Phẫu thuật nội soi TAPP điều trị thoát vị bẹn

2021 ◽  
Author(s):  
Thanh Xuan Nguyen
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Complications ◽  
Prospective Study ◽  
Hospital Stay ◽  
Operative Time ◽  
Postoperative Hospital Stay ◽  
Tapp Repair ◽  
The Mean ◽  
A Prospective Study

TÓM TẮT Đặt vấn đề: Thoát vị bẹn là một bệnh lý ngoại khoa thường gặp và có nhiều tác giả đưa ra nhiều kỹ thuật mổ khác nhau. Phẫu thuật xuyên phúc mạc tiếp cận khoang trước phúc mạc (TAPP) với nhiều ưu điểm như tiếp cận phẫu trường nội soi rộng rãi, các mốc giải phẫu rõ ràng, có thể quan sát, đánh giá và xử trí tạng thoát vị khá dễ dàng, có thể phát hiện thoát vị bẹn đối diện và xử trí những bệnh lý kèm theo trong ổ phúc mạc. Phương pháp: Nghiên cứu mô tả có theo dõi 125 bệnh nhân được chẩn đoán thoát vị bẹn tại Bệnh viện Trung Ương Huế và Bệnh viện trường Đại học Y - Dược Huế từ tháng 6/2016 đến tháng 3/2019. Kết quả: Tuổi trung bình 56,25 ± 19,06. Nam chiếm 97,6%. Thoát vị bẹn có triệu chứng 76,8%, có biến chứng 23,2%. Thoát vị bẹn 1 bên 92%, 2 bên 8%. Thoát vị bẹn ẩn đối bên phát hiện trong mổ 2,4%. TAPP 1 bên 92,8%, TAPP 2 bên 7,2%, TAPP kèm phẫu thuật khác 2,4%. Thời gian mổ trung bình 1 bên là 48,62 ± 13,05 phút, 2 bên là 66,11 ± 12,19 phút. Không có tai biến trong mổ. VAS sau mổ 24 giờ: 3,53 ± 0,56. Tụ dịch vùng bẹn sau mổ 11,2%. Thời gian nằm viện sau mổ 4,41 ± 1,25 ngày. Kết luận: Phẫu thuật TAPP là một phẫu thuật an toàn, có thể thực hiện được. Phẫu thuật TAPP có thể phát hiện và xử trí những tổn thương trong ổ phúc mạc cũng như các bệnh lý đi kèm. ABSTRACT LAPAROSCOPIC TRANS - ABDOMINAL PRE - PERITONEAL (TAPP) REPAIR FOR TREATMENT INGUINAL HERNIA DISEASE Background: Inguinal hernia is one of the commonest surgical diseases and there are many different techniques applied. The laparoscopic trans - abdominal pre - peritoneal (TAPP) repair allows a better view of the inguinal anatomy, evaluation of opposite side and resolve combined peritoneal diseases as well. Methods: A prospective study was carried in 125 cases with inguinal hernia that have been treated by laparoscopic trans - abdominal pre-peritoneal (TAPP) repair. Results: The mean age was 56.25 ± 19.06 years old. 96.7% were male. 76,8% of hernia were symptomatic, and 23.3% were complicated. 92% of hernia were unilateral, 8% were bilateral, 2.4% were occult. 92.8% would perfom an unilateral TAPP repair, 7.2% bilateral TAPP repair, 2.4% simultaneous TAPP and cholecystectomy. The mean operative time was 48.62 ± 13.05 minutes for unilateral TAPP, 66.11 ± 12.19 minutes for bilateral TAPP. The mean VAS 24h post - op was 3.53 ± 0.56. Regarding postoperative complications, inguinal seroma was detected in 11,2% of cases. The mean postoperative hospital stay was 4.41 ± 1.25 days. Conclusion: TAPP is a safe and feasible procedure, allows evaluation of opposite side and resolve combined peritoneal diseases. Keywords: Inguinal hernia, laparoscopic, trans - abdominal pre - peritoneal (tapp)

scholarly journals A Single Surgeon’s Experience of Total Extra Peritoneal Repair Vs Transabdominal Preperitoneal Repair- A Prospective Cohort Study

2021 ◽  
Author(s):  
Tharun Ganapathy Chitrambalam ◽  
Koshy Mathew Panicker ◽  
Jeyakumar Sundaraj ◽  
Sidhu Rajasekhar ◽  
Pradeep Joshua Christopher
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Pain Score ◽  
Operative Time ◽  
P Value ◽  
Tep Repair ◽  
Duration Of Hospital Stay ◽  
Tapp Repair ◽  
The Mean

Introduction: Hernia surgery has evolved over a period of 2500 years from the Bassini-Shouldice era to conventional Lichenstein’s meshplasty to the laparoscopic era. Since, inception of the laparoscopic approach 25 years ago, there were several advancements in the techniques of inguinal hernia repairs. The two most commonly practiced laparoscopic approaches are the Total Extra Peritoneal (TEP) and Transabdominal Preperitoneal (TAPP) repair. Aim: To compare the outcomes for TEP and TAPP approaches in laparoscopic inguinal hernia surgery in terms of operative time consumed, postoperative pain, duration of hospital stay, complications and recurrence rate when performed by a single surgeon. Materials and Methods: A prospective interventional cohort study was carried out among 70 patients with uncomplicated inguinal hernia. Patients were divided equally into two groups of 35 patients and underwent TAPP and TEP repairs depending on group randomisation. All surgeries were performed by the same surgeon. Factors including operative time, postoperative pain, duration of hospital stay, complications and recurrence were documented and compared for both the groups. The statistical analysis was done using Statistical Package for the Social Sciences (SPSS) software version 21. Unpaired t-test was used to compare the mean between the two groups. The p-value of <0.05 was considered to be statistically significant. Results: The mean operative time measured in minutes for TEP repair was 31.03 minutes and TAPP repair was 42.26 showing a difference of 11.23 minutes which was statistically significant (p-0.001). The mean Standard Deviation (SD) pain score at 24 hours for TEP repair was 2.43 (1.195) and TAPP repair was 3.43 (0.917). The mean (SD) pain score at 48 hours for TEP repair was 1.31 (1.051) and TAPP repair was 2.20 (0.901). The mean (SD) pain score at one week for TEP repair was 0.37 (0.690) and TAPP repair was 0.91 (0.781). The mean (SD) duration of hospital stay in TEP repair was 2.60 days (0.553) when compared to 3.49 days (0.658) in TAPP repair. All the results were statistically significant with a p-value of 0.001. Conclusion: TEP repair had superior outcomes in terms of reduction in operative time, less postoperative pain and shorter hospital stay than TAPP repair.

LAPAROSCOPIC TRANS-ABDOMINAL PRE-PERITONEAL (TAPP) REPAIR FOR TREATMENT INGUINAL HERNIA DISEASE

2018 ◽  
Vol 8 (4) ◽  
pp. 76-80
Author(s):  
Thao Nguyen Minh ◽  
Vu Pham Anh ◽  
Tri Nguyen Huu ◽  
Phu Nguyen Doan Van ◽  
Phuc Nguyen Thanh ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Operative Time ◽  
Bilateral Hernia ◽  
Repair Method ◽  
Tapp Repair ◽  
Post Operation ◽  
Average Operative Time ◽  
The Mean

Background: Inguinal hernia is one of the commonest surgical diseases and there are many different techniques applied. The laparoscopic trans-abdominal pre-peritoneal (TAPP) repair allows a better view of the inguinal anatomy, evaluation of opposite side and resolve combined peritoneal diseases as well. Patient and method: The study included 60 cases with inguinal hernia that have been treated by laparoscopic transabdominal pre-peritoneal (TAPP) repair. Method: Description, prospective follow-up. Result: The mean age was 58±18.2. 96.7% were males. The average operative time was 45.6±15.1 minutes for one side hernia, 73±25.2 minutes for bilateral hernia. 02 cases have been post-operation inguinal seroma complication (3.3%), 02 cases with hydrocele (3.3%), 01 case with abdominal seroma (1.7%). 04 cases (6.7%) opposite inguinal hernia were detected and 05 cases (8.3%) with combined diseases were resolved. Duration of post-operative stay was 3.9±1.1 days. Conclusion: TAPP is a safe and feasible procedure, allows evaluation of opposite side and resolve combined peritoneal diseases.

scholarly journals Robotically Assisted Hysterectomy versus Vaginal Hysterectomy for Benign Disease: A Prospective Study

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
M. Carbonnel ◽  
H. Abbou ◽  
H. T. N’Guyen ◽  
S. Roy ◽  
G. Hamdi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Prospective Study ◽  
Hospital Stay ◽  
Vaginal Hysterectomy ◽  
Operative Time ◽  
Group Versus ◽  
Length Of Hospital Stay ◽  
Benign Disease ◽  
Post Surgery ◽  
A Prospective Study

Objectives. A prospective study was carried out to compare vaginal hysterectomy (VH) and robotically assisted hysterectomy (RH) for benign gynecological disease.Materials and Methods. All patients who underwent hysterectomy from March 2010 to March 2012 for a benign disease were included. Patients’ demographics per and post surgery results were collected from medical files. A questionnaire was also conducted 2 months after surgery.Results. Sixty patients were included in the RH group and thirty four in the VH one. Operative time was significantly longer in the RH group ( versus  min; ). Blood loss and length of hospital stay were significantly reduced: versus  ml; , and versus days; , respectively. Less pain was reported at D1 and D2 by RH patients, and levels of analgesia were lower compared to those observed in the VH group. No differences were found regarding the rate of conversion to laparotomy, intra- or postoperative complications.Conclusion. Robotically assisted hysterectomy appears to reduce blood loss, postoperative pain, and length of hospital stay, but it is associated with longer operative time and higher cost. Specific indications for RH remain to be defined.

scholarly journals Modification of the Classical Percutaneous Extraperitoneal Procedure for Pediatric Inguinal Hernia to Reduce Complications: A Multiple-Centered Comparison Study

2021 ◽  
Author(s):  
Zhi-bin Luo ◽  
Jing-rong Tu ◽  
Hong-guang Shi ◽  
Zhi-yong Du ◽  
Xian-cai Xiang ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Adverse Events ◽  
Hospital Stay ◽  
Operative Time ◽  
Foreign Body Reaction ◽  
Postoperative Hospital Stay ◽  
Comparison Study ◽  
Pediatric Inguinal Hernia ◽  
Significant Difference ◽  
Safe Approach

Abstract Single-site laparoscopic percutaneous extraperitoneal ligation (SLPEL) for pediatric inguinal hernia gained popularity all over the world. However, complications associated with extraperitoneal knotting were not rare in the classical SLPEL(C-SLPEL) procedure. In order to overcome disadvantages, we herein developed the modified SLPEL (M-SLPEL) procedure, intact circuit ligation of the peritoneum around the internal ring using a homemade hernia needle with a single abdominal wall centesis. To evaluated the effectiveness of the M-SLPEL procedure to decrease adverse events associated with ligation knotting, a comparative study was carried out. A total of 3219 patients from multiple centers were divided into two groups according to the operative procedures: M-SLPEL group and C-SLPEL group. All patients were followed up. Data describing the clinical characteristics, operative time, postoperative hospital stay, and complications was collected and retrospectively analyzed. With equivalent operative time, postoperative hospital stay, there was statistically significant difference between two groups in terms of the overall complications incidence (2.6% in C-SLPEL Vs 0.11% in M-SLPEL, P=0.03), including pain in inguinal area, knot foreign body reaction, palpable knot, recurrence. Together, these findings suggest that the M-SLPEL procedure is an effective and safe approach, with unique advantage in reducing adverse events in the inguinal region.

scholarly journals Flexible Ureteroscopic Lithotripsy Based on the Concept of Enhanced Recovery After Surgery

2021 ◽  
Author(s):  
Ling Shu ◽  
Ping Ao ◽  
Zhenxing Zhang ◽  
Dong Zhuo ◽  
Changbin Dong ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Operative Time ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Postoperative Hospital Stay ◽  
Control Group ◽  
Ureteroscopic Lithotripsy ◽  
Total Cost ◽  
Stone Removal

Abstract Background: To evaluate the efficacy of flexible ureteroscopic lithotripsy (FURSL) based on the concept of enhanced recovery after surgery (ERAS).Methods: 435 patients with upper urinary calculi between 2017-2020 were retrospectively analysed and assigned to ERAS group (ERAS management) and control group (traditional management). Operative time, postoperative ambulation time, postoperative hospital stay, total cost of hospitalization, postoperative complications and stone removal were compared. Results: 427 cases were successfully performed FURSL procedure with 4 cases of ERAS group (n = 216) and 4 cases of control group (n = 219) failed respectively. No postoperative complications occurred in either group except for fever and hematuria. There were no significant difference in postoperative fever and stone removal between the two groups (all p > 0.05). The patients in ERAS group had shorter operative time, shorter postoperative ambulation time, less postoperative severe hematuria, shorter postoperative hospital stay and lower total cost of hospitalization than those in control group (all p < 0.05).Conclusions: FURSL based on the concept of ERAS for the treatment of upper urinary tract calculi is safe and reliable, with rapid postoperative recovery, low cost of hospitalization and worthy of clinical promotion.

scholarly journals Tension free, mesh free inguinal hernia repair: a prospective study of Desarda’s technique

2020 ◽  
Vol 7 (4) ◽  
pp. 1116
Author(s):  
Hosni Mubarak Khan ◽  
B. S. Ramesh ◽  
Viraja Bobburi
Keyword(s):  
Prospective Study ◽  
Hospital Stay ◽  
Operating Time ◽  
Oblique Muscle ◽  
Medical College ◽  
Inguinal Hernias ◽  
Absorbable Sutures ◽  
Mesh Free ◽  
The Mean ◽  
A Prospective Study

Background: The Desarda repair for inguinal hernias is a new tissue-based technique. Application of the external oblique muscle aponeurosis in the form of un-detached strip has been established as a new concept in tissue-based hernia repair.Methods: A prospective study was conducted among 126 cases with 148 inguinal hernias repaired by Desarda’s technique for a period of 3 years in Dr. B. R. Ambedkar Medical College and Hospital, Bangalore, Karnataka, India. The details pertaining to duration of hospital stay, pain, ambulation and complications were recorded.Results: The mean age of the patients was 38.4 years. Mean operating time was 62.5 min for unilateral and 123 min for bilateral hernias. About 97.8% patients were ambulatory within 6.42 hours and were freely mobile within 19.26 hours after surgery. About 96.4% patients returned to work within 6-14 days. About 91.26% patients were discharged on same day. The mean hospital stay duration of the patients was 1.11 days. Postoperative pain on movement out of bed was described as mild and tolerable in 92.6% patients on day 1. Two patients had seroma that subsided on its own. There were no long-term complications, recurrence of the hernias or chronic groin pain.Conclusions: The results of this new technique (Desarda repair) using continuous absorbable sutures appear promising. The continuous suturing saves time and just one packet of suture material without mesh saves cost.

scholarly journals Single incision laparoscopic appendicectomy versus conventional laparoscopic appendicectomy- a prospective study

2017 ◽  
Vol 4 (5) ◽  
pp. 1588
Author(s):  
Rohit Kumar ◽  
Rajan Vaithianathan ◽  
Vinoth Sundaresan
Keyword(s):  
Prospective Study ◽  
Hospital Stay ◽  
Operative Time ◽  
Single Incision ◽  
Laparoscopic Appendicectomy ◽  
Conventional Laparoscopic ◽  
Pain Duration ◽  
Prospective Comparative Study ◽  
Almost All ◽  
A Prospective Study

Background: The advent of Single incision laparoscopic appendicectomy (SILA) has encouraged surgeons to compare its benefits over conventional laparoscopic appendicectomy (CLA). We conducted a prospective study comparing SILA with CLA, evaluating parameters like operative time and complications, post-operative pain, duration of stay and the cosmetic outcome.Methods: A prospective, comparative study of 94 consecutive patients was conducted at our institution between December 2014 and May 2016. The data regarding the various parameters were documented in both groups of patients.Results: Among the 94 patients, 30 underwent SILA and 64 underwent CLA. We found statistically significant outcomes for SILA over CLA in variables such as operative time (p=0.0018), duration of hospital stay (p≤0.0001) and cosmetic outcome (p≤0.0001). Almost all patients in the SILA category showed no evidence of a scar after a three month follow up.Conclusions: SILA was found to have a better outcome than CLA with regard to operative time, hospital stay and cosmesis. We conclude that this technique of SILA can be a better alternative to CLA.

scholarly journals Comparison of early postoperative outcome of laparoscopic and open inguinal hernia mesh repair

2018 ◽  
Vol 5 (8) ◽  
pp. 2732
Author(s):  
Pulkit Garg ◽  
Sreekar Agumbe Pai ◽  
Hosamath Vijaykumar
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hospital Stay ◽  
Postoperative Outcome ◽  
Hernia Mesh ◽  
Laparoscopic Hernioplasty ◽  
The Mean ◽  
The Difference ◽  
A Prospective Study ◽  
Early Postoperative Outcome

Background: Laparoscopic hernia has all the benefits of a tension free repair. The aim of this study was to compare the early postoperative outcome of laparoscopic and open inguinal hernia mesh repair.Methods: This is a prospective study conducted at Ramaiah hospital Bangalore from June 2016 to July 2017. 70 cases of inguinal were included in the study hernia diagnosed clinically and radiologically who fulfilled the inclusion & the exclusion criteria. The principal operative techniques were laparoscopic hernioplasty (LH) and open inguinal mesh hernioplasty (OH).Results: 35 patients each were allotted to two group (LH and OH). The mean age was 50.53. LH group had significantly less postoperative pain than the OH group on 12, 24 and 72 hrs (P <0.05). Although the vas pain scores of LH group were also comparatively lower on postoperative day 14, these differences were not statistically significant. Than mean operative time was significantly higher for LH group (131.86 vs 80.29 min) although in bilateral cases the difference was considerably less but was still significant (138 vs 107 min). The mean hospital stay after surgery was less for LH group (2.68 vs 3.25 days) but was not statistically significant. (p = 0.073). Chronic pain persisted for 2 patients (5.7%) in OH group whereas none had chronic pain in LH group.Conclusions: Laparoscopic hernioplasty is equivalent to open repair in the treatment of inguinal hernia, with less post-operative pain, lower risk of wound infection, shorter duration of hospital stay, and less incidence of chronic pain however requires a long learning curve and is more expensive.

scholarly journals Laparoscopic management of Hydatid cyst

2016 ◽  
Vol 18 (3) ◽  
pp. 42
Author(s):  
Anang Pangeni ◽  
Vikal Chandra Shakya
Keyword(s):  
Minimally Invasive ◽  
Prospective Study ◽  
Hydatid Cyst ◽  
Operative Time ◽  
Energy Sources ◽  
Hydatid Cysts ◽  
Laparoscopic Management ◽  
The Mean ◽  
A Prospective Study ◽  
Surgery Department

Introduction and Objective: Hydatid cyst of the liver is a fairly common parasitic condition. We present here a series of 9 patients with hydatid cyst of the liver managed by minimally invasive surgeryMaterials and Methods: It was a prospective study in patients presenting with hydatid cyst of the liver to Surgery Department who were managed laparoscopically from January 2013 to November 2015.Result: There were 9 patients (5 males and 4 females). The mean operative time was 124+32 minutes. One patient developed mild allergy in the form of skin rashes on 3rd postoperative day, and another patient developed cholangitis which resolved on conservative management. There was no conversion.Conclusion: Laparoscopic management of hydatid cysts is possible, and looks promising provided we have advanced energy sources.

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