scholarly journals Non-closure of the Free Peritoneal Flap During Laparoscopic Hernia Repair of Lower Abdominal Marginal Hernia: A Retrospective Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Qian Xu ◽  
Guangyong Zhang ◽  
Linchuan Li ◽  
Fengting Xiang ◽  
Linhui Qian ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Laparoscopic Hernia Repair ◽  
Abdominal Hernia ◽  
Visceral Injury ◽  
Mesh Placement ◽  
Peritoneal Flap ◽  
Flap Closure

Background: During lower abdominal marginal hernia repair, the peritoneal flap is routinely freed to facilitate mesh placement and closed to conclude the procedure. This procedure is generally called trans-abdominal partial extra-peritoneal (TAPE). However, the necessity of closing the free peritoneal flap is still controversial. This study aimed to investigate the safety and feasibility of leaving the free peritoneal flap in-situ.Methods: A retrospective review was conducted on 68 patients (16 male, 52 female) who underwent laparoscopic hernia repair between June 2014 and March 2021. Patients were diagnosed as the lower abdominal hernia and all required freeing the peritoneal flap during the operation. Patients were divided into 2 groups: one group was TAPE group with the closed free peritoneal flap, another group left the free peritoneal flap unclosed. Analyses were performed to compare both intraoperative parameters and postoperative complications.Results: There were no significant differences in demographic, comorbidity, hernia characteristics and ASA classification. The intra-operative bleeding volume, visceral injury, hospital stay, urinary retention, visual analog scale (VAS) score, dysuria, intestinal obstruction, surgical site infection, mesh infection, recurrence rate and hospital stay were similar among the two groups. Mean operative time of the flap closing procedure was higher than for patients with the free peritoneal flap left in-situ (p = 0.002). Comparisons of postoperative complications showed flap closure resulted in a higher incidence of seroma formation (p = 0.005).Conclusion: Providing a barrier-coated mesh is used during laparoscopic lower abdominal marginal hernia repair, it is safe to leave the free peritoneal flap in-situ and this approach may prevent the occurrence of seromas.

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.

scholarly journals Comparative study of laparoscopic hernia repair versus open hernia repair

2018 ◽  
Vol 7 (2) ◽  
pp. 30-34
Author(s):  
Rohit Prasad Yadav ◽  
Dipendra Thakur ◽  
Bashu Dev Baskota ◽  
Amit Kumar Shah ◽  
Kaushal Samsher Thapa ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Comparative Study ◽  
Hospital Stay ◽  
Laparoscopic Hernia Repair ◽  
Fatty Tissue ◽  
Duration Of Surgery ◽  
Group 2 ◽  
Lower Pain Score ◽  
Open Hernia Repair ◽  
Group 1

 Background: Hernia is the abnormal exit of an organ or fatty tissue, such as the bowel, through the weak wall of the cavity in which it normally resides. Repair of inguinal hernia is common surgical  procedures. This study aims to compare between laparoscopic and open hernia repair. Method: Study is non randomized comparative study. Study includes 76 patients who had undergone surgery for hernioplasty. Among them 38 undergone laparoscopic hernioplasty and 38 undergone open hernioplasty from June 2016 to August 2018. Results: Mean hospital stay was 2.95 days in group 1 and 4.03 in group 2 .VAS was found to be 2.45 in group 1 and 5.71 in group 2 which is significantly low in group 1 patients with p<0.001. Duration of surgery is more in group 1 with mean duration of 94.08 minutes comparing to group 2 with mean duration of 43.55 minutes (with p<0.001). Conclusion: Laparoscopic hernia repair offers advantages over open repair in terms of less hospital stay and lower pain score for patient not contraindicated for general anesthesia and complicated hernia.

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.

Simplifying mesh placement during laparoscopic hernia repair

1995 ◽  
Vol 82 (5) ◽  
pp. 642-642 ◽  
Author(s):  
C. Avery ◽  
R. J. E. Foley ◽  
A. Prasad
Keyword(s):  
Hernia Repair ◽  
Laparoscopic Hernia Repair ◽  
Mesh Placement

COMPARATIVE ANALYSIS OF THE RESULTS OF PLASTIC INGUINAL HERNIA LAPAROSCOPIC AND TRADITIONAL METHODS

2021 ◽  
pp. 27-31
Author(s):  
Diyar Akhmet ◽  
◽  
Zhasulan Baimakhanov ◽  
Erik Nurlanbayev ◽  
Askar Matkerimov ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Comparative Analysis ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Postoperative Period ◽  
Laparoscopic Hernia Repair ◽  
Traditional Methods ◽  
Scientific Center ◽  
Duration Of Hospital Stay ◽  
Analgesic Therapy

Purpose of the study. Conduct a retrospective comparative analysis of the results of laparoscopic and traditional methods of inguinal hernia repair, patients treated at the surgical departments at “A.N. Syzganov National Scientific Center of Surgery”, Almaty, Kazakhstan. Materials and methods. In the period from January 2017 to December 2020 137 patients were operated at the “A.N. Syzganov National Scientific Center of Surgery” in a planned manner for inguinal hernia and all patients were divided into 2 main groups: operated by traditional methods and laparoscopic method. Results.The data of the analysis suggests that the laparoscopic method of hernioplasty has an advantage over the traditional methods. Conclusion. Based on a comparative analysis of the indicators of patients in both groups, it can be concluded that the duration of the operation for laparoscopic hernia repair is 92.3 minutes, significantly more than with traditional methods, which is 79.4 minutes. Despite this, the duration of analgesic therapy in the postoperative period with laparoscopic hernia repair is 2.4 days, and the duration of hospital stay after surgery is 3 days, much less than with traditional methods, in which the duration of analgesic therapy in the postoperative period is 3, 3 days, and the duration of hospital stay after surgery is 4.6 days. This analysis suggests that laparoscopic hernioplasty has an advantage over traditional methods.

Increased risk of postoperative complications with retromuscular mesh placement in emergency incisional hernia repair: A nationwide register-based cohort study

2020 ◽  
pp. 145749692096623
Author(s):  
N. Juul ◽  
N. A. Henriksen ◽  
K. K. Jensen
Keyword(s):  
Postoperative Complications ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Incisional Hernia Repair ◽  
Secondary Outcome ◽  
Emergency Setting ◽  
Mesh Placement ◽  
Increased Risk ◽  
Elective Repair ◽  
Onlay Mesh

Introduction: Incisional hernia is common after abdominal surgery. Watchful waiting carries the risk of incarceration and a need for emergency intervention. The aim of this study was to examine the risk of postoperative complications after emergency versus elective incisional hernia repair. Methods: Patients above 18 years of age undergoing open incisional hernia repair in Denmark in 2017–2018 were identified in the Danish Ventral Hernia Database. Patients were grouped according to elective or emergency hernia repair. The primary outcome was postoperative complications requiring operative intervention within 90 days, and the secondary outcome was postoperative length of stay. Results: We included 1050 patients, of whom 882 were admitted for elective and 168 for emergency operation. Patients undergoing emergency repair were older (64.7 years vs 59.2 years, p < 0.001), more often smokers (25.8% vs 13.6%, p = 0.003), and more often had a Charlson comorbidity score ⩾2 (26.8% vs 19.2%, p = 0.005) compared to patients undergoing elective repair. In a multivariate regression analysis, emergency compared to elective operation (OR = 2.71, 95% CI = 1.4–5.25, p = 0.003) and retromuscular compared to onlay mesh placement (OR = 2.14, 95% CI = 1.08–4.24, p = 0.013) were factors significantly associated with increased risk of postoperative complications. In a subgroup analysis including only emergency repairs, risk of complications after retromuscular mesh placement was even higher (OR = 10.12, 95% CI = 1.81–56.68, p = 0.008). Conclusion: Emergency incisional hernia repair was associated with increased risk of postoperative complications and this risk was accentuated with retromuscular mesh placement. The use of retromuscular mesh in the emergency setting should be avoided, and the abdominal wall could either be closed by sutures or additional onlay mesh.

scholarly journals A COMPARATIVE STUDY ON OUTCOMES OF OPEN & LAPAROSCOPIC REPAIR IN INGUINAL HERNIA IN A TERTIARY CARE CENTRE

2020 ◽  
pp. 23-25
Author(s):  
Konkena Janardhana Rao ◽  
K. Meghana ◽  
N. Prahalada Reddy ◽  
J. Ramanaiah ◽  
Mamatha. V ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Comparative Study ◽  
Hospital Stay ◽  
Laparoscopic Hernia Repair ◽  
Female Ratio ◽  
Duration Of Surgery ◽  
The Mean ◽  
Operative Recovery ◽  
Lichtenstein Operation

Background: Over the last decade, the field of hernia surgery got a new transformation, with exponential growth in mesh technology. Laparoscopic hernia repair has remained a contentious issue since its inception. Though a variety of procedures performed; none can be termed as an ideal procedure as each one is accompanied by varied early and late complications. The most scientific way to conclude the superiority of one method over others is evidence-based medicine. Hence, we have conducted a study in our institute, to compare Lichtenstein tension-free open hernioplasty with Transabdominal pre-peritoneal repair (TAPP) comparing the intraoperative and early postoperative complications. Methods: Our study was a single-centre, prospective comparative study conducted on sixty-one patients, over a period of 2 years from August 2018 to August 2020. All the cases included in the study were uncomplicated inguinal hernias. A detailed history of the symptoms, thorough clinical examination and investigations were done, which were analysed. Results: Most of the patients presented in the 5th decade. Male to female ratio of incidence of inguinal hernia was 11.2:1. Majority of the patients presented with unilateral hernia with right inguinal hernia being the most frequent presentation. The mean duration of surgery for TAPP is more when compared to Lichtenstein operation. The mean duration of hospital stay for open hernioplasty is more when compared to the laparoscopic hernia repair. TAPP is associated with lesser complications when compared to Lichtenstein's hernioplasty. Seroma, hematoma, and wound infection were the common complications noted. Conclusion: TAPP repair is a better procedure when compared to Lichtenstein operation in terms of hospital stay, post- operative recovery, intra-operative and post-operative complications.

scholarly journals Preventing Hernia Recurrence: Optimising Mesh Use in Incisional Hernia Repair

2020 ◽  
Vol 1 (4) ◽  
Author(s):  
Lily Goldblatt ◽  
Julia Merchant
Keyword(s):  
Chronic Pain ◽  
Incisional Hernia ◽  
Hernia Repair ◽  
Laparoscopic Hernia Repair ◽  
Mesh Fixation ◽  
Anatomical Location ◽  
Mesh Placement ◽  
Risk Of Recurrence ◽  
Fixation Methods ◽  
Reduced Risk

Incisional hernia is a common complication of abdominal surgery, affecting up to a quarter of patients undergoing laparotomy. This case report discusses a 72-year-old lady with a recurrent incisional hernia following an emergency Hartman’s procedure. The discussion covers the properties of synthetic vs biological meshes, the significance of the anatomical location of the mesh, fixation methods, laparoscopic surgery, short and long term complications. Key points: The ideal mesh is biocompatible, strong, resistant to infection, has minimal bioreactivity and non-immunogenic Pore size is important to the degree of mesh integration, infection risk and the development of chronic pain Synthetic mesh is useful in contaminated cases but adds a significant cost to the procedure Sublay mesh placement is associated with a reduced risk of recurrence Most recurrences occur at the edge of the mesh. Surgeons should ensure a 5cm overlap between the mesh and native tissues and consider dual fixation methods Laparoscopic hernia repair has been associated with a shorter post-op recovery, less pain and a short term reduced risk of recurrence, however there is a greater risk of bowel injury and development of adhesions Composite meshes can reduce the risk of adhesions with intraperitoneal mesh placement Chronic pain is associated with the use of tacks, heavy weight synthetic meshes and chronic infection Resorbable meshes have not been shown to reduce chronic pain The choice of mesh, method of repair and surgical approach should be individualised to the patient.

Sign in / Sign up

Export Citation Format

Share Document