Diagnostic value of laparoscopic inguinal allohernioplasty in detection of occult hernias of inguinal region

Aim. To evaluate diagnostic value of laparoscopic inguinal allohernioplasty in identification of occult forms of hernias of the inguinal region. Materials and Methods. The study was conducted on the basis of the results of surgical treatment of patients with inguinal hernias on the base of the Department of Hospital Surgery of RyazSMU in Ryazan State Emergency Care Hospital and on the base of the Department of Surgery, Obstetrics and Gynecology of Additional Postgraduate Education Faculty in Ryazan Regional Clinical Hospital, from 2015 to 2020 (n=207). Operations were performed with the absence of contraindications to narcosis and carboxyperitoneum, and if patients desired to be operated on by the proposed method. In all the patients included into the study, hernioplasty was performed using laparoscopic approach, with preperitoneal placement of the endoprosthetic mesh. For purity of the experiment, only polypropylene meshes were used. Standard meshes from monofilament polypropylene were used with surface density 65-80 g/m2 and volumetric porosity 80-85%. Meshes 15x15 cm dimension were used with cut angle with 7.5A cm catheti. Results. Of 207 patients, 28 were operated on for bilateral inguinal hernias. Only in one of them hernia was diagnosed in the preoperative stage. In the rest 27 patients, an occult hernia was found opposite to the previously diagnosed side. In 17 patients, besides hernias diagnosed in the preoperative and intraoperative stages, occult hernias were detected in the process of dissection of the preperitoneal space. Conclusion. Laparoscopic inguinal allohernioplasty permits to diagnose occult hernias that were not detected in the preoperative examination: femoral, obturator, inguinal hernias on the contralateral and/or unilateral side. This permits to perform hernioplasty taking into account the intraoperative finding, in one surgical procedure without subjecting the patient to repeated hospitalization, narcosis and operation.

Download Full-text

laparosopic treatment of strangulation of inguinal hernias

Likarska sprava ◽

10.31640/jvd.3-4.2020(11) ◽

2020 ◽

pp. 76-77

Author(s):

R. N. Abu Shamsieh

Keyword(s):

Laparoscopic Approach ◽

Postgraduate Education ◽

Pain Syndrome ◽

Surface Damage ◽

Lightweight Mesh ◽

National Medical ◽

Results Of Treatment ◽

Inguinal Hernias ◽

Period 2 ◽

Mesh Material

The aim – to improve the results of treatment of patients with strangulation inguinal hernias by laparoscopic technologies use in lightweight mesh implants, fixed themselves, technology electric fabrics [1–9]. Materials and methods. A retrospective analysis of 125 videolaparoscopic surgery for inguinal hernia in 112 (89.6 %) men and 13 (10.4 %) of women aged 17–84 (57.0 ± 19.8) years for transabdominal preperetonial patch (TAPP) technique using different mesh implants at the Department of Surgery, anesthesiology and intensive care postgraduate education of the National Medical University named after A. A. Bogomolets, for the period from 2018 to 2020. Results and discussion. Recurrence [3] were in the first group and reasonable, in our opinion, insufficient size of mesh material. Further, using prostheses that were on a lower side 10 cm, recurrence was observed. Detection of hematoma was evacuated puncture under ultrasound. In 2 cases of hematoma encountered when using conventional polypropylene mesh were due to inadequate hemostasis. Hematoma using heavy monofilament polyester mesh with that fixed itself, caused by the brutality of the prosthesis surface damage and muscle-aponeurotic "platform" to which it is fixed. So when using light grids, fixed themselves, there was no bruising at all. Complications. 1. The use of lightweight mesh, fixed themselves laparoscopic treatment of strangulation hernia for TAPP technique avoids hematoma, reduce the amount of gray in the operation area, practically non- inguinal pain syndrome in the postoperative period. 2. The use of mesh implants, fixed themselves methodologies Electric soft tissue material can reduce transaction costs 2 times that fosters the popularization of laparoscopic approach.

Download Full-text

Comparative study of inflammatory response and adhesions formation after fixation of different meshes for inguinal hernia repair in rabbits

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502005000500002 ◽

2005 ◽

Vol 20 (5) ◽

pp. 347-352 ◽

Cited By ~ 30

Author(s):

Alberto Goldenberg ◽

Jacques Matone ◽

Wagner Marcondes ◽

Fernando Augusto Mardiros Herbella ◽

José Francisco de Mattos Farah

Keyword(s):

Inflammatory Response ◽

Abdominal Wall ◽

Peritoneal Cavity ◽

Abdominal Cavity ◽

Mesh Fixation ◽

Rabbit Model ◽

Laparoscopic Approach ◽

Preperitoneal Space ◽

Similar Amount ◽

The Right

PURPOSE: Compare, in a rabbit model, the inflammatory response and adhesions formation following surgical fixation of polypropilene and Vypro mesh in the inguinal preperitoneal space. METHODS: Fourteen male New Zealand rabbits, weighing between 2.000 to 2.500 g were used. A midline incision was made and the peritoneal cavity was exposed. The 2,0X1,0 cm polypropylene mesh was fixed in the left flank and secured to the margins with 3-0 prolene in a separate pattern. In the right flank, a 2,0X1,0 cm Vypro II mesh was sewn in the same way. After the post surgical period, the animals were again anesthetized and underwent laparoscopic approach, in order to identify and evaluate adhesions degree. Both fixed prosthesis were excised bilaterally with the abdominal wall segment, including peritoneum, aponeurosis and muscle and sent to a pathologist RESULTS: Operative time ranged from 15 to 25 minutes and no difficulties in applying the mesh were found. From the 14 polypropylene meshes fixed to the intact peritoneum, 11 had adhesions to the abdominal cavity (78,6%). Concerning Vypro mesh, 12 animals developed adhesions from the 14 with mesh fixation (85,7%). Histological examination of tissues harvested revealed fibroblasts, collagen, macrophages and lymphocytes between the threads of the mesh. CONCLUSION: Polypropylene and Vypro mesh, when implanted in the peritoneal cavity of rabbits provoke similar amount of adhesions. Vypro mesh tissues had higher fibrosis resulting in better mesh incorporation to the abdominal wall.

Download Full-text

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

Paediatric Surgery Ukraine ◽

10.15574/ps.2021.72.30 ◽

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.

Download Full-text

OV15 EMERGENCY SURGERY OF OBSTRUCTED VENTRAL HERNIA USING TAPP TECHNIQUE: A SAFE AND FEASIBLE APPROACH

British Journal of Surgery ◽

10.1093/bjs/znab396.066 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Victor Vaello ◽

Angela Santana ◽

Diego Oto ◽

Luz Juez ◽

Raquel Arranz ◽

...

Keyword(s):

Elective Surgery ◽

Intestinal Resection ◽

Laparoscopic Approach ◽

Right Hemicolectomy ◽

Postoperative Recovery ◽

Preperitoneal Space ◽

Open Approach ◽

Emergency Procedures ◽

Peritoneal Flap ◽

Ventral Incisional Hernia

Abstract Aim to explain and show the feasibility of laparoscopic TAPP technique in emergency procedures Material and Methods we present a 71-year-old female with personal history of obesity (BMI 32) and a laparoscopic right hemicolectomy performed in 2018, presenting at the ER with a 24-hour intestinal obstruction due to incarcerated ventral incisional hernia. Results laparoscopic reduction of the hernia contents was achieved without need of intestinal resection, prior to access to the preperitoneal space, creating a peritoneal flap that was dissected around the hernia. Following closure of the hernia defect, a polypropylene mesh was placed and the peritoneal flap closed. There were no intraoperative or postoperative events and patient was discharged on 3rd POD. Conclusions laparoscopic approach to emergency hernias in selected patients doesn’t differ from elective surgery, and offers great advantages in terms of evaluation of the incarcerated elements, and postoperative recovery, especially in obese patients where a conventional open approach has higher morbidity.

Download Full-text

The Diagnostic Value of Forced Expiratory Time

Saudi Journal of Internal Medicine ◽

10.32790/sjim.2011.1.1.7 ◽

2011 ◽

Vol 1 (1) ◽

pp. 39-42

Author(s):

Siraj O. Wali

Keyword(s):

Tertiary Care ◽

Airway Disease ◽

Diagnostic Value ◽

Forced Expiratory Volume ◽

Small Airway ◽

Airflow Limitation ◽

Forced Expiration ◽

Care Hospital ◽

Expiratory Time ◽

Small Airway Disease

Objective: Airway obstruction can be clinically quantified at the bedside by measuring the time taken for forced expiration. The aim of this study was to examine the accuracy of the forced expiratory time in detecting airflow limitation, and small airway disease when compared with simple spirometry as a gold standard test. Method: Simple spirometry and forced expiratory time were performed on 201 subjects (age range; 12-81 years), referred to a pulmonary function laboratory at a tertiary care hospital. The diagnostic accuracy of forced expiratory time and its correlation with spirometric parameters were tested. Forced expiratory time > 6 seconds was regarded as abnormal, and the ratio of forced expiratory volume in the first second to forced vital capacity of < 70% was considered indicative of an airflow limitation. Results: Forced expiratory time was found to correlate weakly with spirometric parameters. Forced expiratory time at a cut-off value of => 6 seconds had a sensitivity of 61% and a specificity of 79% in predicting obstructive airway disease when compared with simple spirometry. On the other hand, the sensitivity and the specificity of forced expiratory time in predicting small airway disease were 47% and 86%, respectively. Conclusion: Forced expiratory time does not correlate well with all parameters of a simple spirometry. Its sensitivity and specificity for detecting airflow limitation and small airway disease were not high enough to be used as a diagnostic test. However, it may be effective enough to be utilized to confirm the diagnosis of small airway disease.

Download Full-text

Bilayer Mesh Repair for Inguinal Hernia- The Open Alternative to Laparoscopic Repairs

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/45782.14805 ◽

2021 ◽

Author(s):

Abinash Kanungo ◽

Chinmaya Ranjan Behera ◽

Riddhika Majumder ◽

Subrajit Mishra ◽

Subrat Kumar Sahu ◽

...

Keyword(s):

Mesh Repair ◽

Tertiary Care ◽

Uneventful Recovery ◽

Minimal Risk ◽

Care Hospital ◽

Inguinal Hernias ◽

Resource Setting ◽

Total Extraperitoneal ◽

Patch Plasty ◽

Dual Mesh

Introduction: In 1999, Gilbert described the technique of using a bilayer mesh device, Prolene Hernia System (PHS) for tension free repairs of inguinal hernias through an open anterior approach. This provides an anterior, posterior and plug repair, and hence successfully covers the myopectineal orifice, the lack of which is a glaring drawback for the Lichtensteins repair. This also confers the same benefit provided by the laparoscopic hernia repairs which uses the preperitoneal space to cover this same region that is, Transabdominal Preperitoneal Patch Plasty (TAPP) and Total Extraperitoneal patch Plasty (TEP). Aim: To observe the overall outcome of using the open bi-layered dual mesh in a population of Odisha, attending a tertiary care hospital. Materials and Methods: All patients admitted with inguinal hernias in the Department of General Surgery, Pradyumna Bal Memorial Hospital, KIMS, Odisha, India were included in the study. They all underwent the PHS bilayer mesh repair. The relevant patient specifics like, preoperative clinical findings and intra and postoperative results were noted in a master chart. Patients were followed-up for one year, and further long-term complications were noted, if any. Results: There were a total of 40 patients. The mean duration for the procedure was 61 minutes (SD-22.8) and there was no inadvertent injury. The patients were encouraged to resume all physical activities from the first postoperative day. All the patients had an uneventful recovery, with a mean hospital stay of four days. Four patients presented with seroma after one week of surgery, while 22 patients had cord oedema. Both subsided spontaneously within three weeks, without further intervention. No recurrence was noted in any of the patients. Conclusion: The PHS bilayer dual mesh repair is ideally suited for population in a low resource setting. It ensures coverage of the entire vulnerable area of groin along with a considerably shorter duration of operation, minimal risk of intraoperative injury.

Download Full-text

The Diagnostic Value of Forced Expiratory Time

Saudi Journal of Internal Medicine ◽

10.32790/sjim.1.1.7 ◽

2011 ◽

Vol 1 (1) ◽

pp. 39-42

Author(s):

Siraj O. Wali

Keyword(s):

Tertiary Care ◽

Airway Disease ◽

Diagnostic Value ◽

Forced Expiratory Volume ◽

Small Airway ◽

Airflow Limitation ◽

Forced Expiration ◽

Care Hospital ◽

Expiratory Time ◽

Small Airway Disease

Download Full-text

Role of laparoscopic appendicectomy in management of early appendicular mass

International Surgery Journal ◽

10.18203/2349-2902.isj20202846 ◽

2020 ◽

Vol 7 (7) ◽

pp. 2337

Author(s):

Kota Ramesh ◽

Khyati Kiran Janapareddy

Keyword(s):

Intraoperative Complications ◽

Laparoscopic Approach ◽

Operative Management ◽

Diagnostic Value ◽

Laparoscopic Appendicectomy ◽

Group 13 ◽

Surgical Department ◽

Male Patients ◽

Appendicular Mass

Background: Appendicular mass consists of matted loops of bowel and omentum adherent to the adjacent inflamed appendix. Laparoscopic approach adds diagnostic value and allows visualization of entire abdominal viscera facilitating better and safer dissection.Methods: This is an observational prospective study done in patients presenting to Gandhi Hospital’s surgical department with incidentally detected appendicular mass on laparoscopy from August 2016 to August 2018.Results: Maximum cases belong to adolescent age group (13 out of 30). Majority of cases are male patients (24 out of 30). Each surgery took around 1 hour. No intraoperative complications occurred in 23 patients. Difficult adhesiolysis experienced in 5 patients. Serosal bowel injury occurred in 1 patient. Orals were delayed where intraoperative dissection was prolonged or difficult. Majority of patients were discharged after 3 days.Conclusions: With immediate operative management of appendicular mass presenting in early stages of inflammation, dissection can be safely proceeded with and appendicectomy can be safely performed eliminating the need for second hospitalization and risk of recurrence. The incidence of intra-operative and post-operative complications is low making laparoscopic appendicectomy in early appendicular mass a safe and feasible treatment option.

Download Full-text

A 9-year experience study of single-port micro-laparoscopic repair of pediatric inguinal hernia using a simple needle

Hernia ◽

10.1007/s10029-019-02079-4 ◽

2019 ◽

Vol 24 (3) ◽

pp. 639-644

Author(s):

R. Chen ◽

S. Tang ◽

Q. Lu ◽

X. Zhang ◽

W. Zhang ◽

...

Keyword(s):

Inguinal Hernia ◽

Single Port ◽

Average Length ◽

Operating Time ◽

Laparoscopic Approach ◽

Invasive Procedure ◽

High Ligation ◽

Laparoscopic Technique ◽

Inguinal Hernias ◽

Laparoscopic Techniques

Abstract Purpose As laparoscopic techniques and equipments improve, laparoscopic inguinal hernia repair has been gaining popularity. The objective of the study was to summarize 9 years of experience using a single-port micro-laparoscopic approach to repair pediatric inguinal hernias with a simple hernia needle. Methods 1880 children with inguinal hernias were enrolled using micro-laparoscopic surgery between June 2009 and 2018. All patients underwent high ligation surgery using a single-port micro-laparoscopic technique. The clinical data were retrospectively analyzed. Results All micro-laparoscopic surgeries were successfully performed in the 1880 patients, who ranged in age from 2 months to 14 years (3.66 ± 2.96 years) including 1622 males and 258 females. Among them, 1299 cases were unilateral hernias and 581 cases were bilateral hernias. The average operating time was 12.5 ± 3.5 min for a unilateral hernia and 20.5 ± 4.5 min for bilateral hernias. All patients were discharged 1–2 days after surgery, and the average length of their hospital stay was 2–4 days. Complications of knot reaction and pneumoscrotum occurred in 5 cases (0.27%) and 54 cases (2.87%), respectively, but these cases were properly managed, with no major impact on the operational outcomes. All patients were followed up for 3–65 months; there were 13 recurrent cases (0.69%). Conclusions Single-port micro-laparoscopic herniorrhaphy in children using a simple hernia needle is a reliable and minimally invasive procedure.

Download Full-text

ULTRAPRO Hernia System Versus Lichtenstein Repair in Treatment of Primary Inguinal Hernias: A Prospective Randomized Controlled Study

International Surgery ◽

10.9738/intsurg-d-14-00064.1 ◽

2014 ◽

Vol 99 (4) ◽

pp. 391-397 ◽

Cited By ~ 4

Author(s):

Faruk Karateke ◽

Sefa Ozyazici ◽

Ebru Menekse ◽

Hatice Özdogan ◽

Mevlüt Kunt ◽

...

Keyword(s):

Inguinal Hernia ◽

Operation Time ◽

Postoperative Recovery ◽

Controlled Study ◽

Preperitoneal Space ◽

Lichtenstein Repair ◽

Lichtenstein Technique ◽

Recurrence Rates ◽

Inguinal Hernias ◽

First Choice

Abstract The Lichtenstein repair has been recommended as the gold standard for inguinal hernia repair. However, postoperative discomfort still constitutes a concern and an area for improvement. New mesh materials have been continuously introduced to achieve this goal. The goal of the present study was to investigate the outcomes of ULTRAPRO Hernia System (UHS) compared with Lichtenstein mesh repair. A total of 99 male patients with primary unilateral inguinal hernia were included in the study during the period of September 2010–January 2012. Patients with body mass index >30, comorbid diseases, and anesthetic risk of ASA-III and ASA-IV were excluded. The patients were randomly allocated to operation with the Lichtenstein technique (group L) or UHS. Demographics, operative and postoperative/recovery data, and short- and medium-term outcomes of the patients were recorded. A total of 50 patients in group L and 49 patients in group UHS were analyzed. The median follow-up time for the study was 33 months. There were no significant differences regarding demographics, complications, and rehabilitation between the groups. Overall, there was a prolonged operation time in the UHS group compared with the L group (UHS: 53.7 ± 5.7 minutes; L: 44.5 ± 5.5 minutes; P < 0.001). UHS may provide results similar to those for the Lichtenstein technique in open repair of inguinal hernias regarding perioperative course, complications, recovery, and recurrence rates. However, because of reduced costs and the lack of need for the exploration of the preperitoneal space, we conclude that the Lichtenstein technique should be recommended as the first choice.

Download Full-text