operation

Background: In the era of minimal invasive surgery, hernia repair has seen a paradigm shift from open to laparoscopic technique. However, superiority of laparoscopic repair over open repair is still controversial. Available literatures have shown laparoscopic technique to be better in term of post-operative pain and early return to work.Methods: In this prospective study, a total of 102 patients aged 21-78 years with inguinal hernia were recruited and enrolled into two comparative groups, namely Lichtenstein’s and Transabdominal pre-peritoneal, and each group containing 51 participants. Hospital ethical committee approval and written informed consent from patients was obtained. Primarily, the duration of operation, post-operative pain and complication, and quality of life after surgery was compared between the two different approaches of hernia repair.Results: The study results demonstrated a statistically significant superiority of trans abdominal pre-peritoneal repair over Lichtenstein’s hernioplasty in terms of post operative pain (2.00±0.63 vs 3.90±0.74 VAS score, P value<0.001), hospital stay (2.33±0.62 vs 2.96±0.20 days, P value <0.001) and quality of life with early return to normal work (13.39±0.60 vs 17.88±0.86 days, P value <0.001); whereas a prolonged operative time was seen in transabdominal pre-peritoneal repair (96.08±27.08 vs 42.55±5.95 mins, P value <0.001). Conclusions: This study has shown that transabdominal pre-peritoneal repair is better than Lichtenstein’s in respect to post-operative pain, quality of life and post-operative complication. However, it has prolonged operative duration than conventional method.

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