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

Comparision of PIRS technique and open surgery in pediatric inguinal hernia

2020 ◽  
Author(s):  
Ergun Ergün ◽  
Ufuk Ateş ◽  
Kutay Bahadır ◽  
Fırat Serttürk ◽  
Bahtiyar Mehdi ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Open Surgery ◽  
Contralateral Side ◽  
Laparoscopic Inguinal Hernia Repair ◽  
High Ligation ◽  
Laparoscopic Inguinal Hernia ◽  
Inguinal Hernia Surgery ◽  
The Mean

Objective: Laparoscopic inguinal hernia surgery has recently been a preferred surgical approach among pediatric surgeons. The aim of this study is to compare open and laparoscopic inguinal hernia repair techniques in terms of complications and recurrences in children. Method: Patients whose inguinal hernias were operated with laparoscopic percutaneous internal ring suturing technique and open high ligation technique were included in the study. Dermographic data, surgical details and postoperative complications of the patients were reviewed retrospectively. Results: A total of 246 patients were included in the study. Among them 113 patients underwent laparoscopic inguinal hernia repair and 133 patients open inguinal hernia repair. The mean age of patients in the laparoscopic group was 27.7 months (1-192 months) and the mean age of patients in the open surgery group was 27.5 months (1-156 months). Diagnostic laparoscopy was performed in 104 patients who underwent open surgery, and the contralateral inguinal hernia repair was performed in 33 of the patients after hernia was detected on the contralateral side. Recurrence was observed in 2.6% (n=3) of the patients who underwent laparoscopic surgery and 3.7%(n=5) of the patients undergoing open surgery. In 2 of the patients who underwent laparos- copic surgery had hematomas that resolved without intervention and 1 had hydrocele. On the other hand 4 of the patients who underwent open surgery had iatrogenic undescended testis and 1 had hydrocele. The follow-up periods of the patients who underwent laparoscopic or open surgery were 13.2, and 74 months, respectively. Conclusion: Laparoscopic inguinal hernia repair has results comparable to open repair in terms of recurrence and complications. The advantage of the laparoscopic method can be considered as the ability to evaluate the contralateral side in all cases without increase in the risk of recur- rence and complications, and the ability to operate without scarring , but with good cosmetic results.

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.

Assessment of Intra-Operative Difficulties and Early Post-Operative Complications in Laparoscopic Inguinal Hernia Repair using Conventional Polypropylene Mesh Versus 3D Mesh

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hazem AbdelSalam Mohamed ◽  
Karim Fahmy ◽  
Mohammad Ahmad Abd-erRazik ◽  
Shaimaa Atef Ismaeil Awwad Elkomy
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Three Dimensional ◽  
Laparoscopic Inguinal Hernia Repair ◽  
Fixation Time ◽  
3D Mesh ◽  
Laparoscopic Inguinal Hernia ◽  
Operative Complications

Abstract Background The fundamental mechanism of abdominal wall hernia formation is the loss of structural integrity at the musculotendinous layer. The exact cause of inguinal hernia is still unknown but the factors contributing in its occurrence include; preformed congenital sac, chronic passive rise in the intra-abdominal pressure and weak abdominal wall. Aim of the Work To assess intra-operative difficulties of laparoscopic inguinal hernia repair using two different meshes: The conventional polyproline mesh and the three-dimensional (3D) mesh, as regard the operative time. And early post-operative complications including post-operative seroma, early postoperative pain, chronic pain and limitation of function. Patients and Methods In our study 30 patients were recruited according to our preset inclusion and exclusion criteria. They were divided randomly into two groups, a group in which the 3D mesh was used and a group in which the polypropylene mesh was used. The study was conducted in Ain Shams University hospitals for 6 months, in which patients where followed up from 3 to 6 months and compared in terms of intraoperative time, post-operative pain after one week, restriction of physical activity, seroma formation and presence of chronic pain. Results In our study the mean application time (minutes) in 3D group was found to be 7.07 ± 2.66 while in PP group it was found to be 12.53±3.66 with highly statistically significant difference between them at p < 0.001. We believe that this difference in fixation time in our present study is attributed to easy insertion through the port, easy intraoperative handling, and easy unfolding of 3D mesh. Conclusion The use of three-dimensional mesh (3D mesh) for laparoscopic inguinal hernia repair is a safe and viable option. It offers many advantages in terms of less fixation time, shorter hospital stays, early recovery with a better movement limitation score. Whereas chronic pain was found to be similar in both groups. Further, elimination of tacks for fixation and shorter hospital stay may reduce the cost of 3D mesh. Longer-term studies are recommended with a larger sample size and follow up duration for better assessment of chronic pain, also for following up on recurrence.

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