scholarly journals Laparoscopic Repair of Inguinal Hernia : Early Experience in A Tertiary Care Hospital

2016 ◽  
Vol 4 (1) ◽  
pp. 19-22
Author(s):  
Sharmistha Roy ◽  
Samiron Kumar Mondal ◽  
Tapas Kumar Maitra
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Laparoscopic Repair ◽  
Open Repair ◽  
Laparoscopic Group ◽  
Normal Activity ◽  
Laparoscopic Inguinal Hernia Repair ◽  
Open Group ◽  
Laparoscopic Inguinal Hernia

Background : The introduction of laparoscopic techniques has added a new dimension to groin hernia surgery. The laparoscopic repair of inguinal hernia has had a staggering beginning in the surgical arena. Laparoscopic repairs have had to compete with the current gold standard for inguinal hernia repair ie Liechtenstein repair. This study shows the results of laparoscopic inguinal hernia repair in comparison to open repair in a similar group of patients.Methods and materials : This is a prospective study done on 50 male patient of inguinal hernia aging from 18- 65years. Among 50 patients selected for study 25 patient underwent open hernioplasty and 25 patient underwent laparoscopic hernioplasty. In the laparoscopic group, in 20 patients (80%) TAPP procedure was done & in 5 patients (20%) TEP procedure was done.Aims and Objective : The aim of this study is to compare the effectiveness and safety of laparoscopic and conventional open repair, in the treatment of inguinal hernia.Results : Average operating time in open procedure was 55±12 minutes, and in laparoscopic procedure 65±10 minutes. Opoid analgesics were required in 36% patient in open group and 16% in laparoscopy group. Within 7 days most of the patient (76%) in laparoscopic group returned to their normal activity, but in the open group 92% patient required more than 7 days to return to normal activity. Post operative complication like hematoma formation (8%), Testicular pain (8%), retention of urine (3%), and mesh infection (4%) was more in open repair than in laparoscopic repair. In Laparoscopic group 1patient (5%) had bladder injury, and 1 patient (5%) developed illeus.Conclusion : Early results of laparoscopic inguinal hernia repair are encouraging, but the chance of organ injury like bladder, or major vessel injury are more. So laparoscopic repair of inguinal hernia should only be practiced with adequate training and experience in laparoscopic surgery.Bangladesh Crit Care J March 2016; 4 (1): 19-22

scholarly journals The primary surgical treatment of inguinal hernia: a changing trend towards laparoscopic hernioplasty

2019 ◽  
Vol 6 (3) ◽  
pp. 764
Author(s):  
Sridar Govindaraj ◽  
A. P. Roshini ◽  
Clement Prakash ◽  
Pavithra B.
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Laparoscopic Repair ◽  
Open Repair ◽  
Laparoscopic Inguinal Hernia Repair ◽  
Care Hospital ◽  
Open Technique ◽  
Laparoscopic Inguinal Hernia ◽  
Laparoscopic Hernioplasty

Background: Inguinal hernias are the most common conditions presenting to the surgical department, which is repaired either with open technique or laparoscopically, Total Extra Peritoneal (TEP) or Trans-Abdominal Pre-Peritoneal (TAPP). Each procedure has its own advantages and drawbacks, none of them have been declared as the gold standard.Methods: Author did a prospective cohort study in a tertiary care hospital to assess the predictors and compare the outcomes for Open and Laparoscopic (TEP/TAPP) Inguinal hernia repair. A total of 180 patients were recruited into the study and followed up for a period of 1 year. Descriptive and inferential statistics was used to analyze the data.Results: 131 (72.8%) underwent open hernioplasty and 49 (27.2%) underwent laparoscopic hernioplasty. There was a significant difference between the time taken to complete an open and laparoscopic inguinal hernia repair (p=0.004), with laparoscopic repair taking lesser operating time. Laparoscopy was converted to open repair in 3 (6.1%) patients. Mean pain scores at 6-hours post-operative was 5.28±1.355 with no difference in the pain among patients who underwent open and laparoscopic repair. Seroma or hematoma are known complications, which was seen more in the open technique. The reason for choosing open surgery was secondary to the higher cost of laparoscopic repair (Adjusted Odds Ratio=0.168, p=0.004).Conclusions: The outcomes of laparoscopic inguinal hernia repair are comparable to that with the open repair.

Robotic Inguinal Hernia Repair

2017 ◽  
Vol 83 (12) ◽  
pp. 1418-1421 ◽  
Author(s):  
David S. Edelman
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Open Repair ◽  
Laparoscopic Inguinal Hernia Repair ◽  
Laparoscopic Inguinal Hernia ◽  
American Society ◽  
Robotic Inguinal Hernia Repair ◽  
Room Time

Laparoscopic inguinal hernia repair has certain advantages over open repair including less pain and earlier return to normal activity. Concurrent robotic inguinal hernia repair at the time of prostatectomy has been shown to have a lower recurrence rate than open repair. Robotic surgery adds high definition visualization and articulating instruments which enhances dexterity that makes laparoscopic hernia repair more refined. A series of robotic, laparoscopic, inguinal hernia repairs by a single surgeon with an extensive laparoscopic hernia experience at a single institution was undertaken to determine the role of robotic laparoscopic inguinal hernia repair in minimally invasive surgery. Five hundred forty-two laparoscopic inguinal hernia operations were performed from April 2012 through December 2015. There were 154 cases of robotic transabdominal pre-peritoneal procedures done during that time. Hospital records and follow-up care were pro-spectively reviewed and data collected for age, sex, American Society of Anesthesia class, and operative time. Follow-up was done at 2, 8, and 16 weeks after surgery. All patients consented for the study. Ninety percent of the patients were male. Age averaged 57.04 years with a range of 21 to 85 years. American Society of Anesthesia averaged 2.01 with comorbidities of hypertension, hypercholesterolemia, and gastroesophageal reflux disease being the most common. Body mass index was between 19 and 31.6, averaging 24.34. Twenty-five patients (16%) had an umbilical hernia repair done concomitantly. Operating room time ranged from 25 to 140 minutes with an average of 63.6 minutes decreased as experience increased. One patient with a large, left scrotal hernia was converted to open; one patient developed perforated sigmoid diverticulitis seven days postop and case #5 recurred indirectly after a direct hernia repair. Four patients required prolonged postoperative Foley catheterization. Robotic inguinal hernia repair is safe and effective. Operating room time was longer than standard laparoscopic herniorrhaphy but decreased with experience. A single-port platform may have use in patients with umbilical hernias, 16 per cent, and will need to be studied.

scholarly journals Laparoscopic versus open mesh repair of unilateral inguinal hernia: a comparative study

2017 ◽  
Vol 4 (3) ◽  
pp. 921
Author(s):  
Sudarshan P. B. ◽  
Sundaravadanan B. S. ◽  
Kaarthik V. P. ◽  
Prabu Shankar S.
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Return To Work ◽  
Inguinal Hernia Repair ◽  
Laparoscopic Group ◽  
Laparoscopic Inguinal Hernia Repair ◽  
Unilateral Inguinal Hernia ◽  
Laparoscopic Inguinal Hernia ◽  
Post Operative Pain ◽  
Significant Difference

Background: Inguinal hernia repair is now one of the most commonly performed general surgical procedures in practice. Laparoscopic inguinal hernia repair was started in year 1999 and since then has gained popularity over the last 2 decades. The introduction of a laparoscopic technique has sparked a debate in the literature over the superiority of this method versus open repair. Even though for bilateral and recurrent inguinal hernias, laparoscopic approach is recommended, there is not enough literature to recommend its routine use in unilateral inguinal hernia repair.Methods: A randomised prospective study was conducted at a tertiary care teaching hospital, comparing both Laparoscopic inguinal hernia repair and lichensteins tension free mesh repair as treatment modalities for unilateral inguinal hernia. Total number of patients in the study group was 60. Patients who were willing for the study were selected for the open or laparoscopic procedure in a randomised way. Open procedure was done by 2 senior surgeons and laparoscopic procedure was performed by 2 other senior surgeons at associate professor designation. Various parameters like the complication rate, post-operative pain, post-operative stay and time to return to work were analysed.Results: Out of the 60 patients, 30 patients underwent open inguinal hernia repair and another 30 patients underwent Laparoscopic inguinal hernia repair. The mean age group was 46.73 in open surgery group and 42.10 in laparoscopic group. 23.3% of the patients in open hernioplasty developed seroma, hematoma in the post-operative period. Whereas 10% had seroma collection in laparoscopic group. No incidence of recurrence in both the groups. No significant difference in pain score between both the groups during immediate post-operative period on POD 0, however there was significant difference in pain score on POD 3 (mean pain in open group 4.13 and lap group 2.87) and POD 7(mean pain in open group 2.90 and lap group 1.23). Mean duration of stay in hospital for open hernioplasty was 7.8 days and for Laparoscopic hernioplasty was 3.07 days. Mean duration of return to work in open hernioplasty was 14.37 days and in laparoscopy group was 9.13 days.Conclusions: There are potential benefits for laparoscopic inguinal hernia repair over lichtenstein’s repair for unilateral inguinal hernias in terms of post-operative pain, hospital stay and early return to work.

scholarly journals LAPAROSCOPIC VERSUS OPEN REPAIR OF INGUINAL HERNIA

2017 ◽  
Vol 27 (1) ◽  
pp. 28-34
Author(s):  
Žilvinas Dambrauskas ◽  
Lina Pankratjevaitė ◽  
Vaidotas Bogusevičius ◽  
Antanas Mickevičius
Keyword(s):  
Inguinal Hernia ◽  
Laparoscopic Surgery ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Laparoscopic Repair ◽  
Open Repair ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Group ◽  
Open Hernia Repair

Background and objective. Inguinal hernia repair is one of the most common general surgery procedures. Laparoscopic repair is technically more demanding, though it has been shown to be superior in terms of pain and discomfort, however, there is no apparent difference in recurrence between laparoscopic and open mesh methods of hernia repair. Over the years we see a relatively slow increase of laparoscopic procedures and even scepticism of the patients; thus we decided to test the hypothesis that more demanding and costly laparoscopic surgery has little benefits over the open procedure. The aim of our study was to compare postoperative pain, short- and long-term outcomes after laparoscopic hernia repair and conventional open hernia repair. Results. Laparoscopic procedure was significantly more often performed for the patients, who were younger, had shorter history of disease. The mean operative time for laparoscopic inguinal hernia repair was significantly longer than for open repair (p=0.02). The pain score for laparoscopic surgery was significantly lower according to VAS on day 1, 2, 3 (overall p≤ 0.002). The patients in the laparoscopic group required significantly lower doses of narcotic analgesics on the third postoperative day; the doses of nonsteroidal anti-inflammatory drugs were also significantly lower on the second and third postoperative day in this group. The postoperative hospital stay was shorter after laparoscopic repair (p=0.01). Sixty-four patients (71.11%) completed follow-up at one year after the operation. Nine (14.06%) of them had postoperative complications and eight of them were after open hernia repair. Two patients (3.1%) were re-operated (both patients were treated by Lichtenstein hernioplasty): one for inguinal hernia recurrence, another for testicular necrosis. Conclusions. The patients from laparoscopic group had significantly shorter postoperative pain duration (p=0.019), returned to daily activity slightly earlier and had better satisfaction with the operation comparing with the patients who undergone open surgery (p=0.915, p=0.893), but the duration of the sick leave (time off from work) was similar in both hernia repair group (p=0.260). Data shows that laparoscopic hernia repair has advantages in terms of post-operative pain intensity and duration, as well as risk of complications and patient satisfaction.

Airway management with I-gelTM for ambulatory laparoscopic inguinal hernia repair in children; a retrospective review of 230 cases

2020 ◽  
Vol 24 (5) ◽  
Author(s):  
Carla Hipólito ◽  
Vicente Vieira ◽  
Virginia Antunes ◽  
Petra Alves ◽  
Adriana Rodrigues ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Airway Management ◽  
Inguinal Hernia Repair ◽  
Neuromuscular Blockade ◽  
Retrospective Review ◽  
Laparoscopic Inguinal Hernia Repair ◽  
Laparoscopic Inguinal Hernia ◽  
Increased Risk ◽  
The Mean

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

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