scholarly journals TAPP technique for congenital inguinal hernia

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Dan Dumitrescu ◽  
Costel Savlovschi ◽  
Victor Dumitrescu
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Surgical Intervention ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Approach ◽  
Surgical Team ◽  
Hernia Surgery ◽  
New Era ◽  
Recommended Treatment ◽  
The Right

Laparoscopic hernia repair has opened a new era in hernia surgery shifting paradigms from anterior to posterior approaches. This has exposed surgeons to new anatomical perspective, tehnical challenges and clinical implication. We present the case of a 53-year-old patient admitted to surgery in outpatient conditions with the diagnosis of bulky inguinal-scrotum hernia. Transabdominal pre-peritoneal (TAPP) repair was our option to solve the inguinal parietal defect. Intraoperatively, in the peritoneal cavity, lateral to the epigastric vessels, the parietal flaccid defect was revealed, communicating with the right scrotum cavity, with clear evidence of testicle, suggestive of external congenital oblique hernia. Peritoneal sectioning and take-off, with Cooper's, spermatic vessels and the relevant channel, were the precursors of the dissection and 360-degree take-off of the herniated sac, with the support of the herniated suture ligament, followed by in-line, and the abandonment of the distal, open, unbounded end. The application of the 3D-MAX mesh, fixed with Capsure at the Cooper ligament, preperitoneal drainage and closure of the resorbable thread peritoneum were the endpoints of surgical intervention. The postoperative progression was favorable with discharge on the 2nd postoperative day. Control at 30 days postoperatively did not identify possible complications, it presented without painful accusations, without suggestive elements for hydrocele and without signs of relapse. The laparoscopic approach, even in the case of bulky parietal defects, remains a recommended treatment option with the best results, but largely depending on the surgical team experience.

scholarly journals Litigation claims following laparoscopic and open inguinal hernia repairs

Hernia ◽  
2020 ◽  
Vol 24 (5) ◽  
pp. 1113-1120
Author(s):  
R. Varley ◽  
C. Lo ◽  
B. Alkhaffaf
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Vascular Injury ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Hernia Surgery ◽  
Visceral Injury ◽  
Inguinal Hernia Surgery ◽  
The Uk

Abstract Purpose Groin hernia repair is the most frequently performed general surgical operation in the UK. Complications from laparoscopic and open repair are well recognised; however, potential differences are yet to be considered in relation to litigation. Methods Administrative data were obtained and analysed from the NHS Litigation Authority for inguinal hernia-related claims from 1995 to 2016. Claims identified as using an open or laparoscopic approach were compared. Results 880 claims were made, 760 had been settled. 88 laparoscopic and 241 open procedures were identified; 65% laparoscopic and 63% open hernia claims were found to be in favour of the claimant. Payouts totalled to 4.1GBP/4.8EUR/5.3USD million and 9.4GBP/11.0EUR/12.1USD million for laparoscopic (mean 82,824GBP/96,579EUR/106,453USD) and open (mean 66,796GBP/77,892EUR/85,852USD) approaches, respectively. The most common reasons for claim initiation were visceral/vascular injury (54%) in the laparoscopic group, and testicular complications or chronic pain (35%) in the open group. Additional procedures were necessary for 48% and 44% of laparoscopic and open claims, respectively. The highest average payouts were associated with visceral injury, (laparoscopic 116,482GBP/135,820EUR/149,715USD; open 199,103GBP/232,246EUR/255,905USD) and vascular injury (laparoscopic 88,624GBP/103,369EUR/113,892USD; open 64,460GBP/75,163EUR/82,870USD). Additional procedures resulted in an average payout of 93,352GBP/108,917EUR/120,008USD (laparoscopic) and 60,408GBP/70,506EUR/77,657USD (open). The most common additional procedures were corrective visceral/vascular repairs, orchidectomy and recurrent hernia repair. Conclusions The rate of litigation for clinical negligence in inguinal hernia surgery in the UK is increasing. Whilst there has been a recent increase in laparoscopic hernia repair claims, the volume and burden of claims related to open procedures remain greater.

scholarly journals Laparoscopic Repair of Morgagni Hernia Combined with Right Hemicolectomy for Bleeding Ascending Colon Carcinoma Lodged within the Chest: A Case Report and Review of the Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Oluwatobi O Onafowokan ◽  
Kiran Khosa ◽  
Hugo Bonatti
Keyword(s):  
Colon Cancer ◽  
Case Report ◽  
Hernia Repair ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Approach ◽  
Rare Condition ◽  
Right Hemicolectomy ◽  
Morgagni Hernia ◽  
The Right ◽  
Diaphragmatic Hernias

Background. Morgagni hernias are rare in adults and may be asymptomatic but, nevertheless, require surgical repair, with laparoscopy offering an excellent option. The colon dislodged into the chest through diaphragmatic hernias may be affected by various disorders, including malignancies. Case Report. A 70-year-old obese male presented with fatigue and shortness of breath. CT scan showed the right colon lodged in the chest through a Morgagni hernia. He was anaemic, and colonoscopy revealed a colon cancer. He underwent combined laparoscopic hernia repair with bioabsorbable mesh and right hemicolectomy. Recovery was uneventful, but the patient died 5 months later from chemotherapy-associated cardiac failure. Literature review revealed eight similar published cases, and including ours, there were seven Morgagni hernias, one traumatic hernia, and one Bochdalek hernia. Median age of the five men and four women was 66 (range 49-85) years. Surgical approach was thoracotomy (2), laparotomy (5), and laparoscopy (2). Conclusion. Outcome of the rare condition is determined by the course of the colon cancer. Hernia repair was successful in ours and all other published cases. A combined laparoscopic approach can be safely done.

The most recent recommendations for the surgical treatment of inguinal hernia

2019 ◽  
Vol 98 (7) ◽  
pp. 268-272
Keyword(s):  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Hernia Repair ◽  
Mesh Repair ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Approach ◽  
Safe Procedure ◽  
Recurrence Rates ◽  
Hernia Sac ◽  
Minimal Invasiveness

Introduction: The publication of new guidelines in recent years shows that surgical treatment of inguinal hernia remains topical. The main goal is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain. The main purpose of this article is to summarize the latest recommendations in surgical treatment of the groin hernias, especially in the case of strangulation. Methods: The authors made literature review of all the guidelines published by the hernia societies, including related articles, in the last ten years. Results: The use of the EHS classification system is suggested. In elective operations, mesh repair is recommended. The Lichtenstein technique is the standard in open inguinal hernia repair. Transabdominal preperitoneal and totally extraperitoneal approach have comparable outcomes. Their clear advantages include minimal invasiveness. Mesh repair is recommended also in the case of strangulation, but only in clean and clean-contaminated operations. A laparoscopic approach should be considered as well. Inter alia, it allows an assessment of bowel viability during the whole procedure. The need of bowel resection is hence lower compared to open surgery. If it is not possible to use the mesh, the Shouldice method is regarded as the best non-mesh repair technique. If there is concern about bowel viability, visualization, either by formal laparoscopy, hernia sac laparoscopy or laparotomy, is recommended. Hernioscopy is a simple and safe procedure that uses the hernia sac for insertion of a port following insufflation and diagnostic examination. It requires less advanced laparoscopic skills than does emergency laparoscopic hernia repair. It can be performed even by surgeons who lack sufficient experience with laparoscopy. Conclusion: In elective procedures, the mesh repair is recommended. It is recommended also in the case of strangulation, but not in a contaminated- dirty surgical field. If there is concern about bowel viability, visualization, either by formal laparoscopy, hernia sac laparoscopy or laparotomy, is needed.

scholarly journals Hybrid Laparoscopic and Anterior Approach for Postsurgical Inguinal Hernia After Iliofemoral Arterial Bypass

2015 ◽  
Vol 100 (3) ◽  
pp. 431-435 ◽  
Author(s):  
Tomoya Tsukada ◽  
Hiroto Saito ◽  
Koji Amaya ◽  
Itsuro Terada ◽  
Masahide Kaji ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Femoral Artery ◽  
Anterior Approach ◽  
Bypass Surgery ◽  
Laparoscopic Hernia Repair ◽  
Perioperative Complications ◽  
Artery Bypass ◽  
Laparoscopic Approach ◽  
Arterial Bypass

Laparoscopic hernia repair has become popular due to its rapid recovery time, fewer postoperative complications, and less chronic pain compared with conventional approaches. Currently, laparoscopic hernia repair is also used for more complex pathogenesis, including extra-anatomic bypass surgery for femoral artery. To the best of our knowledge, cases of inguinal hernia after femoral arterial bypass are extremely rare. We report the case of a 77-year-old Japanese man who was diagnosed with inguinal hernia after a previous left external iliac artery–right common femoral artery bypass. We used a hybrid laparoscopic and anterior approach, and the procedure was completed successfully without perioperative complications. A laparoscopic approach is useful for the diagnosis and treatment of inguinal hernia after extra-anatomic bypass surgery for femoral artery. While complicated, the addition of anterior reinforcement should be considered in cases of insufficient preperitoneal repair using transabdominal preperitoneal patch plasty.

scholarly journals STUDY OF PATTERNS OF PRESENTATION AND MANAGEMENT OF COMPLICATED INGUINAL HERNIAS

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.

scholarly journals Open and laparoscopic transabdominal preperitoneal approach for inguinal hernia: our single institution experience

2020 ◽  
Vol 7 (4) ◽  
pp. 1179
Author(s):  
Bhushankumar A. Thakur ◽  
Vivek Mukhamale ◽  
Snehal Deotale
Keyword(s):  
Inguinal Hernia ◽  
Retrospective Study ◽  
Hernia Repair ◽  
Rural Areas ◽  
Laparoscopic Hernia Repair ◽  
Single Institution ◽  
Revolutionary Change ◽  
Hernia Surgery ◽  
Open Procedure ◽  
Preperitoneal Approach

Background: Trans abdominal preperitoneal (TAPP) a novel approach for inguinal hernia was introduced by Arregui (1991) and Dion in early 1990’s has brought the revolutionary change in the era of hernia surgery over open preperitoneal inguinal hernia repair procedure introduce by Stoppa. Based on this we have done single institution retrospective study of TAPP and open preperitoneal procedure for inguinal hernia.Methods: This study was single institution retrospective study, where we have analyzed the data of 93 male and 7 female patients out of which 50 underwent standard TAPP procedure and 50 patients who underwent open preperitoneal procedure for inguinal hernia, with median 1 year of follow up. Their data analyzed for demographics, surgical site occurrence and short terms recurrence.Results: 100 patients with mean age of 55 years, median ASA of 1, ratio of left: right: bilateral for open 18:30:2 and for laparoscopic 26:20:4. Mean time for surgery was 102.3 min for open and 142.4 mins for TAPP. There was surgical site infection in 3 patients operated by open procedure and 2 patients in TAPP procedure. 4 patients from open procedure group and no one with TAPP group developed seroma which were managed conservatively and resolved at 6 weeks and 8 weeks. One recurrence in TAPP group patient at the 1 week follow.Conclusions: Open preperitoneal repair is hence a technique as effective as laparoscopic hernia repair with a minimal learning curve, ability to be performed under regional anaesthesia and cost effective. It can hence be used to carry out inguinal hernia repairs effectively in rural areas. 

scholarly journals Inguinal hernia repair: can one identify the three main nerves of the region?

2015 ◽  
Vol 42 (3) ◽  
pp. 149-153 ◽  
Author(s):  
João Vicente Machado Grossi ◽  
Leandro Totti Cavazzola ◽  
Ricardo Breigeiron
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Randomized Study ◽  
Operating Time ◽  
Hernia Surgery ◽  
Nerve Branch ◽  
Ilioinguinal Nerve ◽  
Inguinal Hernia Surgery ◽  
The Right

<sec><title>OBJECTIVE:</title><p> To identify the nerves in the groin during inguinal hernia repair by inguinotomy.</p></sec><sec><title>METHODS:</title><p> We conducted a prospective, sequenced, non-randomized study comprising 38 patients undergoing inguinal hernia repair with placement of polypropylene mesh.</p></sec><sec><title>RESULTS:</title><p> The male patients were 36 (94.7%), with a mean age and standard deviation of 43.1 ± 14.5, body mass index of 24.4 ± 2.8. Comorbidities were hypertension in two (5.2%), smoking in 12 (31.5%) and obesity in two (5.2%). The hernia was located only on the right in 21 (55.2%) patients, only on the left in 11 (28.9%), and was bilateral in six (15.7%) patients. Prior hernia repair was present in seven (18.4%) patients. The identification of the three nerves during operation was made in 20 (52.6%) patients, the ilioinguinal nerve and the iliohypogastric nerve were identified in 33 (86.8%), and the genital nerve branch of the genitofemoral nerve, in 20 (52.6%). Resection of at least one of the nerves was performed in seven (18.4%) cases, two iliohypogastric nerves and five ilioinguinal nerves. The average operating time was 70.8 ± 18.2 minutes. The hospital stay was 1.42 ± 1.18 days. Ten patients (26.3%) returned to physical activity around the first postoperative visit, and 37 (97.3%) in the last. The follow-up time was 95.6 ± 23.5 days. The inability to identify the ilioinguinal nerve was associated with previous repair (p = 0.035).</p></sec><sec><title>CONCLUSION:</title><p> The identification of the three nerves during inguinal hernia surgery has been described in more than half of the cases and prior repair interfered with the identification of ilioinguinal nerve.</p></sec>

Is Robotic-Assisted Inguinal Hernia Repair Comparable or Superior to Laparoscopic Approach?

2018 ◽  
Vol 227 (4) ◽  
pp. e20-e21
Author(s):  
Pedro P. Gomez ◽  
Guilherme S. Mazzini ◽  
Jad Khoraki ◽  
Gretchen R. Aquilina ◽  
Jennifer Salluzzo ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Laparoscopic Approach ◽  
Robotic Assisted

scholarly journals Comparative study between laparoscopic trans-abdominal preperitoneal and open mesh hernioplasty in repair of non-complicated inguinal hernia

2019 ◽  
Vol 7 (1) ◽  
pp. 24
Author(s):  
Waleed Yusif El Sherpiny
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Laparoscopic Hernia Repair ◽  
Laparoscopic Group ◽  
Routine Activities ◽  
Group A ◽  
Group B ◽  
Open Hernia Repair ◽  
Mesh Hernioplasty

Background: Inguinal mesh hernioplasty is one of the common procedures performed all over the world. It can be done either through open or laparoscopic techniques. The aim of this study was to compare the outcomes of Lichtenstein tension free hernioplasty versus laparoscopic transabdominal pre-peritoneal (TAPP) mesh repair considering, duration of the surgery, hospital stay, and duration to resume normal activity, degree of postoperative pain, wound infection, recurrence and complications.Methods: Adult patients presented to the general surgical OPD, with the diagnosis of inguinal hernia underwent either Lichtenstein repair or laparoscopic repair by TAPP.Results: Patients in Group A (open-repair) had significantly greater level of local pain during rest and during routine activities than those within Group B (laparoscopic group) during the postoperative period assessed on the visual-analogue scale. Mean operative time for open hernia repair was 43.7 minutes and for laparoscopic hernia repair was 59.03 minutes and the difference were statistically significant (p=0.0001). The mean duration of hospital stay for open hernia repair was 2.16 days and that for laparoscopic hernia repair was 1.08 days with a (p=0.00001) which was statistically significant. The time to resume routine activities was much shorter among Group B patients than patients in Group A. Only one recurrence (3.3%) was seen in Group B after 6 months follow up.Conclusions: It is concluded that laparoscopic TAPP repair of inguinal hernia in adults is safe and preferred operation as compared to open inguinal hernia repair.

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