Non-plug technique of bilayer patch device insertion for indirect inguinal hernia repair

Background/Aim. Despite a huge success in decrease rate of recurrences of inguinal hernia in mesh and ?plug in? techniques, a new problem appears such as chronic pain and other complications. The aim of this paper was to present the original modification of bilayer patch device (Prolene Hernia System?, Ethicon) insertion in ?non-plugged? fashion and 11-year experience with this open technique for the indirect hernia repair in a male. Methods. This retrospective study included 96 male patients with 103 indirect unilateral and bilateral inguinal hernias, operated due to a primary or recurrent hernia in an 11-year interval (2004?2015). In all operation an extended Prolene Hernia System? (PHS) bilayer patch device was inserted medially of inferior epigastric vessels through a small incision in Hasselbach's triangle, thus avoiding plug component of device connector into the internal ring. All data were taken from the medical records, operative protocols, and telephone questionnaire. Results. Non-plugged technique of bilayer patch device insertion was presented in details. Mean age of patients was 59 years. There were 3 (2.91%) patients with procedure-related complications, two patients with postoperative seroma and one with scrotal ecchymosis. There were 86 (89.6%) patients who answered on the questionnaire. During 11 years of following, recurrence of a hernia occurred in 1 patient, one had funiculocele and only one had chronic pain during 6 months. Almost all patients (97.68%) were satisfied with the procedure and results of hernia surgery. Conclusion. Nonplugged insertion of bilayer patch device is a safe technique for solving the primary and recurrent indirect inguinal hernias. The low incidence of the recurrence and chronic pain many years after the operation justifies this technique even in hospitals not specialized for the hernioplasty.

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Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Using Memory-Ring Mesh: A Pilot Study

Surgery Research and Practice ◽

10.1155/2016/9407357 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5

Author(s):

Takeshi Matsutani ◽

Tsutomu Nomura ◽

Nobutoshi Hagiwara ◽

Akihisa Matsuda ◽

Yoshimune Takao ◽

...

Keyword(s):

Chronic Pain ◽

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Operation Time ◽

Indirect Inguinal Hernia ◽

Trocar Site ◽

Transabdominal Preperitoneal ◽

Tapp Repair ◽

Inguinal Hernias

Purpose.To evaluate the feasibility, safety, and effectiveness of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair using a memory-ring patch (Polysoft™mesh).Patients and Methods.Between April 2010 and March 2013, a total of 76 inguinal hernias underwent TAPP repair using Polysoft mesh in 67 adults under general anesthesia. Three different senior resident surgeons performed TAPP repair under the instruction of a specialist surgeon. Nine patients had bilateral hernias. The 76 hernias included 37 indirect inguinal hernias, 29 direct hernias, 1 femoral hernia, 1 pantaloon hernia (combined direct/indirect inguinal hernia), and 8 recurrent hernias after open anterior hernia repair. The immediate postoperative outcomes as well as the short-term outcomes (mainly recurrence and incidence of chronic pain) were studied.Results.There was no conversion from TAPP repair to anterior open repair. The mean operation time was 109 minutes (range, 40–132) for unilateral hernia repair. Scrotal seroma was diagnosed at the operation site in 5 patients. No patient had operation-related orchitis, testicle edema, trocar site infection, or chronic pain during follow-up.Conclusions.The use of Polysoft mesh for TAPP inguinal hernia repair does not seem to adversely affect the quality of repair. The use of this mesh is therefore feasible and safe and may reduce postoperative pain.

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How To Prevent Inguinodynia - After Tension-Free Inguinal Hernia Repair – Our Experience

International Journal of Medical Science and Diagnosis Research ◽

10.32553/ijmsdr.v5i3.765 ◽

2021 ◽

Vol 5 (3) ◽

Author(s):

Vinod Nigam ◽

Dr. SIIDDHARTH NIGAM

Keyword(s):

Quality Of Life ◽

Chronic Pain ◽

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Tension Free ◽

Inguinal Hernia Operation ◽

Hernia Operation ◽

Low Incidence

Abstract: Inguinodynia is persistence of pain for more than 3 months after inguinal hernia operation. Chronic pain may be associated with hyperesthesia or hypoesthesia. This pain may be mild, moderate or severe. Inguinodynia may even effect quality of life. Pain may resolve on its own or after conservative treatment. Sometimes it persists and conservative methods fail then various other modalities of treatment are considered including re-exploration and neurectomy. We performed all 396 inguinal hernia repair by a modified Lichtenstein tension-free procedure. In our series of 396 cases inguinodynia happened only in 3 cases, a real low incidence. Some researchers have reported the incidence of inguinodynia as high as 19 percent 1 year after operation. No case required re-exploration, removal of mesh or neurectomy in our series. Keywords Chronic pain, Inguinal hernia, Inguinodynia, inguinal hernia repair

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Absorbable Meshes in Inguinal Hernia Surgery: A Systematic Review and Meta-Analysis

Surgical Innovation ◽

10.1177/1553350617697849 ◽

2017 ◽

Vol 24 (3) ◽

pp. 289-298 ◽

Cited By ~ 8

Author(s):

Stina Öberg ◽

Kristoffer Andresen ◽

Jacob Rosenberg

Keyword(s):

Systematic Review ◽

Chronic Pain ◽

Inguinal Hernia ◽

Hernia Repair ◽

Hernia Surgery ◽

Absorbable Mesh ◽

Inguinal Hernia Surgery ◽

Increased Risk ◽

Meta Analyses

Purpose. Absorbable meshes used in inguinal hernia repair are believed to result in less chronic pain than permanent meshes, but concerns remain whether absorbable meshes result in an increased risk of recurrence. The aim of this study was to present an overview of the advantages and limitations of fully absorbable meshes for the repair of inguinal hernias, focusing mainly on postoperative pain and recurrence. Methods. This systematic review with meta-analyses is based on searches in PubMed, Embase, Cochrane, and Psychinfo. Included study designs were case series, cohort studies, randomized controlled trials (RCTs), and non-RCTs. Studies had to include adult patients undergoing an inguinal hernia repair with a fully absorbable mesh. Results. The meta-analyses showed no difference in recurrence rates (median 18 months follow-up) and chronic pain rates (1 year follow-up) between absorbable- and permanent meshes. Crude chronic pain rates for the RCTs were 2.1% for the absorbable meshes and 7.6% for the permanent meshes. For the absorbable meshes, medial hernias were more susceptible for recurrence compared with lateral hernias ( P < .0005). None of the studies reported allergic reactions or other serious adverse events related to the absorbable mesh. Conclusions. Patients with an absorbable mesh seem to have less chronic pain following inguinal hernia surgery compared with permanent meshes, without increased risk of recurrence.

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Chronic Pain after Inguinal Hernia Repair

International Scholarly Research Notices ◽

10.1155/2014/839681 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 6

Author(s):

Mallikarjuna Manangi ◽

Santhosh Shivashankar ◽

Abhishek Vijayakumar

Keyword(s):

Chronic Pain ◽

Inguinal Hernia ◽

Postoperative Pain ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Nerve Injury ◽

Statistical Significance ◽

Preemptive Analgesia ◽

Preoperative Pain ◽

Hernia Surgery

Background. Chronic postherniorrhaphy groin pain is defined as pain lasting >6 months after surgery, which is one of the most important complications occurring after inguinal hernia repair, which occurs with greater frequency than previously thought. Material and Methods. Patients undergoing elective inguinal hernioplasty in Victoria Hospital from November 2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for followup at end of six months. Detailed preoperative, intraoperative, and postoperative details of cases were recorded according to proforma. The postoperative pain and pain at days two and seven and at end of six months were recorded on a VAS scale. Results. Chronic pain at six-month followup was present in 89 patients constituting 39.4% of all patients undergoing hernia repair. It was seen that 26.9% without preoperative pain developed chronic pain whereas 76.7% of patients with preoperative pain developed chronic pain. Preemptive analgesia failed to show statistical significance in development of chronic pain (P=0.079). Nerve injury was present in 22 of cases; it was found that nerve injury significantly affected development of chronic pain (P=0.001). On multivariate analysis, it was found that development of chronic pain following hernia surgery was dependent upon factors like preoperative pain, type of anesthesia, nerve injury, postoperative local infiltration, postoperative complication, and most importantly the early postoperative pain. Conclusions. In the present study, we found that chronic pain following inguinal hernia repair causes significant morbidity to patients and should not be ignored. Preemptive analgesia and operation under local anesthesia significantly affect pain. Intraoperative identification and preservation of all inguinal nerves are very important. Early diagnosis and management of chronic pain can remove suffering of the patient.

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SEROMA AFTER TENSION-FREE INGUINAL HERNIA REPAIR – OUR EXPERIENCE

International Journal of Medical Science and Diagnosis Research ◽

10.32553/ijmsdr.v5i2.762 ◽

2021 ◽

Vol 5 (2) ◽

Author(s):

Vinod Kumar Nigam ◽

Siddarth Nigam

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Dead Space ◽

Hernia Surgery ◽

Tension Free ◽

Body Tissues ◽

Inguinal Hernia Surgery ◽

Tissue Dissection ◽

Low Incidence

Seroma Is a collection of fluid called serum that gets collected at the site of inguinal hernia surgery. It is common after inguinal hernia repair with a mesh. Usually seroma develops after 7 to 10 day of operation but can develop even earlier depending upon the amount of tissue dissection. More the dissection more the chances of development of seroma. The fluid in seroma is usually clear or straw colored. Seroma generally does not require any treatment; it disappears by absorption by body tissues within few weeks. Large seromas may require repeated aspiration. To avoid developing seroma after inguinal hernia surgery is to do minimal tissue dissection and avoid dead space formation. We operated 400 cases of inguinal hernia by a modified Lichtenstein tension-free procedure called NICH (Nigam’s inverted curtain hernioplasty) our incidence of development of seroma was 1.5% against international incidence of 7% which is a real low incidence. We have discussed the ways to avoid formation of seroma after open inguinal hernioplasty. Keywords: dead space, dissection, inguinal hernia, Lichtenstein, mesh, NICH, seroma.

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Laparoscopic total extraperioneal mesh hernioplasty is a novel approach for inguinal hernia: our experience over 7 years

International Surgery Journal ◽

10.18203/2349-2902.isj20195109 ◽

2019 ◽

Vol 6 (11) ◽

pp. 3982

Author(s):

Dheer Singh Kalwaniya ◽

Ranjith Mahadevan ◽

Satya V. Arya ◽

Jaspreet Singh Bajwa ◽

Gowtham K. Gowda ◽

...

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Mesh Repair ◽

Wound Complications ◽

Indirect Inguinal Hernia ◽

Bilateral Inguinal Hernia ◽

Hernia Surgery ◽

Early Recovery ◽

Inguinal Hernia Surgery ◽

Laparoscopic Tep

Background: Inguinal hernia surgery is the most common performed surgery all over the world. Among them laparoscopic totally extra-peritoneal (TEP) mesh repair fulfils all the requirements with better clinical outcomes than other procedures.Methods: Data was collected from the inpatient and out-patient records of 60 patients who underwent laparoscopic TEP for unilateral or bilateral inguinal hernia in a single unit in the Department of General Surgery during May 2012-June 2019 including the two years of follow-up. 3D mesh was used for application and was fixed with tackers. Then patients were followed up in outpatient department after 1 week, 2 week, and 3 months, 6 months and yearly up to two years. In every visit post-operative pain (assessed by visual analogue scale), local wound complication (hematoma, seroma, wound infection) and recurrence were noted. The data was collected and evaluated and the results shown.Results: All patients were men, with average age of 36.5 years (range 32-58). On categorization 53 (88.3%) of them had unilateral inguinal hernia and 7 (11.6%) of them had bilateral inguinal hernia. Intra operatively 12 (20%) of them had direct inguinal hernia and 48 (80%) of them had indirect inguinal hernia. Haematoma was seen in 1 patients, surgical emphysema in 3, seroma in 5 and recurrence in 2 patients.Conclusions: Laparoscopic TEP mesh repair was effective and safe tool for hernia repair, in terms of lesser postoperative painless number of hospital days, early recovery and lesser wound complications. However recurrence rates are comparable with other methods of hernia repair.

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Portuguese Inguinal Hernia Cohort (PINE) study

10.1101/2020.12.19.20247585 ◽

2020 ◽

Author(s):

◽

J Simões ◽

AA João ◽

JM Azevedo ◽

M Peyroteo ◽

...

Keyword(s):

Chronic Pain ◽

Cohort Study ◽

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Collaborative Research ◽

Research Network ◽

Hernia Surgery ◽

Inguinal Pain ◽

Chronic Postoperative Inguinal Pain

AbstractPurposeRecent comprehensive guidelines have been published on the management of inguinal hernia. Contrary to other European countries, no Portuguese hernia registry exists. This represents an opportunity to assess outcomes of hernia surgery in the Portuguese population. The primary aim is to define the prevalence of chronic pain after elective inguinal hernia repair. The secondary aims are to identify risk factors for chronic pain after elective inguinal hernia repair, to characterise the management of elective inguinal hernia in public Portuguese hospitals.MethodsProspective national cohort study of patients submitted to elective inguinal hernia repair. The primary outcome is the prevalence of chronic postoperative inguinal pain, according to the EuraHS QoL questionnaire at 3 months postoperatively. The study will be delivered in all Portuguese regions through a collaborative research network. Four 2-week inclusion periods will be open for recruitment. A site-specific questionnaire will capture procedure volume and logistical facilities for hernia surgery.ConclusionThis protocol describes the methodology of a prospective cohort study on the elective management of inguinal hernia. It discusses key challenges and describes how the results will impact future investigation. The study will be conducted across a nationwide collaborative research network, with prospective quality assurance and data validation strategies. It will provide the basis for a more accurate prediction of chronic postoperative inguinal pain and the research on adequate patient selection strategies for surgery and therapeutic strategies for postoperative pain.

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Two-center Analysis of Long-term Outcomes after High Ligation Inguinal Hernia Repair in Adolescents

The American Surgeon ◽

10.1177/000313481508101229 ◽

2015 ◽

Vol 81 (12) ◽

pp. 1260-1262 ◽

Cited By ~ 4

Author(s):

Alessandra C. Gasior ◽

E. Marty Knott ◽

Arielle Ranters ◽

Shawn D. Peter ◽

Todd A. Ponsky

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Recurrent Hernia ◽

High Ligation ◽

Long Term Outcomes ◽

Recurrence Rates ◽

Hernia Sac ◽

Telephone Surveys ◽

Low Incidence

High ligation of the inguinal hernia sac is standard practice for many pediatric surgeons in post-pubertal adolescents. Most adult surgeons do not use this technique to repair indirect inguinal hernias because of concerns for higher recurrence rates compared with mesh repairs. Therefore, we examined long-term outcomes of adolescent high ligation hernia repair performed by pediatric surgeons. Telephone surveys were conducted on children over 12 years old at the time of repair, and patients and/or their parents were contacted 18 months postrepair. Patients were identified from two institutions between 1998 and 2010. The incidences of reoperation, recurrence, presence of bulge, chronic pain, or numbness were determined. A total of 210 patients (40.7% response rate) were available for phone interviews at 18.6 to 159.5 months postrepair. Mean age was 14.6 ± 1.8 (range: 12.0–19.0 years). Fourteen patients had pain (6.7%) and five had numbness (2.4%). There were four (1.9%) patients with a second operation, two of which confirmed a recurrent hernia. Three patients expressed concern about possible recurrence. Two report a bulge, but have not been evaluated. Pediatric hernia repair with high sac ligation appears effective in patients anatomically similar to adults with low recurrence rate and low incidence of chronic symptoms. These data suggest that prospective trials on the adequacy of high ligation in adults are warranted.

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A randomized controlled study of transinguinal pre peritoneal repair vs Lichtenstein repair for inguinal hernia

International Surgery Journal ◽

10.18203/2349-2902.isj20193350 ◽

2019 ◽

Vol 6 (8) ◽

pp. 2757

Author(s):

Santosh M. Patil ◽

Augusty Dharmapuri

Keyword(s):

Chronic Pain ◽

Inguinal Hernia ◽

Hernia Repair ◽

Controlled Study ◽

Chronic Groin Pain ◽

Inguinal Hernias ◽

Group I ◽

History Of ◽

Study Population ◽

Group Ii

Background: Inguinal hernia repairs are one of most common surgeries performed world-wide. Inguinal hernias are present in 1.7% of the world population.Methods: Total of 100 patients was included in this study with 50 patients in each group. Group I (n=50): patients in this group underwent hernia repair using open preperitoneal mesh procedure. Group II (n=50): patients in this group underwent hernia repair using Lichtenstein procedure.Results: The proportion of patients with left inguinal hernia was higher in group I (48.00%) as compared to group II (46.00%), but this difference was not statistically significant. In overall study population (81.25%) as well as in group I (82.50%) and group II (80.00%) of the study, no history of straining was observed in the majority of the cases. Though the proportion of straining was higher in group I (32.00%) as compared to group II (26.00%), but this difference was not statistically significant (p=0.775). Chronic pain (see Table 4) was found in 28.75% of total patients, though the chronic pain was found in higher proportion of patients of group II (32.0%) as compared to group I (22.0%).Conclusions:In conclusion, this study shows that the TPT provides significant advantages over the Lichtenstein technique in case of repair of unilateral inguinal hernias. Patients in TPT group had less incidence of wound induration and chronic groin pain. They were also able to return to their jobs earlier.

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STUDY OF PATTERNS OF PRESENTATION AND MANAGEMENT OF COMPLICATED INGUINAL HERNIAS

10.36106/ijsr/4029417 ◽

2020 ◽

pp. 1-2

Author(s):

Sarita Durge ◽

Mayur Bandawar

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Surgical Intervention ◽

Age Distribution ◽

Emergency Setting ◽

Indirect Inguinal Hernia ◽

Hernia Surgery ◽

Inguinal Hernia Surgery ◽

The Mean

Background There are a lot of advancement in techniques of elective inguinal hernia surgery, but progress for management of complicated inguinal hernia repair in emergency, fall behind. The aim of study was to know age distribution, pattern of presentation, to evaluate the outcome of various types of surgical procedure done for complicated inguinal hernia and their post-operative complications. Methods and Materials This retrospective study included 62 patients suffering from complicated inguinal hernia,and who underwent emergency surgery, from Jan-2016to Dec-2019. Results The mean of age of sampled patients was 53.88 + 14.23 years, with increased incidence in males.Right sided, indirect inguinal hernia was frequently involved.Commonest postoperative complication was wound infection.Tension free repair Lichenstein’s technique (Hernioplasty) was done in maximum cases. Conclusion Mesh repair (hernioplasty) is acceptable and safe option for inguinal hernia repair in emergency setting. Early hospitalization and timely surgical intervention are associated with better outcome.

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