Comparison of Lichtenstein and Laparoscopic Transabdominal Preperitoneal Repair of Recurrent Inguinal Hernias

2011 ◽  
Vol 96 (3) ◽  
pp. 233-238 ◽  
Author(s):  
Z. Demetrashvili ◽  
V. Qerqadze ◽  
G. Kamkamidze ◽  
G. Topchishvili ◽  
L. Lagvilava ◽  
...  
Keyword(s):  
Urinary Retention ◽  
Operation Time ◽  
Long Term Results ◽  
Recurrent Inguinal Hernia ◽  
Physically Active ◽  
Transabdominal Preperitoneal ◽  
Inguinal Hernias ◽  
First Choice ◽  
Surgical Methods ◽  
Significant Difference

Abstract The aim of our study was the comparative analysis of the results of two surgical methods: tension-free repair by the Lichtenstein technique and laparoscopic transabdominal preperitoneal (TAPP) repair. In total 52 patients with recurrent inguinal hernia were randomly assigned to the two groups: Lichtenstein (28 patients) and TAPP (24 patients). Comparisons between these groups were done by several preoperative, intraoperative, and postoperative factors. For postoperative factors both short-term and long-term results were considered. Average operation time for Lichtenstein group was 59.6 ± 9.9 minutes, compared with 64.4 ± 8.4 minutes for TAPP patients (P  =  0.068). In TAPP patients there was less pain in the postoperative period (P  =  0.002) and fewer sick-leave days (13.4 ± 1.7 versus 17.5 ± 2.6 days; P < 0.001) and, correspondingly, faster recovery. In the Lichtenstein group a total of 4 postoperative complications (infection, hematoma, seroma, urinary retention) were observed, compared with 8 in the TAPP group (P  =  0.19). Statistically significant difference was only by urinary retention (0 for Lichtenstein, 4 for TAPP; P  =  0.039). There were no cases of hernia recurrence observed during the follow-up. Chronic pain developed in 5 patients from the Lichtenstein group (17.9%) and 2 patients from the TAPP group (8.3%; P  =  0.28) more than 1 year after the operation; 4 Lichtenstein patients (14.3%) and 1 TAPP patient (4.2%; P  =  0.23) more than 2 years after the operation; and 3 Lichtenstein patients (10.7%) and 1 TAPP patient (4.2%; P  =  0.36) more than 3 years after the operation. For the treatment of recurrent inguinal hernias, which are developed after use of conventional (nonmesh) methods, the first choice should be given to the laparoscopic method, especially for young, physically active, nonobese patients, and if there are any contraindications for the laparoscopy, the Lichtenstein approach should be recommended.

A Comparison of Outcomes between Lichtenstein and Laparoscopic Transabdominal Preperitoneal Hernioplasty for Recurrent Inguinal Hernia

2018 ◽  
Vol 84 (11) ◽  
pp. 1774-1780 ◽  
Author(s):  
Bin Yang ◽  
Shengning Zhou ◽  
Yingru Li ◽  
Jianan Tan ◽  
Shuang Chen ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Intraoperative Complications ◽  
Incidence Rates ◽  
Laparoscopic Technique ◽  
Recurrent Inguinal Hernia ◽  
Complication Rates ◽  
Transabdominal Preperitoneal ◽  
Inguinal Hernias ◽  
Significant Difference

There remain concerns about the optimal technique for repairing recurrent inguinal hernias because of the high risks of complications and recurrence. The aim of this study was to compare Lichtenstein hernioplasty with the transabdominal preperitoneal (TAPP) laparoscopic technique in the treatment of recurrent inguinal hernias. One hundred twenty-two patients who underwent surgery for recurrent inguinal hernia were prospectively randomized to receive either Lichtenstein (n = 63) or TAPP (n = 59) hernioplasty between January 2010 and December 2014. Baseline characteristics, intraoperative complications, and short- and long-term postoperative factors were evaluated. Preoperative factors were comparable between the two groups. The average follow-up period was 46.2 ± 8.5 months. The two groups had similar intraoperative and short-term postoperative complication rates, whereas the rate of long-term postoperative complications was lower for the TAPP group than the Lichtenstein group (6.8% vs 23.8%, respectively, P = 0.012). The TAPP group had significantly lower visual analogue scale scores, fewer analgesics consumption, and faster recovery than the Lichtenstein group ( P < 0.05). Chronic pain was more prevalent in the Lichtenstein group than the TAPP group (15.9% vs 3.4%, respectively, P = 0.031). The recurrence rate was 4.8 per cent for the Lichtenstein group and 1.7 per cent for the TAPP group, with no significant difference ( P = 0.62). Both the Lichtenstein and TAPP procedures are safe and effective methods for repairing recurrent inguinal hernia with low incidence rates of life-threatening complications and recurrence. The TAPP procedure is superior to the Lichtenstein repair in terms of reduced postoperative pain, shorter sick leave, faster recovery, and better cosmetic results. Careful selection of the surgical procedures and implementation of technical essentials are necessary.

scholarly journals Clinical Evaluation of Microendoscopy-Assisted Oblique Lateral Interbody Fusion

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 135
Author(s):  
Tomohide Segawa ◽  
Hisashi Koga ◽  
Masahito Oshina ◽  
Katsuhiko Ishibashi ◽  
Yuichi Takano ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Outcome Measure ◽  
Operation Time ◽  
Secondary Outcome ◽  
Invasive Technique ◽  
Lateral Interbody Fusion ◽  
Surgical Methods ◽  
Significant Difference ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Background and objectives: Oblique Lateral Interbody Fusion (OLIF) is a widely performed, minimally invasive technique to achieve lumbar lateral interbody fusion. However, some complications can arise due to constraints posed by the limited surgical space and visual field. The purpose of this study was to assess the short-term postoperative clinical outcomes of microendoscopy-assisted OLIF (ME-OLIF) compared to conventional OLIF. Materials and Methods: We retrospectively investigated 75 consecutive patients who underwent OLIF or ME-OLIF. The age, sex, diagnosis, and number of fused levels were obtained from medical records. Operation time, estimated blood loss (EBL), and intraoperative complications were also collected. Operation time and EBL were only measured per level required for the lateral procedure, excluding the posterior fixation surgery. The primary outcome measure was assessed using the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). The secondary outcome measure was assessed using the Oswestry Disability Index (ODI) and the European Quality of Life–5 Dimensions (EQ-5D), measured preoperatively and 1-year postoperatively. Results: This case series consisted of 14 patients in the OLIF group and 61 patients in the ME-OLIF group. There was no significant difference between the two groups in terms of the mean operative time and EBL (p = 0.90 and p = 0.50, respectively). The perioperative complication rate was 21.4% in the OLIF group and 21.3% in the ME-OLIF group (p = 0.99). In both groups, the postoperative JOABPEQ, EQ-5D, and ODI scores improved significantly (p < 0.001). Conclusions: Although there was no significant difference in clinical results between the two surgical methods, the results suggest that both are safe surgical methods and that microendoscopy-assisted OLIF could serve as a potential alternative to the conventional OLIF procedure.

scholarly journals Efficacy and safety of a novel personalized navigation template in proximal femoral corrective osteotomy for the treatment of DDH

2020 ◽  
Author(s):  
qiang shi ◽  
Deyi Sun
Keyword(s):  
Radiation Exposure ◽  
Corrective Osteotomy ◽  
Operation Time ◽  
Conventional Group ◽  
The Novel ◽  
Efficacy And Safety ◽  
Reduce Radiation Exposure ◽  
Surgical Methods ◽  
Significant Difference ◽  
Navigation Template

Abstract Background: This present study is aimed to retrospectively evaluate the efficacy and safety of a novel personalized navigation template in proximal femoral corrective osteotomy for the treatment of DDH.Methods: Twenty-nine consecutive patients with DDH who underwent proximal femoral corrective osteotomy were evaluated between August 2013 and June 2017. Based on the different surgical methods, they were divided into the conventional group (n = 14) and navigation template group (n = 15). The osteotomy degrees, radiation exposure, and operation time were compared between the two groups.Results: No major complications relating to osteotomy surgery such as redislocation or avascular necrosis occurred in the navigation template group, which had more accurate osteotomy degrees, less radiation exposure, and shorter operation time when compared with the conventional group (P<0.05). Moreover, there was significant difference according to the McKay criteria between the two groups (P=0.0362).Conclusions: The novel personalized navigation template in proximal femoral corrective osteotomy is effective and safe, which could improve the femoral osteotomy accuracy, reduce radiation exposure, and shorten operation time.

scholarly journals Comparison of Totally Extraperitoneal versus Transabdominal Preperitoneal repair of inguinal hernias

2020 ◽  
Vol 23 (2) ◽  
pp. 47-51
Author(s):  
Rohit Prasad Yadav ◽  
Manish Gautam ◽  
Ashok Koirala ◽  
Sameer Bhattarai ◽  
Sachhidanand Shah ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Operating Time ◽  
Total Duration ◽  
Recurrent Inguinal Hernia ◽  
Transabdominal Preperitoneal ◽  
Significant Difference ◽  
Scrotal Hematoma ◽  
Duration Of Operation

Introduction: Laparoscopic inguinal hernia repair is a tension-free mesh repair that is based on pre-peritoneal approach of repair. It provides mechanical advantage to the surgeon, by being able to place a large piece of mesh and by using the natural force of the abdominal wall to disperse the intra-abdominal pressure over a large area to support the mesh. This retrospective study is aimed to study the demography of inguinal hernia and to compare operating time, complications and postoperative pain between patients undergoing Total Extrapritoneal (TEP) or Transabdominal Preperitoneal (TAPP) repair.Methods: A retrospective comparative study was conducted in patients with inguinal hernia who underwent laparoscopic repair by either TEP or TAPP, between April 2019 to July 2020 at Nobel Medical Collage Teaching Hospital, Biratnagar, Morang. Age, sex, type of hernia, duration of operation, post-operative complications, severity of pain and duration hospital stay were analyzed between two groups of patients undergoingsurgery by either TEP or TAPP.Results: One hundred and five patients underwent either TEP or TAPP during study period. There were 96 males and 9 females. There were 50 patients with right, 40 with left and 6 patients with bilateral inguinal hernia. Four patients had left sided irreducible inguinal hernia, 2 patients had bilateral recurrent inguinal hernia, 2 patients had right sided recurrent inguinal hernia and 1 patient had left sided recurrent inguinal hernia.There was significant difference in duration of operation (TEP 64.43min) / (TAPP 84.46min), p<0. 001. Total duration of hospital stay and postoperative pain were not significant between patients operated with TEPor TAPP. Accidental pneumoperitoneum was noticed in 8 cases, 10 cases of subcutaneous emphysema, 5 cases of seroma and 1 case of scrotal hematoma in TEP group. In TAPP group scrotal hematoma occurred in 4 cases and seroma in 5 cases which was not significantly different from TEP group.Conclusion: TAPP had significantly longer operating time as compared to TEP. However, there was no significant difference in post-operative pain and hospital stay in both group.

scholarly journals Surgical treatment of 125 cases with congenital diaphragmatic eventration in a single institution

2020 ◽  
Author(s):  
Shengliang Zhao ◽  
Zhengxia Pan ◽  
Yonggang Li ◽  
Yong An ◽  
Lu Zhao ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Open Surgery ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Operation Time ◽  
Diaphragmatic Eventration ◽  
Diaphragmatic Plication ◽  
Paradoxical Movement ◽  
First Choice ◽  
Surgical Methods

Abstract Backgrounds This study sought to investigate the clinical characteristics of congenital diaphragmatic eventration (CDE) and to compare the efficacy of thoracoscopy and traditional open surgery in infants with congenital diaphragmatic eventration. Methods We retrospectively analyzed the clinical data of 125 children with CDE(90 boys, 35girls; median age:12.2 months, range 1h-7years;body weight1.99-28.5kg,median body weight 7.87±4.40kg) admitted to our hospital in recent 10years,　and statistically analyzed their clinical manifestations and surgical methods. Results 108 children in this group underwent surgery, of which 67 underwent open surgery and 41 underwent thoracoscopic diaphragmatic plication.107 patients recovered well postoperatively, except for 1 patient died of respiratory distress after surgery.Followed up for 1-9.5 years,107 patients had significantly improved preoperative symptoms.During follow-up, the location of the diaphragm was normal and no paradoxical movement was observed.Eleven of the 17 children who did not undergo surgical treatment did not see a decrease in diaphragm position after 1-6 years of follow-up.In the thoracoscopy group, the index data on the operation time, intraoperative blood loss, chest drainage time, postoperative mechanical ventilation time, postoperative hospital stay and postoperative CCU admission time were better than those in the open group.The difference between the two groups was statistically significant (P＜0.05). Conclusions Clinical symptoms of congenital diaphragmatic eventration varied in severity. Patients with severe symptoms should be operated.Both thoracoscopic diaphragmatic plication and traditional open surgery can effectively treat congenital diaphragmatic eventration,but compared with open surgery, thoracoscopic diaphragmatic plication has the advantages of short operation time, less trauma, rapid recovery,　so it should be the first choice for children with congenital diaphragmatic eventration.

scholarly journals Inguinal hernias in patients on continuous ambulatory peritoneal dialysis: is tension-free mesh repair feasible?

2020 ◽  
Author(s):  
Qiyu Chi ◽  
Zheng Shi ◽  
Zhibo Zhang ◽  
Chunzhong Lin ◽  
Guozhong Liu ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Mesh Repair ◽  
Alternative Therapy ◽  
Operation Time ◽  
Abdominal Wall Hernia ◽  
Tension Free ◽  
Inguinal Hernias ◽  
Hernia Formation ◽  
First Choice

Abstract Background:Continuous ambulatory peritoneal dialysis (CAPD), which often causes a common complication such as abdominal wall hernia, is a prevalent alternative therapy for end-stage renal failure patients. However, relevant studies are somewhat rare, and the peritoneal dialysis (PD) protocol during the perioperative period is still controversial. The aim of this study was to evaluate the effectiveness and perioperative management of tension-free mesh repair for inguinal hernias in CAPD patients.Methods:Between January 2013 and December 2019, 18 CAPD patients with 20 inguinal hernias who underwent tension-free mesh repair were retrospectively analyzed. Data on demographics, perioperative features, the perioperative dialysis protocol and surgical complications were collected and assessed.Results:All hernias were diagnosed after the start of CAPD, and the median duration from PD onset to hernia formation was 16 months (2-61 months). All patients underwent successful tension-free mesh repair, including 17 Lichtenstein and 3 anterior Kugel procedures. The median operation time was 62.5 min, and the median postoperative hospital stay was 3 days. Fifteen patients received low-exchange volumes and high-frequency exchanges from 1-3 days after surgery for 2 weeks with gradual resumption of the original CAPD regimen within 4 weeks. Complications included seroma (n = 2) and hematoma (n = 1). No wound or mesh infection or recurrence occurred during the follow-up period.Conclusions:Tension-free mesh repair is safe and feasible for inguinal hernias in CAPD patients, The Lichtenstein mesh repair should be the first choice, and anterior Kugel repair may be considered an effective procedure. Bridging hemodialysis seems unnecessary except for emergency surgery.

Autogenous versus Allograft Fascia Lata in Frontal Sling Surgery - Long-Term Results

2003 ◽  
Vol 13 (2) ◽  
pp. 202-206 ◽  
Author(s):  
C. Gürdal ◽  
U. Erdener ◽  
M. Orhan ◽  
M. Irkeç
Keyword(s):  
Fascia Lata ◽  
Long Term Results ◽  
Repeat Surgery ◽  
Sling Procedure ◽  
Preseptal Cellulitis ◽  
First Choice ◽  
Significant Difference ◽  
Sling Surgery

Purpose Either autogenous or allograft fascia lata frontal sling procedures can be used for the treatment of severe ptosis. We retrospectively evaluated the late outcomes of both approaches. Methods Medical records of patients who underwent frontal sling ptosis surgery between 1978 and 2000, with a follow-up of one year or more were included in the study. Success rates and the complications of the surgery for autogenous and allograft fascia lata were recorded. The results were compared statistically. Results Surgeries were performed with 82 autogenous or 43 allograft fascia lata. At last follow-up there were 71 eyes (86.6%) with good, 8 eyes (9.7%) with moderate, 3 eyes (3.7%) with poor results after autogenous fascia lata and 35 (81.4%), 3 (7%) and 5 (11.6%) after the allograft fascia lata frontal sling procedure. There was no significant difference between the two groups. Repeat surgery was carried out on three patients after autogenous and five after allograft fascia lata surgery. Two cases of preseptal cellulitis were observed, one abscess after autogenous and one lagophthalmus after allograft fascia lata sling surgery. All patients had slight edema early after surgery which resolved in a few days. Only one patient developed a hematoma at the site of the leg incision. Conclusions Although the long-term success rate with the autogenous fascia lata is slightly higher and this remains the first choice, allograft fascia lata is a good alternative in patients in whom fascia could not be harvested.

scholarly journals Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Using Memory-Ring Mesh: A Pilot Study

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Takeshi Matsutani ◽  
Tsutomu Nomura ◽  
Nobutoshi Hagiwara ◽  
Akihisa Matsuda ◽  
Yoshimune Takao ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Operation Time ◽  
Indirect Inguinal Hernia ◽  
Trocar Site ◽  
Transabdominal Preperitoneal ◽  
Tapp Repair ◽  
Inguinal Hernias

Purpose.To evaluate the feasibility, safety, and effectiveness of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair using a memory-ring patch (Polysoft™mesh).Patients and Methods.Between April 2010 and March 2013, a total of 76 inguinal hernias underwent TAPP repair using Polysoft mesh in 67 adults under general anesthesia. Three different senior resident surgeons performed TAPP repair under the instruction of a specialist surgeon. Nine patients had bilateral hernias. The 76 hernias included 37 indirect inguinal hernias, 29 direct hernias, 1 femoral hernia, 1 pantaloon hernia (combined direct/indirect inguinal hernia), and 8 recurrent hernias after open anterior hernia repair. The immediate postoperative outcomes as well as the short-term outcomes (mainly recurrence and incidence of chronic pain) were studied.Results.There was no conversion from TAPP repair to anterior open repair. The mean operation time was 109 minutes (range, 40–132) for unilateral hernia repair. Scrotal seroma was diagnosed at the operation site in 5 patients. No patient had operation-related orchitis, testicle edema, trocar site infection, or chronic pain during follow-up.Conclusions.The use of Polysoft mesh for TAPP inguinal hernia repair does not seem to adversely affect the quality of repair. The use of this mesh is therefore feasible and safe and may reduce postoperative pain.

scholarly journals ULTRAPRO Hernia System Versus Lichtenstein Repair in Treatment of Primary Inguinal Hernias: A Prospective Randomized Controlled Study

2014 ◽  
Vol 99 (4) ◽  
pp. 391-397 ◽  
Author(s):  
Faruk Karateke ◽  
Sefa Ozyazici ◽  
Ebru Menekse ◽  
Hatice Özdogan ◽  
Mevlüt Kunt ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Operation Time ◽  
Postoperative Recovery ◽  
Controlled Study ◽  
Preperitoneal Space ◽  
Lichtenstein Repair ◽  
Lichtenstein Technique ◽  
Recurrence Rates ◽  
Inguinal Hernias ◽  
First Choice

Abstract The Lichtenstein repair has been recommended as the gold standard for inguinal hernia repair. However, postoperative discomfort still constitutes a concern and an area for improvement. New mesh materials have been continuously introduced to achieve this goal. The goal of the present study was to investigate the outcomes of ULTRAPRO Hernia System (UHS) compared with Lichtenstein mesh repair. A total of 99 male patients with primary unilateral inguinal hernia were included in the study during the period of September 2010–January 2012. Patients with body mass index &gt;30, comorbid diseases, and anesthetic risk of ASA-III and ASA-IV were excluded. The patients were randomly allocated to operation with the Lichtenstein technique (group L) or UHS. Demographics, operative and postoperative/recovery data, and short- and medium-term outcomes of the patients were recorded. A total of 50 patients in group L and 49 patients in group UHS were analyzed. The median follow-up time for the study was 33 months. There were no significant differences regarding demographics, complications, and rehabilitation between the groups. Overall, there was a prolonged operation time in the UHS group compared with the L group (UHS: 53.7 ± 5.7 minutes; L: 44.5 ± 5.5 minutes; P &lt; 0.001). UHS may provide results similar to those for the Lichtenstein technique in open repair of inguinal hernias regarding perioperative course, complications, recovery, and recurrence rates. However, because of reduced costs and the lack of need for the exploration of the preperitoneal space, we conclude that the Lichtenstein technique should be recommended as the first choice.

scholarly journals Treating incarcerated inguinal hernias with TEP is a viable option for experienced surgeons

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Kayo Augusto de Almeida Medeiros ◽  
Bárbara Justo Carvalho ◽  
Leonardo Zumerkorn Pipek ◽  
Gustavo Heluani Antunes de Mesquita ◽  
Fernanda Nii ◽  
...  
Keyword(s):  
Public Health ◽  
Postoperative Complications ◽  
Laparoscopic Hernia Repair ◽  
Technical Difficulty ◽  
Viable Option ◽  
Hernia Surgery ◽  
Inguinal Hernias ◽  
Surgical Methods ◽  
Significant Difference

AbstractDespite inguinal hernias being a common problem in public health, there is still scarce information about the epidemiology of the complications, especially incarceration, and their influence on the laparoscopic surgical methods considering the role of the learning process of the surgeon. Compare laparoscopic totally extraperitoneal (TEP) approach in the repair of incarcerated and non-incarcerated inguinal hernias from the perspective of technical difficulty for trained surgeons. We obtained data about sex, age, location and type of hernia, surgery duration, ASA score, postoperative complications, previous surgeries and BMI. Groups were descriptively analyzed and statistically compared to verify how similar the samples were. 265 (90.1%) patients had non-incarcerated hernias and 29 (9.9%) incarcerated. We observed that there was no significant difference in the pattern of location (right, left or bilateral), sex, ASA, previous or complications between the two groups. Unilateral incarcerated hernias had longer operative times compared to non-incarcerated. No difference was found between bilateral hernias. We didn´t find significant epidemiological differences between incarcerated and non-incarcerated hernias. In our experience, with the limitation of a single-surgeon series, laparoscopic hernia repair achieved satisfactory results in terms of feasibility (especially for bilateral hernias) and safety.

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