LAPAROSCOPIC TOTAL EXTRAPERITONEAL (TEP) REPAIR OF INGUINAL HERNIA: A PROSPECTIVE CONTROLLED STUDY

2012 ◽  
pp. 9-14
Author(s):  
Dinh Tuan Dung Phan ◽  
Nhu Hiep Pham ◽  
Loc Le
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Groin Hernia ◽  
Controlled Study ◽  
Complication Rates ◽  
Tep Repair ◽  
Totally Extraperitoneal ◽  
Inguinal Hernias ◽  
Laparoscopic Tep

Objectives: Inguinal hernia is the most common hernia and inguinal hernia repair is the most frequently performed operation in gerenal surgery. Hernioplasty by laparoscopy was gradually the standard method for inguinal hernia repair all over the world. The objective of this study is to demonstrate the effectness and safeness of laparoscopic totally extraperitoneal (TEP) hernia repair. Materials and methods: A prospective analysis of patients, admitted for groin hernia and operated by laparoscopic TEP hernia repair, performed between June 2010 and December 2011. Data were collected regarding general characteristics, complication rates, length of hospital stay and the recurrence rate postoperative of this laparoscopic method. Results: 35 patients underwent laparoscopic totally extraperitoneal (TEP) hernia repair with an average age of 51.3±13.8 years (range 31 – 72 years); 5.7% of the inguinal hernias were operated bilaterally, peritoneal laceration was noticed during dissection in 14.3%, there was no injury of the inferior epigastric vessels during dissection. Unilateral hernia had an operative time of 66.52 ± 17.4 minutes (range 45 – 115 minutes) and bilateral hernia took 107.5 minutes (range 95 – 120 minutes). All of these patients in the study were controlled, 5.7% had seroma at the time 3 months postoperative, there were no recurrences during follow-up ranging from 3 – 18 months (average 9.6 months). Conclusions: The laparoscopic (TEP) repair of inguinal hernia is safe and effective. That laparoscopy method should be the gold standard technique in treatment for the repair of inguinal hernias. Keywords: groin hernia – TEP hernioplasty - laparoscopy

LAPAROSCOPIC TOTAL EXTRAPERITONEAL REPAIR OF INGUINAL HERNIA DIRECT: NONFIXATION OF THREE-DIMENSIONAL MESH

2016 ◽  
pp. 21-27
Author(s):  
Dinh Tuan Dung Phan ◽  
Anh Vu Pham ◽  
Manh Ha Le
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Groin Hernia ◽  
Three Dimensional ◽  
Complication Rates ◽  
3D Mesh ◽  
Tep Repair ◽  
Totally Extraperitoneal ◽  
Laparoscopic Tep

Introduction: Laparoscopic inguinal hernia repair frequently is performed with mechanical fixation of a flat polypropylene mesh. Mechanical fixation is associated with pain syndromes and mesh migration may occur without fixation of flat protheses. An anatomically contoured mesh 3D-Max (3DMAX Mesh/Bard-Davol, France) using no fixation would avoid these problems. The objective of this study is to demonstrate the effectiveness and safeness of laparoscopic totally extraperitoneal (TEP) hernia repair with nonfixation of three-dimensional mesh. Materials and methods: A prospective analysis of patients, admitted for groin hernia type direct and operated by laparoscopic TEP hernia repair with nonfixation of 3D mesh (3DMAX Mesh), performed between June 2010 and June 2015. Data were collected regarding general characteristics, complication rates, length of hospital stay and the recurrence rate postoperative of this method. Results: 36 patients/42 hernias type direct underwent laparoscopic totally extraperitoneal (TEP) repair with nonfixation of 3D mesh. The results show with an average age of 59,5±13,2 years (range 36–85 years); peritoneal laceration was noticed during dissection in 7,1%, there was no injury of the inferior epigastric vessels during dissection. Unilateral hernia had an operative time of 54,5±18,1 minutes (range 30–115 minutes), bilateral hernia was 88,3±24,6 (range 65-120 minutes). All of these patients in the study were controlled with 2,4% had pain post-op at 3 months follow-up postoperative, but at 12 months and 24 months follow-up, there were no complication, no recurrences. Conclusions: The laparoscopic (TEP) repair of inguinal hernia with nonfixation of three-dimensional mesh is safe and effective. Keywords: groin hernia – TEP hernioplasty - laparoscopy

scholarly journals Early outcomes of laparoscopy for totally extra - peritoneal (TEP) inguinal hernia repair at E Hospital

2019 ◽  
Vol 9 (2) ◽  
Author(s):  
Đức Anh Lương ◽  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Advanced Technique ◽  
Mesh Placement ◽  
Tep Repair ◽  
Early Results ◽  
Technical Issues ◽  
Alternative Choice ◽  
Laparoscopic Tep

Tóm tắt Đặt vấn đề: Phẫu thuật nội soi đi đường ngoài phúc mạc hoàn toàn đặt lưới để điều trị bệnh thoát vị bẹn (TVB) ở người lớn là một tiến bộ kỹ thuật đang được phát triển và áp dụng bổ sung cho các phương pháp khác, nhưng đây lại là phương pháp có nhiều thách thức về kỹ thuật nhất với các phẫu thuật viên. Tại Bệnh viện E từ tháng 5/2017 đến tháng 5/2019 có 35 ca được mổ theo phương pháp này. Mục tiêu nghiên cứu nhằm đánh giá kết quả sớm, một số kinh nghiệm về chỉ định và kỹ thuật mổ. Phương pháp nghiên cứu: Thiết kế nghiên cứu can thiệp, một nhóm, dạng quan sát mô tả tiến cứu, đánh giá kết quả trước và sau can thiệp. Kết quả: 35 bệnh nhân (BN) TVB gồm 2 nữ, 33 nam; tuổi TB 66,2±10,65 (41- 91); TVB 1 bên: 33 (94,3%), 2 bên: 2 (5,7%); TVB trực tiếp: 13 (37,1%), gián tiếp: 22 (62,9%); một ca có tiền sử mổ Bassini hai lần cùng bên và tái phát được mổ thành công. Hai ca thủng phúc mạc trong khi phẫu tích, khắc phục không phải chuyển TAPP. Thời gian mổ: 121,1±33,20 phút (90-190). Kết luận: Phương pháp khả thi an toàn thời gian nằm viện giảm, thẩm mỹ và ít đau, tuy nhiên có nhiều điểm cần lưu ý trong kỹ thuật cần nghiên cứu tiếp tục liên quan đến kết quả mổ như nhận định giải phẫu, phẫu tích, xử lý thủng khi thủng phúc mạc, cố định chắc chắn vật liệu vào khoang để che phủ lỗ thoát vị... Abstract Introduction: Laparoscopic totaly extraperitoneal inguinal hernia repair with placement of a mesh outside the peritoneum to repair inguinal hernia in adult patients is an advanced technique has been developing as alternative choice for surgeons. However, this method has is challenging in technical issues for surgeons. Over a 24-month period (May 2017 through May 2019), a total of 35 laparoscopic TEP inguinal hernia repairs were carried out. This paper aimed to evaluate the early results and discuss some important technical issues as well. Material and Methods: A prospective observational study, one group, evaluating results before and after intervention. Results: 35 patients including 2 females and 33 males with mean age of 66,2±10,65 years old (41- 91); unilateral inguinal hernia (IH): 33 patients (94,4%), bilateral IH: 2 patients (5,7%); direct IH: 13 patients (37,1%), indirect IH: 22 (62,9%); One patient underwent two times previously by Bassini procedure due to recurrence. Per-operative adverse events including: peritoneum laceration during dissection in 2 cases, overcome by repair peritoneum damaged without conversion into TAPP. Mean operative time: 121,1±33,20 min (90-190). Conclusion: Laparoscopic TEP IH repair with prolene mesh placement is a suitable treatment option for selected inguinal hernia patients. However, some technical issues should be considered such as accuracy recognization of endoscopic anatomy landmarks during dissecting inguinal canal elements and management of incident happened management for example peritoneum being lacerated, clearing the pre- peritoneal space for laying mesh, substantial fine fixation of mesh... may cause the outcomes. Keywords: Laparoscopy, Inguinal hernia, TEP repair.

scholarly journals Laparoscopic inguinal hernia repairs: comparison between TAPP and TEP at a tertiary center of Nepal

2018 ◽  
Vol 5 (11) ◽  
pp. 3719
Author(s):  
Komal B. Gurung ◽  
Niroj Banepali ◽  
Rakesh R. Sthapit ◽  
Baikuntha Adhikari
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Postoperative Complications ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Tep Repair ◽  
Laparoscopic Inguinal Hernia ◽  
Inguinal Hernias ◽  
Tertiary Center ◽  
Duration Of Surgery

Background: Laparoscopic inguinal hernia repair has been proven to be a safe and effective procedure for groin hernias. In recent years, many of the tertiary centers in Nepal have started performing laparoscopic hernia repair. With the availability of resources and the facilities, the laparoscopic repairs for inguinal hernias are going to be more accessible in near future in Nepal. The aim of this study was to compare the intraoperative events and postoperative complications of transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) techniques of laparoscopic inguinal hernia repairs.Methods: Out of 56 patients, 30 underwent TAPP and 26 TEP repairs for primary unilateral inguinal hernias and were prospectively analyzed. Patient demographics, past medical and surgical history, intraoperative, and postoperative events were recorded. Patients were followed-up for two years.Results: Demographic parameters were comparable in both the groups. The difference in mean operating time was statistically significant (longer in the TAPP group). Intraoperative events such as port-site bleeding and peritoneal tear were comparable in both groups. The immediate postoperative complications like skin ecchymosis, cord hematoma, and scrotal edema were comparable in both repairs.  Immediate postoperative pain was significantly lesser in TEP repair whereas the hospital stays and time to return to the normal physical activity were comparable in both groups.Conclusions: Both TAPP and TEP laparoscopic techniques are safe and effective for inguinal hernia repair. However, there are few advantages of TEP repair such as shorter duration of surgery and less postoperative pain.

scholarly journals Laparoscopic total extraperitoneal (tep) repair of direct inguinal hernia using nonfixation of three-dimensional mesh: Long term follow up

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Đình Tuấn Dũng Phan ◽  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Three Dimensional ◽  
Mesh Migration ◽  
Direct Inguinal Hernia ◽  
Tep Repair ◽  
Total Extraperitoneal ◽  
Laparoscopic Tep

Tóm tắt Đặt vấn đề: Đến nay, phẫu thuật nội soi trong điều trị bệnh lý thoát vị bẹn được thực hiện ngày càng nhiều trên lâm sàng, trong đó phẫu thuật nội soi hoàn toàn ngoài phúc mạc đã được sử dụng rộng rãi cùng một tấm lưới nhân tạo được cố định vào thành bụng trước. Tuy nhiên, sự cố định này là một trong những nguyên nhân chủ yếu gây ra tình trạng đau sau mổ và ngược lại sự di chuyển của tấm lưới nhân tạo phẳng chính là nguyên nhân gây ra tình trạng thoát vị tái phát. Việc sử dụng tấm lưới nhân tạo 3D (3DMAX Mesh/Bard-Davol) có thể tránh được những vấn đề này. Mục tiêu của đề tài nhằm đánh giá kết quả lâu dài của phương pháp phẫu thuật đặt tấm nhân tạo 3D ngoài phúc mạc qua ngã nội soi trong điều trị bệnh lý thoát vị bẹn trực tiếp. Phương pháp nghiên cứu: Phương pháp nghiên cứu mô tả tiến cứu được thực hiện trên các người bệnh được chẩn đoán thoát vị bẹn trực tiếp và được điều trị phẫu thuật nội soi hoàn toàn ngoài phúc mạc (TEP) đặt tấm nhân tạo 3D (3D-Max - Davol) từ tháng 6 năm 2010 đến tháng 12 năm 2018. Nghiên cứu đánh giá về các đặc điểm chung, đặc điểm phẫu thuật, biến chứng, thời gian nằm viện và đánh giá tái khám sau phẫu thuật sau 36 tháng. Kết quả: Có 62 người bệnh (tổng số 67 trường hợp thoát vị trực tiếp) đã được phẫu thuật bằng phương pháp đặt tấm nhân tạo 3D ngoài phúc mạc bằng nội soi. Độ tuổi trung bình 54,7 ± 13,1 tuổi (nhỏ nhất 41 tuổi, lớn nhất 81 tuổi). 91,9% là thoát vị bẹn một bên. Đặc điểm phẫu thuật: thủng phúc mạc trong quá trình phẫu thuật chiếm tỷ lệ 4,5%, không có trường hợp nào tổn thương các mạch máu lớn trong phẫu thuật. Thời gian phẫu thuật trung bình là 47,2±11,9 phút (35-95 phút) đối với thoát vị bẹn một bên và 81,4±18,9 phút (65-120 phút) đối với thoát vị bẹn hai bên. Tái khám sau mổ: 3/67 (4,5%) trường hợp còn cảm giác đau khi tái khám vào tháng thứ 3, không có trường hợp tụ dịch ở vết mổ, không có trường hợp tái phát nào được ghi nhận lúc tái khám vào ở vết mổ, không có trường hợp tái phát nào được ghi nhận lúc tái khám vào tháng thứ 36. Kết luận: Phẫu thuật nội soi hoàn toàn ngoài phúc mạc với tấm nhân tạo 3D trong điều trị thoát vị bẹn trực tiếp có tính an toàn và hiệu quả cao. Kỹ thuật này có thể được áp dụng rộng rãi và nên được xem như là tiêu chuẩn vàng trong điều trị bệnh lý thoát vị bẹn. Abstract Introduction: Laparoscopic inguinal hernia repair is frequently performed using the mechanical fixation of a flat polypropylene mesh. This procedure is associated with pain issue and mesh migration that may occur without fixation of flat prothesis. An anatomically contoured mesh 3D-Max (3DMAX Mesh/Bard-Davol, France) using no fixation would prevent these problems. The objective of this study is to evaluate the effectiveness and safety of laparoscopic totally extraperitoneal (TEP) for inguinal hernia repair with nonfixation of three-dimensional mesh. Material and Methods: A retrospective analysis of patients, admitted for direct inguinal hernia and operated by laparoscopic TEP with nonfixation of 3-D mesh, performed between June 2010 and December 2018. Data were collected regarding general characteristics, complications, length of hospital stay and the recurrence rates. Results: 62 patients with 67 direct hernias underwent laparoscopic (TEP) to repair hernia with an average age of 54.7±13,1 years (range 41 – 81 years); peritoneal injury was noticed during dissection in 4.5%, there was no injury of the inferior epigastric vessels during dissection. Average operative time of unilateral hernia was 47.2±11.9 minutes (range 35 – 95 minutes). All patients in this series were followed, pain in 4.5% at 3 months after operation. There were no recurrences at 36 months postoperative follow up. Conclusion: The laparoscopic (TEP) repair of inguinal hernia is safe and effective. It is considered as the gold standard technique in treatment of direct hernia. Keyword: Inguinal hernia – Laparoscopic TEP, hernioplasty – laparoscopy.

scholarly journals A comparative study of totally extraperitoneal versus transabdominal preperitoneal repair of inguinal hernias

2017 ◽  
Vol 4 (4) ◽  
pp. 1244
Author(s):  
Sudarshan P. B. ◽  
Sundaravadanan B. S. ◽  
Prabu Shankar S.
Keyword(s):  
Inguinal Hernia ◽  
Retrospective Study ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Laparoscopic Repair ◽  
Laparoscopic Approach ◽  
Bilateral Hernia ◽  
Totally Extraperitoneal ◽  
Transabdominal Preperitoneal ◽  
Inguinal Hernias

Background: The two common procedures which are nowadays commonly performed for laparoscopic repair of inguinal hernia are transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) mesh repair. This retrospective study was aimed to compare these two, TAPP and TEP laparoscopic approaches for inguinal hernia repair in terms of various outcomes.Methods: In this retrospective study, we included 50 cases of inguinal hernia who underwent laparoscopic approach of inguinal hernia repair at Saveetha medical college and hospital between 2014 and 2016 for a duration of 3 years. Various parameters including the age, sex of patient, type of hernia, preoperative and post-operative complications, duration of hospital stay was analysed.Results: Of the 50 patients who underwent laparoscopic repair, 26 patients underwent TEP and 24 patients under went TAPP procedure. 31 cases were indirect inguinal hernias and 30 cases were direct inguinal hernias, totalling 61 hernia repairs, as 11 patients had bilateral hernia. One female inguinal hernia and 4 cases of recurrent hernia were operated by TAPP method. Postoperative complications like seroma formation; subcutaneous emphysema was seen in TEP group. Two cases of TEP were converted to TAPP and open lichenstein procedure. Postoperative pain was less in both the group. Patients who underwent TEP procedure spent less time in the hospital compared to those who underwent TAPP procedure.Conclusions: There is no major difference in the outcome after TEP and TAPP surgeries except for some minor complications and the results are comparable in both techniques TAPP and TEP. Both the procedures can be practiced according to surgeon’s familiarity of the procedure.

scholarly journals Feasibility of laparoscopic inguinal hernia repair (TEP) in rural centre in India

2017 ◽  
Vol 4 (7) ◽  
pp. 2336
Author(s):  
Prashant Sawarkar ◽  
Ranjana Zade ◽  
Suchine Dhamanaskar ◽  
Bhupendra Gathe ◽  
Pradip Sawardekar ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Return To Work ◽  
Inguinal Hernia Repair ◽  
Gold Standard ◽  
Lichtenstein Technique ◽  
Hernia Surgery ◽  
Tep Repair ◽  
The Mean ◽  
Laparoscopic Tep

Background: Inguinal hernia repair is one of the most frequently performed operations in general surgery worldwide. Routinely used gold standard Lichtenstein technique gives a long scar and more post-operative pain. TEP has demonstrated favourable short-term results, with regards to reduced postoperative stay, pain and earlier return to physical activity in comparison with open mesh repairs.Methods: This study was prospective observational study in which 75 patients were included for TEP repair and followed for the outcome measured as the time taken for operation, incidence of intra operative and post-operative complications, severity of pain at post-operative day 1, 1 week, 1 month and 6 months after operation, return to work and cost effectiveness of inguinal hernia repair.Results: We have enrolled the 75 patients from 16 to 80 years out of which 34 (45.3%) patients were from age group 50 to 70 years.  47 (62.7%) patients operated on right side and 58 (77.4%) were operated for indirect hernia. Mean time taken for TEP was 81.5 minutes with minimum of 45 minutes and maximum of 135 minutes. There was single most complications of Pneumoperitoneum in 24 (32.0%) which was benign and managed conservatively. Other complications include bleeding in 4 (5.3%) and vas injury in one (1.3%). the mean duration of time taken for return to work was 11 days. The mean cost of TEP was Rs. 5932 with minimum of Rs. 4327 and maximum of Rs. 7742.Conclusions: The laparoscopic (TEP) repair is well established surgery for primary hernia repair and the other open tension free Lichtenstein technique is still regarded as a gold standard for inguinal hernia repair. The laparoscopic hernia surgery attempting similar claims underwent controversies with conflicting results. Laparoscopic (TEP) inguinal hernia repair gives greater patient’s satisfaction and better cosmetic results than open (Lichtenstein) repair.

Outcome of tension free open mesh repair of inguinal hernia

2020 ◽  
Vol 22 (1) ◽  
pp. 21-24
Author(s):  
Mohammad Masum ◽  
Md Aminul Islam ◽  
Masflque Ahmed Bhuiyan ◽  
Kazi Mazharul Lslam ◽  
Md Selim Morshed ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Repair ◽  
Groin Hernia ◽  
Synthetic Mesh ◽  
Indirect Inguinal Hernia ◽  
Prolene Mesh ◽  
Tension Free ◽  
Open Mesh Repair

Background: In the practice of General Surgery, hernia repair is the second most common procedure after appendectomy. Several methods have been developed over the years to try to improve hernia repair. Good result can be expected using Bassini's, McVay's, Shouldice's techniques provided the exact nature of hernia is recognized and the repair is done without tension using healthy tissue. The introduction of synthetic mesh started a new era in hernia surgery. The use of synthetic mesh repair of primary and recurrent hernias has gradually gained acceptance among surgeons. Objective: To find out the outcome and complications of open inguinal hernia repair with prolene mesh. Methods: This is a prospective cross sectional study conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from December, 2011 to May, 2012. One hundred patients of inguinal hernia admitted in different surgical units of BSMMU, Dhaka for elective surgery were studied. We have given 1 gm ijv Cephradine per operatively and then 500 gm cephradine ijv 6 hourly for 24 hours followed by oral form of Cephradine for next 5 days. Polypropylene mesh of 11 cm x 7 cm size was used in all cases. All the operations were done by open tension free prolene mesh repair technique. Patients were followed for one year to see the outcome. Results: Out of 100 cases of inguinal hernia, 71 patients (71%) had indirect inguinal hernia and 29 cases (29%) had direct inguinal hernia; 90 cases (90%) were primary hernia and only 10 cases (10%) were recurrent hernia; 58 cases were right sided, 34 cases (34%) were left sided and 8 cases (8%) were bilateral. Complications of mesh repair of groin hernia in this study included wound infection (5%), scrotal oedema (2%), mesh infection (0%), scrotal hematoma (2%), echymoces of peri-incisional skin (5%), early wound and groin pain (7%), chronic inguinodynia (2%), hernia recurrence (1%). Conclusion: In the present study an attempt is made to evaluate the outcome of patients undergoing inguinal hernia repair by prolene mesh. The results confirm that Lichtenstein tension free mesh repair of inguinal hernia is safe and reliable for both primary and recurrent groin hernia, with less recurrence rate. Patient's compliance was good with minimum morbidity. Journal of Surgical Sciences (2018) Vol. 22 (1): 21-24

scholarly journals Transcutaneous Electrical Acupoint Stimulation Reduces Postoperative Analgesic Requirement in Patients Undergoing Inguinal Hernia Repair: A Randomized, Placebo-Controlled Study

2021 ◽  
Vol 10 (1) ◽  
pp. 146
Author(s):  
Mateusz Szmit ◽  
Siddarth Agrawal ◽  
Waldemar Goździk ◽  
Andrzej Kübler ◽  
Anil Agrawal ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Inguinal Hernia ◽  
Side Effects ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Adverse Drug Events ◽  
Controlled Trial ◽  
Controlled Study ◽  
Anesthetic Technique ◽  
Analgesic Requirement

Given the rising rate of opioid-related adverse drug events during postsurgical pain management, a nonpharmacologic therapy that could decrease analgesic medication requirements would be of immense value. We designed a prospective, placebo-and-randomized controlled trial to assess the clinical effect of transcutaneous acupoint electrical stimulation (TEAS) on the postoperative patient-controlled analgesia (PCA) requirement for morphine, as well as side effects and recovery profile after inguinal hernia repair. Seventy-one subjects undergoing inguinal hernia repair with a standardized anesthetic technique were randomly assigned to one of three analgesic treatment regimens: PCA + TEAS (n = 24); PCA + sham-TEAS (no electrical stimulation) (n = 24), and PCA only (n = 23). The postoperative PCA requirement, pain scores, opioid-related side effects, and blood cortisol levels were recorded. TEAS treatment resulted in a twofold decrease in the analgesic requirement and decreased pain level reported by the patients. In addition, a significant reduction of cortisol level was reported in the TEAS group at 24 h postoperatively compared to the sham and control groups. We conclude that TEAS is a safe and effective option for reducing analgesic consumption and postoperative pain following inguinal hernia repair.

Sign in / Sign up

Export Citation Format

Share Document