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

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 >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 < 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.

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A Rare Case of Inguinal Hernia with Complete Bladder Herniation

Case Reports in Surgery ◽

10.1155/2017/4658169 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Ayaaz Habib

Keyword(s):

Renal Function ◽

Inguinal Hernia ◽

Complete Resolution ◽

Rare Case ◽

Obstructive Uropathy ◽

Postoperative Recovery ◽

Diagnosis And Management ◽

Inguinoscrotal Hernia ◽

Inguinal Hernias ◽

Bladder Herniation

Involvement of the bladder in inguinal hernias is rare and occurs in less than 5% of the cases. The diagnosis and management of this condition may present a challenge to the surgeon. We present a case of an elderly gentleman who presented with a large left-sided inguinoscrotal hernia causing an obstructive uropathy which was surgically repaired. The patient made a quick postoperative recovery with complete resolution of renal function.

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Modifield Desarda Repair and Hernioplastia Lichtenstein Repair for Inguinal Hernia

Journal of Clinical and Laboratory Research ◽

10.31579/2768-0487/014 ◽

2021 ◽

Vol 2 (3) ◽

pp. 01-05

Author(s):

Pedro Rolando Lòpez Rodrìguez ◽

Eduardo Garcia Castillo ◽

Olga Caridad Leòn Gonzàlez ◽

Jorge Agustin Satorre Rocha ◽

Luis Marrero Quiala ◽

...

Keyword(s):

Inguinal Hernia ◽

Operative Time ◽

Controlled Trial ◽

Operation Time ◽

Lichtenstein Repair ◽

Prospective Randomized Controlled Trial ◽

The Mean ◽

Group 2 ◽

Location Type ◽

Mean Time

Introduction: The objective of this study is to compare the outcomes of Modified Desarda repair no mesh and Lichtenstein repair for inguinal hernia. Methods: This is a prospective randomized controlled trial study of 1342 patients having 1394 hernias operated from January 2008 to December 2020. 690 patients were operated using Lichtenstein repair and 652 using Desarda repair. The demographie data (Age,Sex) , hernia type and location , anesthetic , operative time , postoperative pain and complications were analysed. Results: There were no significant differences regarding age, sex, location, type of hernia, and pain in both the groups. The operation time was 52 minutes in Modified Desarda group and 42 minutes in the Lichtenstein group that is significant (p<0.05). The recurrence was 0.0 % in Modified Desarda group and 0.28 % in Lichtenstein group. But, there were 9 cases of infection to the polypropylene mesh in the Lichtenstein group, 2 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (7,6 %) as compared to Modified Desarda group (3.8 %). The mean time to return to work in the Modified Desarda group was 8.26 days while a mean of 12.58 days was in the Lichtenstein group. The mean hospital stay was 29 hrs. in Modified Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized. Conclusions: The modified Desarda repair scores significantly on Lichtenstein repair in most of all aspects, including reexplorations and morbidity. Modified Desarda repair is a better option compared to Lichtenstein repair.

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Laparoscopic cauterization of hernia sac in girls; the Burnia technique

Turkish Association of Pediatric Surgeons ◽

10.5222/jtaps.2020.77598 ◽

2020 ◽

Author(s):

Sabriye Dayı

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Abdominal Cavity ◽

Operation Time ◽

Contralateral Side ◽

Hernia Sac ◽

Inguinal Hernias ◽

Laparoscopic Techniques

INTRODUCTION: Inguinal hernia repair is one of the most common surgical procedures in pediatric surgery. In parallel with the advances in the field of medicine, various laparoscopic techniques have been developed in inguinal hernia repair. The Burnia technique is one of the latest published techniques and it is the cauterization of the inguinal hernia sac laparoscopically without using sutures in girls. The aim of this study is the investigation of the use of Burnia technique in clinical practice, and its postoperative outcomes. Any article concerning the use of this technique in Turkey has not been encountered. METHODS: The demographic features of patients, preoperative, peroperative, postoperative and follow-up results of 41 patients who had been operated with Burnia technique by a single surgeon within 2 years were reviewed retrospectively. Laparoscopically, the camera was first placed at an inclination of 30 degrees to the umbilical region using Hasson technique, and then, a single port was used for cauterization of the hernia sac. The Hernia sac was pulled into the abdominal cavity and cauterized. RESULTS: Burnia technique was applied to 62 inguinal hernia sacs in 41 girls. Their ages ranged from 1.5 to 16 years (median 36 months) with body weights ranging between 3.5 kg-40 kg (median 12 kg). Preoperatively 15 patients had right (37%), 19 patients left (46%), 7 patients bilateral inguinal hernias (17%). During surgery, 14 of the unilateral inguinal hernias were found to have a hernia sac on the contralateral side, and the rate of bilateral hernia increased to 51 percent. In one patient ovary was in the inguinal canal, and after its reduction, we proceeded with the operation Unexpectedly. in one patient, right ovarian torsion was detected which was detorsioned, and hernia surgery was performed in the same session. The duration of the operation was 5-35 min (median 15 min) for unilateral and 8-45 min (median 20 minutes) for bilateral hernias. None of these patients developed peroperative and postoperative complications. Follow-up time was minimum 10 months, and maximum 3 years. Recurrence was not detected. DISCUSSION AND CONCLUSION: Burnia technique seems to be effective and safe. The contralateral side and other intra-abdominal pathologies are explored. The cosmetic appearance is its another advantage. The operation time is very short due to the fact that only the hernia sac is cauterized. Comparison of this technique with other laparoscopic techniques is planned in the future study.

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

10.21203/rs.3.rs-60947/v2 ◽

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.

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

Surgery Research and Practice ◽

10.1155/2016/9407357 ◽

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.

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Mini-mesh and Lichtenstein repair compared with a modified Kugel technique for femoral hernia: a randomised controlled trial

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2019.0181 ◽

2020 ◽

Vol 102 (4) ◽

pp. 284-289

Author(s):

D Wang ◽

Y Shen ◽

F Wang ◽

J Chen ◽

Y Chen ◽

...

Keyword(s):

Femoral Hernia ◽

Controlled Trial ◽

Operation Time ◽

Preperitoneal Space ◽

Lichtenstein Repair ◽

Operative Outcomes ◽

Significant Difference ◽

Randomised Controlled ◽

Kugel Repair ◽

Kugel Technique

Introduction A modified Kugel patch is more expensive than ordinary mesh and demands a wide dissection of the preperitoneal space in femoral hernia repair. We therefore adopted a novel method using mini-mesh and a Lichtenstein repair. This study compared mini-mesh and Lichtenstein repair with a modified Kugel technique in patients with a primary unilateral femoral hernia. Methods Patients with unilateral femoral hernia were assigned randomly to undergo mini-mesh and Lichtenstein repair (M group) or modified Kugel repair (K group), followed-up at one week, three months, one year and two years. Demographics, hernia characteristics and operative outcomes of two groups were analysed. Results A total of 48 patients in the K group and 49 participants in the M group completed follow-up. The operation time for the M group (68.6 ± 13.4 minutes) was significantly shorter than that of the K group (80.6 ± 10.1 minutes; p=0.030). There was no significant difference between the two groups for chronic pain, foreign body feeling and quality of life, and no recurrence occurred. Conclusions Mini-mesh and Lichtenstein repairs have reasonable results in the patients with femoral hernia in this study, with a reduced operation time compared with a modified Kugel repair. The trial was registered with the Chinese Clinical Trials Registry: ChiCTR1900022264.

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A randomized controlled study of transinguinal pre peritoneal repair vs Lichtenstein repair for inguinal hernia

International Surgery Journal ◽

10.18203/2349-2902.isj20193350 ◽

2019 ◽

Vol 6 (8) ◽

pp. 2757

Author(s):

Santosh M. Patil ◽

Augusty Dharmapuri

Keyword(s):

Chronic Pain ◽

Inguinal Hernia ◽

Hernia Repair ◽

Controlled Study ◽

Chronic Groin Pain ◽

Inguinal Hernias ◽

Group I ◽

History Of ◽

Study Population ◽

Group Ii

Background: Inguinal hernia repairs are one of most common surgeries performed world-wide. Inguinal hernias are present in 1.7% of the world population.Methods: Total of 100 patients was included in this study with 50 patients in each group. Group I (n=50): patients in this group underwent hernia repair using open preperitoneal mesh procedure. Group II (n=50): patients in this group underwent hernia repair using Lichtenstein procedure.Results: The proportion of patients with left inguinal hernia was higher in group I (48.00%) as compared to group II (46.00%), but this difference was not statistically significant. In overall study population (81.25%) as well as in group I (82.50%) and group II (80.00%) of the study, no history of straining was observed in the majority of the cases. Though the proportion of straining was higher in group I (32.00%) as compared to group II (26.00%), but this difference was not statistically significant (p=0.775). Chronic pain (see Table 4) was found in 28.75% of total patients, though the chronic pain was found in higher proportion of patients of group II (32.0%) as compared to group I (22.0%).Conclusions:In conclusion, this study shows that the TPT provides significant advantages over the Lichtenstein technique in case of repair of unilateral inguinal hernias. Patients in TPT group had less incidence of wound induration and chronic groin pain. They were also able to return to their jobs earlier.

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Endoscopic Techniques in the Treatment of Inguinal Hernias

Vestnik of Experimental and Clinical Surgery ◽

10.18499/2070-478x-2020-13-2-138-145 ◽

2020 ◽

Vol 13 (2) ◽

pp. 138-145

Author(s):

Wadim Trukhalev ◽

Alexander Vlasov ◽

Аleksandra Kalinina ◽

Elena Krivenkova

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Mesh Fixation ◽

Safe Procedure ◽

Recurrence Rates ◽

Tension Free ◽

Inguinal Hernias ◽

Total Extraperitoneal ◽

Endoscopic Methods

The review is devoted to the treatment methods of inguinal hernia. Inguinal hernia repair is one of the most common operations in the world and is performed on more than 20 million patients per year. Recurrence rates of inguinal hernias after different types of surgical interventions range from 10 to 15%. The use of synthetic materials reduced the rates of hernia recurrence on average to 1-5%. Currently there are traditional tissue-based techniques, open tension-free mesh hernia repair, and laparoscopic mesh hernioplasty. Nowadays tension-free repair with synthetic mesh is a technique of choice for inguinal hernia repair. The emphasis has been placed on endoscopic methods of inguinal hernia prosthetic repair. According to the literature, laparoscopic repair is associated with low rates of wound infection and fewer haematomas, which leads to early resumption of everyday activities compared with Lichtenstein hernia repair. The paper discusses two standardized endoscopic methods for inguinal hernia treatment, namely laparoscopic transabdominal preperitoneal patch (TAPP) and total extraperitoneal (TEP) repair. Analysis of the literature has shown that criteria of necessity and method of mesh fixation during TAPP procedure were not completely identified. However, a number of researches have demonstrated that TAPP technique without mesh fixation proved to be a safe procedure which can be used in most patients with unilateral and bilateral inguinal hernia showing no increase in postoperative complications and low recurrence rates.

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

10.21203/rs.3.rs-60947/v1 ◽

2020 ◽

Author(s):

Qiyu Chi ◽

Shangeng Weng ◽

Zheng Shi ◽

Zhibo Zhang ◽

Chunzhong Lin ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Mesh Repair ◽

Alternative Therapy ◽

Operation Time ◽

Abdominal Wall Hernia ◽

Perioperative Period ◽

Tension Free ◽

Inguinal Hernias ◽

Hernia Formation ◽

First Choice

Abstract PurposeContinuous 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.MethodsBetween 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.ResultsAll 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.ConclusionsTension-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.

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Desarda repair no Mesh and Lichtenstein repair for inguinal hernia (A study of 2793 patients)

Clinical Medical Reviews and Reports ◽

10.31579/2690-8794/096 ◽

2021 ◽

Vol 3 (9) ◽

pp. 01-05

Author(s):

Pedro Rolando Lòpez Rodrìguez ◽

Eduardo Garcia Castillo ◽

Olga Caridad Leòn Gonzàlez ◽

Jorge Agustin Satorre Rocha ◽

Luis Marrero Quiala ◽

...

Keyword(s):

Inguinal Hernia ◽

Hospital Stay ◽

Controlled Trial ◽

Operation Time ◽

Lichtenstein Repair ◽

Prospective Randomized Controlled Trial ◽

Duration Of Surgery ◽

The Mean ◽

Location Type

Introduction: The objective of this study is to compare the outcomes of Desarda repair no mesh and Lichtenstein repair for inguinal hernia. Methods: This is a prospective randomized controlled trial study of 2793 patients having 2936 hernias operated from January 2002 to December 2020.1434 patients were operated using Lichtenstein repair and 1359 using Desarda repair. The variables like age, sex, location, type of hernia, tolerance to local anesthesia, duration of surgery, pain on the first, third and fifth day, hospital stay, complications, re-explorations, morbidity and time to return to normal activities were analyzed. Follow up period was from 1-10 years (median 6.5 years). Results: There were no significant differences regarding age, sex, location, type of hernia, and pain in both the groups. The operation time was 53 minutes in Desarda group and 43 minutes in the Lichtenstein group that is significant (p<0.05).The recurrence was 0.4 % in Desarda group and 0.4 % in Lichtenstein group. But, there were 14 cases of infection to the polypropylene mesh in the Lichtenstein group, 7 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (5,1 %) as compared to Desarda group (3.1 %). The mean time to return to work in the Desarda group was 8.26 days while a mean of 12.58 days was in the Lichtenstein group. The mean hospital stay was 29 hrs. In Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized. Conclusions: Desarda repair scores significantly over the Lichtenstein repair in all respects including re-explorations and morbidity. Desarda repair is a better choice as compared with Lichtenstein repair.

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