scholarly journals Outcomes on mesh fixation vs non-fixation in laparoscopic totally extra peritoneal inguinal hernia repair: a comparative study

2021 ◽  
Vol 37 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Abu Kamal Nahid ◽  
Sanjida Rahman ◽  
Keerthanaa Veerapatherar ◽  
Roland Fernandes
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Comparative Study ◽  
Inguinal Hernia Repair ◽  
Mesh Fixation ◽  
Clinical Effects ◽  
Open Approach ◽  
Post Operative Pain ◽  
Group A ◽  
Group B

Objective: Inguinal hernia repair is one of the most common general surgical procedure, and laparoscopic approach gained popularity over the open approach. This study aimed to compare the clinical effects of TEP inguinal hernioplasty with or without mesh fixation. The primary outcome was acute post-operative pain. Material and Methods: A retrospective comparative study on a prospectively collected data was conducted in a large DGH in England between Janu- ary 2017 and December 2019 on 47 patients. The patients were divided into two groups. In group A, mesh fixation was performed with absorbable tackers and in group B no fixation was performed. Patients were followed up to 18 months postoperatively. Data was collected on post-operative pain, cost, recurrences and time taken to return to normal activities. Patients with lower midline scar and complicated inguinal hernias were excluded. Results: Out of the 47 patients 53% (n= 25) were in group A and 47% (n= 22) in group B. All the patients in both groups were male. The mean postopera- tive pain score at 72h in group A was 7.12 (SD 1.13) and 4.91 (SD 1.23) in group B (p< 0.001). Group B patients have taken shorter time to return to normal activities in comparison to group A (p< 0.001), while recurrence (2%) rate is higher in group B (p> 0.05). Conclusion: Pain and time taken to return to normal work postoperatively were significantly less in the non-fixation group. The study recommends non-fixation over fixation as it is feasible, cost-effective, causes less post-operative pain and no differences in terms of recurrences.

Comparative Study between the Use of Self-Fixating Mesh and Non Self-Fixating Mesh in Laprascopic Inguinal Hernia Repair Transabdominal Preperitoneal (TAPP) Technique

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
E F Ebied ◽  
A A Khalil ◽  
A I I Soliman
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Comparative Study ◽  
Inguinal Hernia Repair ◽  
Inguinal Hernioplasty ◽  
Vas Score ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background Hernia is a common problem of the modern world with an incidence ranging from 5%-7%. Of all groin hernias, around 75% are inguinal hernias. Recently with advancement in laparoscopy, endoscopic repairs seem to offer better quality of life, decreasing hospital stay and early return to work. Aim of the Work To compare between self fixating mesh and non self fixating mesh in laproscopic inguinal hernia repair transabdominal preperitoneal (TAPP) approach as regards intraoperative time, complications, postoperative pain, return to normal activity and incidence of recurrence. Patients and Methods This study was conducted on 30 adult patients presenting with inguinal hernias. They were divided into 2 equal groups of 15 patients each. The first group (A): includes fifteen patients and was operated upon by a Laparoscopic transabdominal pre-peritoneal inguinal hernioplasty technique using self -gripping (SGM group) (Parietex ProGrip] Laparoscopic (PPL) meshes), while the second group (B): includes fifteen patients and were operated upon by a Laparoscopic transabdominal pre-peritoneal inguinal hernioplasty technique with non-self fixating mesh. Results The postoperative pain assessment at 24 hours and 4 weeks shows that the mean VAS score for GROUP A was (3.70 ± 1.72) and for GROUP B (3.90 ± 1.25) while after 1 month duration follow up, the mean VAS score was (1.25 ± 0.79) for Group A and (1.20 ± 0.77) for Group B with no difference between the two groups confirming the atraumatic nature of the self gripping mesh. Conclusion After this comparative study, both mesh fixation with absorpable tacks and fixation using SGM approaches are similarly effective in terms of operative time, the incidence of recurrence, complications and chronic pain coinciding with all the available literature.

scholarly journals Prospective trial comparing open approach of Lichtenstein tension-free mesh with laparoscopic transabdominal preperitoneal approach for repair of inguinal hernia: tertiary center experience

2019 ◽  
Vol 6 (11) ◽  
pp. 3927
Author(s):  
Ahmed M. Helmy ◽  
Ahmed A. Aldardeer ◽  
Alaa A. Redwaan
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Open Approach ◽  
Tension Free ◽  
Postoperative Stay ◽  
Group A ◽  
Group B ◽  
Open Mesh

Background: The introduction of various open mesh and laparoscopic techniques has increased the interest in inguinal hernia surgery. But still controversy persists about the most effective inguinal hernia repair. The aim of this study was to compare the results of open Lichtenstein tension-free mesh technique and laparoscopic transabdominal preperitoneal (TAPP) repair for inguinal hernia.Methods: We considered 55 patients were enrolled between. Patients were divided into two groups, group A had open mesh repair and group B had laparoscopic TAPP repair of groin hernia. Time to full recovery and return to work, operative time, postoperative pain, hospital postoperative stay, complications and recurrence rate were recorded in both groups.Results: Significant difference was observed in the median time to return to normal activities in TAPP group versus in open approach. The mean hospital postoperative stay was 1-2 days in both groups. On follow up of our patients we found that in group A 3 patients had seroma, no haematoma discovered among our patients, 3 patients had wound infection, all previous complications were managed conservatively, in group B none of all 30 patients develop seroma, haematoma or infection. In group A 4 patients who were had bilateral hernia develop recurrence, while in group B we had no recurrence among the patients.Conclusions: Laparoscopic (TAPP) approach to inguinal hernia repair is considered safe and effective as excellent alternative to conventional surgery repair. It is associated with less postoperative pain, hospital postoperative stay, postoperative complications, and recurrence, earlier return to normal activities.

scholarly journals A prospective comparative study of Lichtenstein procedure with and without mesh-fixation for inguinal hernia repair

2021 ◽  
Vol 9 (2) ◽  
pp. 390
Author(s):  
Ravinder Kumar ◽  
Hilal A. Wani ◽  
Anshuman Mahesh ◽  
Irfan N. Mir
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Operative Time ◽  
Mesh Fixation ◽  
P Value ◽  
Recurrence Rates ◽  
Fixation Group ◽  
Post Operative Pain ◽  
Group A ◽  
Group B

Background: Repair of inguinal hernia is one of the most common elective operations performed in general surgery worldwide. Mesh-hernioplasty became the gold standard, because of its low recurrence rate in comparison with tissue repairs. The ideal repair must be simple, safe easy to perform and require minimal dissection which provides enough space, should be cost effective with less hospital stay, less pain and less recurrence. The present study aimed at comparing the effect of mesh fixation and non-fixation in Lichtenstein technique for inguinal hernia repair.Methods: Hundred (100) patients with primary uncomplicated, unilateral inguinal hernia were treated between April 2019 and September 2020. Patients with inguinal hernia underwent Lichtenstein repair with mesh-fixation (group A) (n=50) and non-fixation (group B) (n=50). The mean operative time, post-operative pain score, average hospital study, post-operative complications and recurrence rates were compared between the two groups.Results: Mean operative time in non-fixation group- (group B) (32.24 min) was shorter as compared to fixation group-(G1) (49.36 min) with a p value of 0.002. Post-operative pain score was lower in (group B) at 12 and 24 hours (3.71±1.409 and 2.2±0.8169) as compared to G1 at 12 and 24 hours (4.77±1.196 and 2.98±1.295) with a p value of <0.0001. The analgesia required in (group B) was less as compared to (group A). The post-operative complication and recurrence rates were almost identical in both the groups, with lesser incidence of groin pain and paresthesias in group B.Conclusions: In Lichtenstein inguinal hernia repair, non-fixation of mesh is safe and preferable option, with less operative time and less postoperative pain.

scholarly journals Minimal Accesss (TEP) versus Open Inguinal Hernioplasty: A Pragmatic Randomized Control Trial

2021 ◽  
Vol 7 (1) ◽  
pp. 75-78
Author(s):  
Ratna Rani Roy ◽  
Pankaj Kumar Saha ◽  
Md Abdulla Yusuf ◽  
Haridas Saha ◽  
Md Ibnul Hasan ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Laparoscopic Technique ◽  
Minimal Access ◽  
Post Operative Pain ◽  
Group A ◽  
Randomized Control ◽  
Group B ◽  
Duration Of Operation

Background: Inguinal hernia repair is the most frequently performed operation in general surgery. The standard method for inguinal hernia repair had changed little over a hundred years until the introduction of synthetic mesh. This mesh can be placed by either using an open approach or by using a minimal access laparoscopic technique. Objectives: The purpose of the present study was to compare minimal access laparoscopic mesh techniques with open techniques in hernioplasty. Methodology: This pragmatic randomized control trial was conducted in the Department of Surgery at Shaheed Suhrawardy Medical College & Hospital, Dhaka from January 2014 to December 2015 for a period of two years. Patients at any age with both sexes who were presented with inguinal hernia were selected as study population. These patients were divided into two group designated as group A and group B. In group A inguinal hernia repair was performed by laparoscopic technique and in group B open technique was used to repair the inguinal hernia. The comparison was done between open and laparoscopic technique of inguinal hernia repair in terms of duration of operation, per-operative complication, immediate post-operative pain, numbness, duration of hospital stay and time of return to normal activities. Follow up was done from 6 months to 2 years. Results: A total number of 200 patients were recruited for repairing of inguinal hernia. Duration of operation was longer initially in the laparoscopic groups (Laparoscopic approach 90 min vs. Lichtenstein approach 60 min). Post-operative pain was another important outcome to consider when choosing between laparoscopic and open repair of inguinal hernia. Laparoscopic repair had been associated with less post-operative pain than open repair. Operative complications were uncommon for both methods. Length of hospital stay was little shorter in laparoscopic group (laparoscopic 1-2 days vs. open technique 3-4 days); however, return to usual activity was earlier for laparoscopic groups (7 days) where open group: 20-30 days. The data available showed less persisting pain (Overall 8/80 versus 12/100) and less persisting numbness (Overall 3/80 versus 7/100) in the laparoscopic groups. Conclusions: In conclusion, minimal access laparoscopic mesh technique is better than open techniques in inguinal hernia repair. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 75-78

scholarly journals INGUINAL HERNIA REPAIR;

2014 ◽  
Vol 21 (06) ◽  
pp. 1144-1146
Author(s):  
Iftikhar Ahmed Bhatti
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Prosthetic Mesh ◽  
Indirect Inguinal Hernia ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Group A ◽  
Group B

Objective: To compare the results of Inguinal Hernia repair using commonly employed methods of Bassini’s and Mesh repair. Methodology: This study included 90 cases of hernia repair ranging over a period of 18 months from October 2008 to Mar 2010 at Social Security Hospital Lahore. All the cases were done by the consultants and senior surgeons. The methods of repair included Bassini’s and Hernioplasty with Prosthetic mesh. Results: Out of 90 patients, 88 were males (97.78%) and 02 were females (2.22%). Male – female ratio 45 : 1. The peak incidence was found in 3rd and 4th decades of life. 56(62.22%) had Rt.sided Inguinal hernia, 29 (32.22%) had Lt. sided and 5(5.56%) had bilateral Inguinal hernia. 72 patients (80%) had Indirect Inguinal hernia, 17 (18.89%) had direct inguinal hernia while 1(1.11%) had both types. All the cases were done under Spinal anaesthesia. The Bassini’s repair was performed in 50% cases, using non-absorble no. 1 Prolene interrupted suturing (Group- A). In the Group – B, 50% cases underwent Hernioplasty with prosthetic prolene mesh 6x11 cms. Post-operative follow up was done for a period of 01 year. In the group- A, 3 (6.67%) patients had recurrence and 3 (6.67%) had infection of the wound. In group – B, 01 patient (2.22%) got infected and none of the cases did not get recurrence over a period of 01 year. Conclusions: Hernioplasty with prosthetic mesh is a better treatment modality for inguinal hernia repair to get a low recurrence rate.

scholarly journals A comparative study of mesh fixation with polypropylene sutures (prolene) versus polyglactin sutures (vicryl) sutures in assessing inguinodynia in open inguinal hernia repair

2021 ◽  
Vol 8 (3) ◽  
pp. 904
Author(s):  
Ramesh S. Koujalagi ◽  
Vinod Karagi ◽  
Abhijit S. Gogate ◽  
Nikhil M.
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Groin Pain ◽  
Mesh Fixation ◽  
Chronic Groin Pain ◽  
Post Operative Pain ◽  
Severity Scores ◽  
Group A ◽  
Polypropylene Sutures

Background: Inguinal hernia, the most frequently occurring type of hernia globally, Chronic groin pain could be related to nerve mangling while operating. Mesh repair can lead to an inflammatory reaction over a period of time, though it still needs ground work to find out exact cause of pain. So this study aims to compare the effectiveness of polyglactin versus prolene sutures in reducing the post-operative pain in inguinal hernia repair.Methods: A one year hospital prospective study in KLE hospital. A total of 60 adult patients were divided into two groups of 30 each. Mesh fixation with polyglactin sutures was group A (30) and mesh fixation with polypropylene sutures was group B (30) and then post-operative pain, was assessed. Follow-up was for 3 months. Collected data was analyzed using chi–square tests, Mann-Whitney U tests.Results: Our analysis showed that the incidence of postoperative groin pain with mean severity scores of 1.37±0.49 versus 1.43±0.50; 1.40±0.50 versus 1.57±0.73; 1.03±0.61 versus 1.50±0.057; 0.77±0.63 versus 1.30±0.79; at post-operative day 1, 3 in both groups were similar and statistically not significant whereas the 1 week and 3 months follow up in group A and B respectively, were significant (p<0.05).Conclusions: The post-op chronic groin pain is significantly low, hence routine usage of polyglactin sutures to fix a mesh is a safe and effective alternative to polypropylene sutures in Lichtenstein hernia repair.

scholarly journals Comparison of local versus spinal anesthesia in long standing open inguinal hernia repair

2017 ◽  
Vol 4 (11) ◽  
pp. 3701 ◽  
Author(s):  
Anubhav Goel ◽  
Ankur Bansal ◽  
Akash Singh
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Spinal Anesthesia ◽  
Inguinal Hernia Repair ◽  
Local Anesthesia ◽  
Mesh Repair ◽  
Hernia Mesh ◽  
Group A ◽  
Group B ◽  
Hernia Mesh Repair

Background: Hernias are among the oldest known afflictions of human kind and elective inguinal hernia repair is commonly performed operation in general surgery. General or spinal anesthesia are still the most common types of anesthesia being used in India. Studies comparing the recovery profiles of local, general and regional anesthesia show that local anesthesia is ideal for day care surgery.Methods: This study had included 60 cases of male single sided reducible indirect long standing (more than 5 years) inguinal hernia. Patients were divided randomly into two groups of 30 each named Group A and Group B. Patients in group A were subjected to inguinal hernia mesh repair under local anesthesia and patients in group B were subjected to inguinal hernia mesh repair under spinal anesthesia. Tension free Lichtenstein hernioplasty was done in both groups.Results: Time taken in local anesthesia is higher than spinal anesthesia. Intraoperative pain is higher in local anesthesia than spinal anesthesia. There is no difference on post-operative pain. Post-operative complications are more in spinal anesthesia group.Conclusions: Patient selection is very important and patient with long history should be avoided under local anesthesia.

Mesh Fixation in Inguinal Hernia Repair: A Comparative Study

2019 ◽  
Vol 229 (4) ◽  
pp. S102
Author(s):  
Shahed Tish ◽  
Raha AlMarzooqi ◽  
Breanna Perlmutter ◽  
Aldo Fafaj ◽  
Luciano Guilherme Tastaldi ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Comparative Study ◽  
Inguinal Hernia Repair ◽  
Mesh Fixation

scholarly journals The Stoppa procedure in inguinal hernia repair: to drain or not to drain

2003 ◽  
Vol 58 (2) ◽  
pp. 97-102 ◽  
Author(s):  
Aldo Junqueira Rodrigues Jr. ◽  
Hwan Yoo Jin ◽  
Edivaldo Massazo Utiyama ◽  
Consuelo Junqueira Rodrigues
Keyword(s):  
Computed Tomography ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Fluid Collection ◽  
Preperitoneal Space ◽  
Computed Tomography Scan ◽  
Group A ◽  
Group B ◽  
Tomography Scan

OBJECTIVE: The objective of this study is to evaluate the benefits of drainage in the Stoppa procedure for inguinal repair. PATIENTS AND METHODS: The use of a suction drain was randomized at the end of the surgical intervention in 26 male patients undergoing inguinal hernia repair, divided into 2 groups: Group A, 12 patients undergoing drainage, and group B, 14 patients not undergoing drainage. On the second postoperative day, all patients underwent abdominal pelvic computed tomography scan examination to detect the presence of abdominal fluid collection. RESULTS: In group A, no patient developed fluid collection in the preperitoneal space, and 1 patient presented with an abscess in the preperitoneal space on the 15th postoperative day. In group B, 12 patients presented with fluid collections in the preperitoneal space on computed tomography scan evaluation. However, only 3 patients presented minor complications. None of the patients developed a major complication. CONCLUSION: The use of suction drainage with the Stoppa procedure does not provide any benefit.

scholarly journals INGUINAL HERNIOPLASTY

2009 ◽  
Vol 16 (04) ◽  
pp. 475-480
Author(s):  
MUHAMMAD SUHAIL AMER ◽  
MUHAMMAD ASHRAF
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Sampling Technique ◽  
Clinical Problem ◽  
Preoperative Pain ◽  
Group A ◽  
The Difference ◽  
Group B

Introduction: Chronic pain following inguinal hernia repair is becoming a significant clinical problem, involving increased numberof patients and surgeons. Much controversy exists regarding treatment. Elective division of the nerves has been proposed to reduce the riskof chronic post operative pain. O b j e c t i v e s : To evaluate the effectiveness of elective neurectomy during open hernia mesh repair, in reducingpostoperativ pain. Materials a n d m e t h o d s : Settings: All patients admitted in SUN department of surgery, Allied Hospital Faisalabad wereincluded in study. Study was started after the approval of synopsis on with inguinal hernia 2n d Feb, 2007 to Aug, 2007.100 patients of inguinalhernias were divided into 2 groups, 50 in each group i.e. group A & group B. The last patient was registered in the first week of July,convenience nonprobability sampling was used for location of patients in two groups. Results: On day one the pain was assessed in the twogroups i.e. Group A and group B (convenience non probability sampling technique used for patient grouping).It was found to be absent in 24/50(48 %) and 18/50 (36 %), mild in 10/50 (20 %) and 12/50 (24 %), it was moderate in10/50 (20 %) and 10/50 (20 %) and was severe in 6/50(12%) and 10/50 (20%) in the two groups respectively. One week after operation, in groups A and B, respectively, pain assessed with the useof the 4-point verbal scale was absent in 45 patients (90%) and 37 patients (74%), mild in 3/50 (6%) and 4/50 (8%), moderate in 2/50 (4%) and6/50 (12%), and severe in none and 3/50 (6%). Postoperative pain was not correlated with the presence of preoperative pain, and no correlationwas evidenced in the 2 subgroups. One month after operation, follow-up visits were performed in group A patients and group B patients. Inparticular, pain was absent in 46/50 (92%) patients in group A and 41/50 (82%) patients in group B. It was mild in 2 (6%) and 6/50 (12 %),moderate in 2/50 (4%) and 2/50 (4 %) none of the patients with elective neurectomy had pain at follow up of one month and 1 (2 %)one patientwithout elective neurectomy had pain. The numbness was assessed by checking sense of touch around the operated area. The difference foundbetween the 2 groups with respect to the presence of numbness was 15/50 (30 %) and 7/50 (14%) in the two groups i.e. group A and groupB respectively at day 1 and 12/50 (24%) and 7/50 (14%) at follow up of one week and it was 5/50 (10%) and 2/50(4%) at one month in the twogroups. C o n c l u s i o n s : When performing lichtenstein inguinal hernia repair, routine ilioinguinal, iliohypogastric and genital branch ofgenitofemoral nerves neurectomy is a reasonable option.

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