scholarly journals The Operative Time for Unilateral Inguinal Hernia Repair in Children Performed with Percutaneous Internal Ring Suturing (PIRS) or Open Approach Method

2021 ◽  
Vol 10 (6) ◽  
pp. 1293
Author(s):  
Przemyslaw Karol Wolak ◽  
Agnieszka Strzelecka ◽  
Aneta Piotrowska ◽  
Katarzyna Dąbrowska ◽  
Piotr Przemysław Wolak ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Operative Time ◽  
Retrospective Chart Review ◽  
Open Approach ◽  
Internal Ring ◽  
Patients Âgés ◽  
Unilateral Inguinal Hernia ◽  
Approach Method

In this study, we compared the operative time for unilateral inguinal hernia repair in children performed with either an open approach (OA) or the Percutaneous Internal Ring Suturing (PIRS) method. It was a retrospective chart review of all patients ages 0 to 18 who underwent unilateral inguinal hernia repair in the Department of Pediatric Surgery, Urology and Traumatology of the Regional Hospital in Kielce between January 2011 and December 2018. Patients with bilateral hernias or additional problems were excluded. Of 878 patients qualified for the study, 701 were in the OA group and 177 in the PIRS group. Overall, the time needed to complete the procedure was significantly longer for the OA method. The operative time was longer if the hernia was left-sided (p = 0.024). Analysis by gender showed that operative time was generally longer in males. For both genders, surgery was shorter if the PIRS method was used. For males in the PIRS group the operative time was affected by the location of the hernia, and it was longer for a left-sided hernia. The take-home message is that the PIRS procedure is faster than the OA for inguinal hernia repair in children and it might be considered as a preferred method, especially in females.

Laparoscopic Inguinal Hernia Repair—TAPP versus TEP: Results of 301 Consecutive Patients

2021 ◽  
Vol 39 ◽  
Author(s):  
Beslen Goksoy ◽  
◽  
Gokhan Yilmaz ◽  
Ibrahim Azamat ◽  
Ibrahim Ozata ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Operative Time ◽  
Laparoscopic Inguinal Hernia Repair ◽  
Secondary Outcome ◽  
Unilateral Inguinal Hernia ◽  
Laparoscopic Inguinal Hernia ◽  
The Mean

Introduction: Transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) hernia repair are the two most commonly used techniques in laparoscopic inguinal hernia repair, and the results of comparative studies are conflicting. The objective of this study is to compare the two methods in unilateral inguinal hernia repair. Materials and Methods: The data of consecutive patients who underwent TEP and TAPP due to unilateral inguinal hernia between December 7, 2017, and March 15, 2020, were analyzed retrospectively. The primary outcome was to compare the clinical outcomes of the two techniques in terms of complications, conversion, pain, and operative time. The secondary outcome was recurrence rates. Results: A total of 301 (TEP n=234, TAPP n=67) patients were included in the study. The mean age was 43 years, and the follow-up period was two years. The groups were similar in terms of demographic characteristics and hernia type. The mean operative time was longer in the TAPP group than in the TEP group (67 min and 58 min, p=0.007). The recurrence rate was 4.3% in the TEP group and 5.9% in the TAPP group (p>0.05). The conversion rate was 6% in both groups. In total, 19 (6.3%) patients had intraoperative complications (TEP n=16, TAPP n=3), and 23 (7.6%) patients had postoperative complications (TEP n=16, TAPP n=7). Both intraoperative and postoperative complication rates were similar between the groups (p=0.31 and p=0.051, respectively). The early postoperative pain was less in the TEP group (p=0.004). Conclusion: Less early postoperative pain and shorter operative time were detected in patients who underwent TEP.

Bilateral inguinal hernia repair: laparoscopic or open approach?

Hernia ◽  
2010 ◽  
Vol 15 (1) ◽  
pp. 15-18 ◽  
Author(s):  
X. Feliu ◽  
R. Clavería ◽  
P. Besora ◽  
J. Camps ◽  
E. Fernández-Sallent ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Open Approach ◽  
Bilateral Inguinal Hernia

Comparative Study Between Caudal Block And Local Wound Infiltration In Inguinal Hernia Repair In Pediatric Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Azza Mohamed Shafeek Abdel Mageed ◽  
Wael Reda Hussaein ◽  
Rania Hassan Abdel Hafiez ◽  
Tarek Atef Abdullah Hammouda
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Pain Score ◽  
Inguinal Hernia Repair ◽  
Postoperative Analgesia ◽  
Pediatric Patients ◽  
Caudal Block ◽  
Wound Infiltration ◽  
Unilateral Inguinal Hernia ◽  
Significant Difference

Abstract Background Postoperative analgesia can be provided by a multimodal approach includes opioids, nonsteroidal anti-inflammatory drugs, paracetamol infusion and regional anesthetic techniques such as local infiltration or nerve blocks. In contrast to opioids, local anesthetics can be administered safely and in recent guidelines regional anesthesia is accepted as the cornerstone of postoperative pain relief in the pediatric patients. Objective Compare the postoperative analgesic effectiveness of local wound infiltration of bupivacaine against bupivacaine administered caudally in pediatric patients undergoing unilateral inguinal hernia repair. Patients and methods This study was carried out in Ain Shams University hospitals on 40 pediatric patients of both sexes aged from 6 months to 7 years belonging to ASA I or II undergoing elective unilateral inguinal hernia repair. They were randomly allocated into two groups: group C receiving caudal block, group L receiving local wound infiltration. Hemodynamic changes, postoperative pain score using FLACC pain score, postoperative analgesia and complications were recorded. Results There was no significant difference between the two groups as regard demographic data or hemodynamic variables. Pain score shows no statically significant differences between two groups in the first hour. But statistically significant decrease in FLACC score after (1, 2 and 3 hours) in group C in comparison with group L.decreased significantly in group C after 1 hour postoperative. Duration of analgesia longer in group C with no significant difference in total amount of postoperative analgesia. There was significant increase in incidence in complications in group C than group L Conclusion Caudal block provides better and longer analgesia but requires experience and may lead to complications. In contrast, wound infiltration is simple without significant side effects. Therefore, local wound infiltration may be a preferred technique for producing postoperative analgesia in pediatric inguinal hernia repair.

scholarly journals A comparative study of Desarda’s mesh free inguinal hernia repair with modified Bassini’s repair

2021 ◽  
Vol 6 (2) ◽  
pp. 104-115
Author(s):  
Hosni Mubarak Khan ◽  
◽  
Tirumal Rao Patwari
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Open Approach ◽  
Medical College ◽  
Inguinal Hernias ◽  
Mesh Free ◽  
Hospital Stays ◽  
A Prospective Study ◽  
Repair Techniques

Objective. This is a prospective study of 50 cases of inguinal hernias which were treated through open inguinal hernia repair techniques. The study was conducted with the objective of comparing the effectiveness of these procedures and complications. Materials and Methods. A number of 50 cases of inguinal hernias admitted to Dr. BR Ambedkar Medical College and Hospital were selected on the basis of the non-probability (purposive) sampling method. All the patients with direct and indirect uncomplicated hernias treated by means of an open approach were included. After the preoperative preparation, they were randomly chosen either for Desarda’s or Modified Bassini’s repair techniques. Results. In the postoperative period, moderate pain was experienced by 19 patients included in the Desarda group and 17 patients included in the Modified Bassini’s repair group on day 1. The postoperative wound infection developed in 2 cases of Desarda and 3 cases of Modified Bassini’s, erythema was observed in 2 cases of Desarda and 3 cases of Modified Bassini’s, 3 cases reported the occurrence of seroma in the Desarda group and 4 cases of seroma were recorded in the Modified Bassini’s group. Conclusions. The patients who underwent Desarda repair complained of a higher intensity of pain, which could probably be attributed to the extensive dissection involved. The duration of Desarda repair was longer due to the learning curve of the surgeons in our hospital. The return to normal gait and normal activities was significantly lower in the Desarda group. The duration of hospital stays and the postoperative complications was not significantly different in the two groups. There were no recurrences in either of the groups until the current study.

scholarly journals Contralateral exploration and repair of occult inguinal hernias during laparoscopic inguinal hernia repair: systematic review and Markov decision process

BJS Open ◽  
2020 ◽  
Vol 5 (2) ◽  
Author(s):  
N H Dhanani ◽  
O A Olavarria ◽  
S Wootton ◽  
M Petsalis ◽  
N B Lyons ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Markov Decision Process ◽  
Decision Process ◽  
Expectant Management ◽  
Contralateral Exploration ◽  
Unilateral Inguinal Hernia ◽  
Inguinal Hernias ◽  
Markov Decision

Abstract Background Contralateral clinically occult hernias are frequently noted at the time of laparoscopic unilateral inguinal hernia repair. There is no consensus on the role of contralateral exploration and repair. This systematic review assessed the safety and efficacy of operative repair of occult contralateral inguinal hernias found during unilateral repair. Methods PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception to February 2020. Adults diagnosed with a unilateral inguinal hernia undergoing laparoscopic repair were included. The primary outcome was the incidence of occult contralateral hernias. Summative outcomes of operative and expectant management were reported along with development of a Markov decision process. Results Thirteen studies (1 randomized trial, 12 observational cohorts) with 5000 patients were included. The incidence of occult contralateral inguinal hernias was 14.6 (range 7.3–50.1) per cent. Among patients who underwent repair, 10.5 (4.3–17.0) per cent experienced a postoperative complication. Of patients managed expectantly, 29 per cent later required elective repair for symptoms. Mean follow-up was 36 (range 2–218) months. Using a Markov decision process, it was calculated that, for every 1000 patients undergoing unilateral inguinal hernia repair, contralateral exploration would identify 150 patients with an occult hernia. Repair would result in 15 patients developing a postoperative complication and 105 undergoing unnecessary repair. Alternatively, expectant management would result in 45 patients requiring subsequent repair. Conclusion Contralateral repair is not warranted in patients with occult hernias diagnosed at the time of elective hernia repair. The evidence is largely based on observational studies at high risk of bias.

Robotic-assisted versus laparoscopic unilateral inguinal hernia repair: a comprehensive cost analysis

2018 ◽  
Vol 33 (10) ◽  
pp. 3436-3443 ◽  
Author(s):  
Walaa F. Abdelmoaty ◽  
Christy M. Dunst ◽  
Chris Neighorn ◽  
Lee L. Swanstrom ◽  
Chet W. Hammill
Keyword(s):  
Inguinal Hernia ◽  
Cost Analysis ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Robotic Assisted ◽  
Unilateral Inguinal Hernia
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