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.

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.

scholarly journals Outcomes of an innovative training course in laparoscopic hernia repair

2017 ◽  
Vol 99 (8) ◽  
pp. 614-616 ◽  
Author(s):  
D Light ◽  
S Bawa ◽  
P Gallagher ◽  
L Horgan
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Inguinal Hernia Repair ◽  
Ventral Hernia Repair ◽  
Operative Time ◽  
Laparoscopic Inguinal Hernia Repair ◽  
Laparoscopic Ventral Hernia Repair ◽  
Hernia Surgery ◽  
The Mean

Introduction The Ethicon™ laparoscopic inguinal groin hernia training (LIGHT) course is an educational course based on three days of teaching on laparoscopic hernia surgery. The first day involves didactic lectures with tutorials. The second day involves practical cadaveric procedures in laparoscopic hernia surgery. The third day involves direct supervision by a consultant surgeon during laparoscopic hernia surgery on a real patient. We reviewed our outcomes for procedures performed on real patients on the final day of the course for early complications and outcomes. Methods A retrospective study was undertaken of patients who had laparoscopic hernia surgery as part of the LIGHT course from 2013 to 2015. A matched control cohort of patients who had elective laparoscopic hernia surgery over the study period was identified. These patients had their surgery performed by the same consultant general surgeons involved in delivering the course. All patients were followed up at 6 weeks postoperatively. Results A total of 60 patients had a laparoscopic inguinal hernia repair and 23 patients had a laparoscopic ventral hernia repair during the course. The mean operative time for laparoscopic inguinal hernia repair was 48 minutes for trainees (range 22–90 minutes) and 35 minutes for consultant surgeons (range 18–80 minutes). There were no intraoperative injuries or returns to theatre in either group. All the patients operated on during the course were successfully performed as daycase procedures. The mean operative time for laparoscopic ventral hernia repair was 64 minutes for trainees (range 40–120 minutes) and 51 minutes for consultant surgeons (range 30–130 minutes). Conclusions The outcomes of patients operated on during the LIGHT course are comparable to procedures performed by a consultant. Supervised operating by trainees is a safe and effective educational model in hernia surgery.

scholarly journals Laparoscopic versus open mesh repair of unilateral inguinal hernia: a comparative study

2017 ◽  
Vol 4 (3) ◽  
pp. 921
Author(s):  
Sudarshan P. B. ◽  
Sundaravadanan B. S. ◽  
Kaarthik V. P. ◽  
Prabu Shankar S.
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Return To Work ◽  
Inguinal Hernia Repair ◽  
Laparoscopic Group ◽  
Laparoscopic Inguinal Hernia Repair ◽  
Unilateral Inguinal Hernia ◽  
Laparoscopic Inguinal Hernia ◽  
Post Operative Pain ◽  
Significant Difference

Background: Inguinal hernia repair is now one of the most commonly performed general surgical procedures in practice. Laparoscopic inguinal hernia repair was started in year 1999 and since then has gained popularity over the last 2 decades. The introduction of a laparoscopic technique has sparked a debate in the literature over the superiority of this method versus open repair. Even though for bilateral and recurrent inguinal hernias, laparoscopic approach is recommended, there is not enough literature to recommend its routine use in unilateral inguinal hernia repair.Methods: A randomised prospective study was conducted at a tertiary care teaching hospital, comparing both Laparoscopic inguinal hernia repair and lichensteins tension free mesh repair as treatment modalities for unilateral inguinal hernia. Total number of patients in the study group was 60. Patients who were willing for the study were selected for the open or laparoscopic procedure in a randomised way. Open procedure was done by 2 senior surgeons and laparoscopic procedure was performed by 2 other senior surgeons at associate professor designation. Various parameters like the complication rate, post-operative pain, post-operative stay and time to return to work were analysed.Results: Out of the 60 patients, 30 patients underwent open inguinal hernia repair and another 30 patients underwent Laparoscopic inguinal hernia repair. The mean age group was 46.73 in open surgery group and 42.10 in laparoscopic group. 23.3% of the patients in open hernioplasty developed seroma, hematoma in the post-operative period. Whereas 10% had seroma collection in laparoscopic group. No incidence of recurrence in both the groups. No significant difference in pain score between both the groups during immediate post-operative period on POD 0, however there was significant difference in pain score on POD 3 (mean pain in open group 4.13 and lap group 2.87) and POD 7(mean pain in open group 2.90 and lap group 1.23). Mean duration of stay in hospital for open hernioplasty was 7.8 days and for Laparoscopic hernioplasty was 3.07 days. Mean duration of return to work in open hernioplasty was 14.37 days and in laparoscopy group was 9.13 days.Conclusions: There are potential benefits for laparoscopic inguinal hernia repair over lichtenstein’s repair for unilateral inguinal hernias in terms of post-operative pain, hospital stay and early return to work.

Postoperative pain reduction by pre-emptive N-acetylcysteine: an exploratory randomized controlled clinical trial

2021 ◽  
pp. rapm-2021-102884
Author(s):  
Chantal Elise Mulkens ◽  
Marieke Staatsen ◽  
Lucie van Genugten ◽  
Barbara A M Snoeker ◽  
Kris C P Vissers ◽  
...  
Keyword(s):  
Placebo Group ◽  
Inguinal Hernia ◽  
Side Effects ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Laparoscopic Inguinal Hernia Repair ◽  
Median Score ◽  
Pain Scores ◽  
Laparoscopic Inguinal Hernia

BackgroundA new potential target for multimodal pain management is the group-II metabotropic glutamate receptor subtypes, which can be activated by N-acetylcysteine. We investigated whether pre-emptive administration of N-acetylcysteine leads to a reduction in postoperative pain after laparoscopic inguinal hernia repair.MethodsSixty American Society of Anesthesiologists I-II patients scheduled for elective inguinal hernia repair were randomized to receive either N-acetylcysteine (150 mg/kg) or placebo intravenously 1 hour before surgery. The primary outcome was the visual analogue score during movement in the morning (approximately 24 hours) after surgery. Among secondary outcomes were postoperative opioid consumption and safety of intravenous N-acetylcysteine.ResultsIn total, 23 patients were analyzed per group. Pain scores were similar at all timepoints with a 24 hours median score of 34 (IQR of 19.0 to 42.5) in the N-acetylcysteine group and a median score of 26 (16.0 to 50.0) in the placebo group. The percentage of patients using opioids after surgery was 22% versus 39% day 1 (p=0.63); 9% versus 26% day 2 (p=0.14); 9% versus 17% day 3 (p=0.35) in the N-acetylcysteine group compared with placebo group. Side effects resembling anaphylactoid reactions in response to the administration of N-acetylcysteine were present in more than half of the patients.ConclusionsWithout finding important differences between N-acetylcysteine and placebo group in pain scores postoperatively, but with a high percentage of bothersome side effects for the N-acetylcysteine group, we would not recommend the use of pre-emptive intravenous N-acetylcysteine to reduce postoperative pain in laparoscopic inguinal hernia repair patients based on this study.Trial registration numberNCT03354572.

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