Is Same-Day Inguinal Hernia Surgery Possible?

2016 ◽  
Vol 101 (3-4) ◽  
pp. 137-143 ◽  
Author(s):  
Recai Capoglu ◽  
Cagri Tiryaki ◽  
Ertugrul Kargi ◽  
Emre Gonullu ◽  
Neset Nuri Gonullu ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Local Anesthesia ◽  
Length Of Hospital Stay ◽  
Day Surgery ◽  
Complication Rates ◽  
Hernia Surgery ◽  
Repair Method ◽  
Lichtenstein Hernia Repair

The Lichtenstein hernia repair is associated with low recurrence rates and short operation times, and can be performed under local anesthesia. Thus, this is among the most-preferred methods used in recent years. Our objective was to explore the same-day discharge rates, and the causes of delayed discharge and re-admission to hospital, of patients treated using the Lichtenstein repair method, to evaluate the feasibility of performing same-day hernia surgery in clinical practice. One hundred of a total of 236 patients diagnosed with unilateral inguinal or femoral hernias, who required surgical treatment, and who agreed with the conditions of the study, were prospectively included. All patients were treated using the Lichtenstein mesh repair method, under local anesthesia between June 2006 and January 2008. We investigated the types and locations of hernias, duration of surgery, seniority of the surgeon, the feasibility of same-day surgery in subgroups stratified by ASA risk scores, and postoperative complication rates, in patients who underwent inguinal surgery under local anesthesia. The rates of pain and postoperative complications were very low in hernia patients who underwent same-day surgery under local anesthesia. The operation reduces the length of hospital stay and helps patients mobilize earlier. Both the literature, and our data, indicate that inguinal hernia repair under local anesthesia is safe and effective, reducing anesthesia-related complications and the length of hospital stay; is cost-effective; and is applicable in all patients.

scholarly journals Using inferior epigastric vascular anatomical landmarks for anterior inguinal hernia repair

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Weiming Li ◽  
Yijun Li ◽  
Lili Ding ◽  
Xiongzhi Chen ◽  
Qingwen Xu ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Foreign Bodies ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Complication Rates ◽  
Anatomical Landmarks ◽  
Post Operative Pain

Abstract Background Inferior epigastric vascular anatomical landmarks for anterior inguinal hernia repair is an alternative surgical procedure. We present our experience and outcome of the way. Methods We performed a retrospective analysis of 230 patients who received anterior tension-free hernia repair between May 2016 to May 2017. Among these cases, 120 were performed using the traditional transinguinal preperitoneal (TTIPP) technique while 100 were performed using the vascular anatomic landmark transinguinal preperitoneal (VALTIPP) technique. Between these two groups, we compared the operation time, length of hospital stay, complication rates, and the visual analog scale (VAS) for pain at 2 days, 3 months, and 6 months after surgery. Results Surgery was well-tolerated in both groups with no significant hemorrhage or complications. The operation times for the VALTIPP and TTIPP groups were 42.52 ± 9.15 and 53.84 ± 10.64 min (P < 0.05), respectively. Ten patients in the VALTIPP group and 17 patients in the TTIPP group reported sensations of foreign bodies (P < 0.05). The VAS pain score in VALTIPP patients at 2 days (4.0 ± 0.5), 3 months (1.0 ± 0.3), and 6 months (0.9 ± 0.3) were significantly lower when compared with those of TTIPP patients (5.3 ± 0.9 at 2 days, 1.8 ± 0.4 at 3 months, and 1.1 ± 0.1 at 6 months, p < 0.05). No statistically significant differences were found in age, gender, BMI, hernia type and location, follow-up period, incidence of post-operative seromas, recurrence rate, or length of hospital stay. Conclusion Anterior inguinal hernia repair using inferior epigastric vascular anatomical landmarks may lead to reduced operation times, reduced sensations of foreign bodies, and reduced post-operative pain. This technique is simple, practical, and effective in the management of inguinal hernias.

scholarly journals Postoperative condition of patients as a result of treatment of inguinal hernias by laparoscopic and open methods

2021 ◽  
pp. 30-35
Author(s):  
V.V. Skyba ◽  
◽  
A.V. Ivanko ◽  
N.V. Voytyuk ◽  
V.V. Lysytsia ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Open Access ◽  
Hospital Stay ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Lower Percentage ◽  
Hernia Surgery ◽  
Inguinal Hernias ◽  
Inguinal Hernia Surgery

Purpose – to analyze condition of patients after surgical treatment of inguinal hernias by laparoscopic and open methods. Materials and methods. A retrospective review of medical histories and outpatient charts of all patients who underwent inguinal hernia surgery at the Kyiv City Clinical Hospital No. 1 from January 2018 to July 2020 was conducted. Results. During the above period of time in our hospital open hernioplasty was performed in 86 patients, laparoscopic hernioplasty – 138 patients. With open hernioplasty, the average duration of surgical treatment was 40±12 minutes. The laparoscopic technique was 35±12 minutes. The length of hospital stay was significantly longer in the group of patients with the open method (48±12 hours) than in the group of laparoscopic plastic surgery (12±3 hours). From the group of patients who underwent open hernioplasty, 62 patients complained of long-term pain syndrome, from the group of laparoscopy – 12 patients. The cosmetic appearance was dissatisfied with 34 patients in the open access group and only 2 patients in the laparoscopic plastic group. Postoperative complications were observed in 34 patients who underwent surgical treatment through open access, and in 15 patients – by laparoscopy. Conclusions. The laparoscopic approach of inguinal hernia surgery is superior to open access, as it reduces the length of hospital stay, postoperative recovery, improves the aesthetic effect of the operation, reduces the frequency of infection of incisions. According to the results of the study, this technique gives a better result in the early postoperative period, a lower percentage of chronic pain and a higher degree of patient satisfaction compared to open access with the same low recurrence rate. Therefore, in our opinion, laparoscopic access to hernioplasty is the optimal method of treatment and can be recommended as a method of choosing inguinal hernia surgery. Postoperative assessment of the quality of life of patients after treatment of inguinal hernia by laparoscopic and open methods. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: inguinal hernia, laparoscopy, open access surgery, analysis of methods, operation.

957 Comparison of Inguinodynia In Patients Undergoing Prophylactic Ilioinguinal Neurectomy vs No Neurectomy In Lichtenstein Mesh Hernioplasty

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Z Hashmi ◽  
R Ahmed ◽  
M Ahmed ◽  
N Yousaf ◽  
T Zafar ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Pain Score ◽  
Local Anesthesia ◽  
Age Group ◽  
Younger Age ◽  
Lichtenstein Hernia Repair ◽  
Male Patients ◽  
Group 10 ◽  
Mesh Hernioplasty

Abstract Objective The objective of this study is to compare the frequency of inguinodynia in ilioinguinal neurectomy VS no neurectomy in patients undergoing Lichtenstein mesh hernioplasty. Method 200 male patients with unilateral, primary, reducible inguinal hernia were randomly distributed in to two groups by using lottery method to undergo Lichtenstein’s hernia repair i.e., with and without ilioinguinal neurectomy. All the operation were carried out under local anesthesia. Pain score was calculated using the VAS system at 3rd month and inguinodynia was labelled if it is more than 1 on VAS scale. Results 200 male patients with mean age of 53.25 ± 6.768 were included. 42 (21%) had Inguinodynia after surgery. When we cross tabulated both groups with inguinodynia, results came up significant (p = 0.001). In neurectomy group 10 patients had inguinodynia while in no neurectomy group, 32 patients were having Inguinodynia. There was no effect of malnutrition on outcome. Younger age group benefitted more from procedure. Conclusions It is concluded that there is difference in frequency of inguinodynia in ilioinguinal neurectomy versus no neurectomy in patients undergoing Lichtenstein hernia repair. Patients with ilioinguinal neurectomy had reduced incidence of inguinodynia.

scholarly journals A COMPARATIVE AND RANDOMIZED STUDY BETWEEN TRANS ABDOMINAL PRE-PERITONEAL VERSUS TOTALLY EXTRA-PERITONEAL LAPAROSCOPIC TECHNIQUES OF INGUINAL HERNIA REPAIR

2020 ◽  
pp. 26-29
Author(s):  
Nikhil Agrawal ◽  
Swapnil Sen
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Statistical Hypothesis ◽  
Categorical Variables ◽  
Chi Squared

A hernia, an abnormal protrusion of an organ or tissue through a defect in its surrounding wall is a very common surgical problem. Approximately 75% of all hernias are usually groin hernias, among which 95% are inguinal region hernias. Various methods of repair have been employed which have progressed from open repair to various laparoscopic approaches. There is insufficient data to draw conclusions about the relative effectiveness of the two laparoscopic methods. Overall superiority of the two laparoscopic methods has not been demonstrated in available literature. AIM: The purpose of this study is to compare the clinical effectiveness and relative efficiency of laparoscopic TAPP and laparoscopic TEP for inguinal hernia repair. MATERIALS AND METHODS: Hospital based comparative randomised study on 100 patients admitted in General Surgical wards with Inguinal hernia at a tertiary care centre of Eastern India. Randomization in two groups was done by lottery system. A well designed proforma containing various parameters under study was used for data collection. Baseline information were collected via structured interview using predesigned questionnaire. For statistical analysis data were entered into a Microsoft excel spreadsheet and then analyzed by SPSS version 24 and GraphPad Prism version 5. Data had been summarized as mean and standard deviation for numerical variables and count and percentages for categorical variables. Two-sample t-tests for a difference in mean involved independent samples or unpaired samples. Paired t-tests were a form of blocking and had greater power than unpaired tests. A chi-squared test (χ2 test) was any statistical hypothesis test wherein the sampling distribution of the test statistic is a chi-squared distribution when the null hypothesis is true. Unpaired proportions were compared by Chi-square test or Fischer’s exact test, as appropriate. RESULTS: TAPP was associated with significantly higher incidence of haematoma, length of hospital stay, early postoperative pain and longer operative time as compared to TEP. Visceral injury and vascular injury were found more in TAPP as compared to TEP but this was not statistically significant. Seroma, port site hernia, persisting numbness and mesh/deep infection was higher in group-A (TAPP) as compared to group-B (TEP) but this was not statistically significant. Conversion to open procedure and persistent pain were comparable among the two methods. Hernia recurrence rates were higher in the TEP group in this study although it was statistically insignificant. CONCLUSION: TAPP was associated with significantly higher incidence of haematoma, length of hospital stay, early postoperative pain and longer operative time as compared to TEP.

scholarly journals Managing bilateral inguinal hernia laparoscopically: is it gold standard?

2016 ◽  
Vol 4 (1) ◽  
pp. 296
Author(s):  
Kalpesh H. Patel ◽  
Jayesh B. Gohel ◽  
Bhumika J. Patel
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Bilateral Inguinal Hernia ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background:Even after many studies done in recent years, no consensus has been achieved on the surgical technique of inguinal hernia repair. It was believed that in bilateral inguinal hernia cases laparoscopic surgery is very much advantageous as it can be done through same incisions as unilateral laparoscopic inguinal hernia repair (no additional incision required), whereas in open surgery for bilateral case separate groin incision for each side required. Aim of this study is to evaluate and compare results of bilateral inguinal hernia patients operated by laparoscopic (transabdominal preperitoneal) or open (lichenstein) repair.Methods: A prospective comparative study was conducted in a tertiary care teaching hospital over the period of two years. 60 patients with bilateral inguinal hernia were taken up and randomly divided into two groups. Group I (study group) includes patients operated by bilateral laparoscopic hernia repair (TAPP) and Group II (control group) includes patients operated by open hernia repair (lichenstein tension free hernioplasty). All patients were followed up for 18 months post-operatively. All patients of both groups were monitored for operative time, conversion rate, length hospital stay, post-operative complications and recurrence, time to return to work.Results:Statistically there was significant difference between both groups in terms of length of hospital stay and time to return to work. Group I patients where TAPP surgery performed, 22 patients (73.33%) were discharged within 36 hours of surgery, whereas in Group II patients - control group where open surgery performed, only 4 patients (13.33%) discharged within 36 hours. All 30 patients (100%) in group I had joined their routine work within 10 days of surgery; whereas in Group II patients only 4 cases (13.33%) joined duties on or before 10 days and most of the patients 26 (86.67%) had taken more than 10 days to resume their duties. But there was no significant difference between operative time, complication rates and recurrence rates. All cases in group I were completed laparoscopically (no conversion to open repair).Conclusions:Simultaneous bilateral inguinal hernia repair laparoscopically does not increase the risk for the patient and has an equal morbidity compared with unilateral repair, length of hospital stay, and return to normal work and over all recovery after laparoscopic repair is faster than after open bilateral simultaneous repair. Laparoscopic inguinal hernia repair of bilateral hernias should be recommended as the gold standard.

scholarly journals The Comparison of Lichtenstein Procedure with and without Mesh-Fixation for Inguinal Hernia Repair

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Feyzullah Ersoz ◽  
Serdar Culcu ◽  
Yigit Duzkoylu ◽  
Hasan Bektas ◽  
Serkan Sari ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Early Stage ◽  
Standard Procedure ◽  
Mesh Fixation ◽  
Cost Effective ◽  
Repair Method ◽  
Lichtenstein Hernia Repair ◽  
Lichtenstein Procedure

Aim.Although inguinal hernia repair is the most frequently performed surgical procedure in the world, the best repair method has not gained acceptance yet. The ideal repair must be safe, simple, and easy to perform and require minimal dissection which provides enough exploration, maintain patient’s comfort in the early stage, and also be cost-effective, reducing operation costs, labor loss, hospital stay, and recurrence.Materials and Methods.There were eighty-five patients between the ages of 18 and 75, diagnosed with inguinal hernia in our clinic. Lichtenstein procedure for hernia repair was performed under spinal anesthesia in all patients. Forty-two patients had the standard procedure and, in 43 patients, the polypropylene mesh was used without fixation. All patients were examined and questioned on the 7th day of the operation in terms of pain, scrotal edema, and the presence of seroma and later on in the 6th postoperative month in terms of paresthesia, neuropraxia, and recurrence by a single physician.Results. Operative time and pain scores in the nonfixation group were significantly lower, without any increase in rates of recurrence.Conclusion.Based on these findings, in Lichtenstein hernia repair method, nonfixation technique can be used safely with better results.

scholarly journals A study of outcome and complications of emergency inguinal hernias repair

2020 ◽  
Vol 7 (2) ◽  
pp. 419
Author(s):  
Dinesh Prasad ◽  
Yash Patel
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Length Of Hospital Stay ◽  
Seroma Formation ◽  
Site Infection ◽  
Wound Site ◽  
Inguinal Hernias ◽  
Mesh Hernioplasty

Background: Mesh hernioplasty in patients undergoing emergency inguinal hernia repair is considered practically, irrespective of complications. The main aim of this study was to assess the morbidity of Lichtenstein mesh hernioplasty in treating obstructed inguinal hernias. Primary outcome measures were post-operative wound site infection, seroma formation, length of hospital stay, hanging testis, testicular infarct, inguinodynia and recurrence.Methods: This study was undertaken in the department of General Surgery, SMIMER, Surat, Gujarat, India from August 2016 to July 2019. Fifteen patients were operated and included in the study. All patients underwent standard Lichtenstein mesh hernioplasty for obstracted inguinal hernia repair in emergency operating room.Results: 5 patients (33%) developed wound site infection, 4 patients (27%) developed inguinodynia, 2 patient (13%) developed seroma formation, 1 patient (6%) developed hanging testis. 1 patient (6%) developed testicular infarct. Average postoperative hospital stay was 5.6 days (range =2-18 days).Conclusions: Mesh repairs can be safely performed in emergency inguinal hernia repair with acceptable morbidity.

scholarly journals Implementation of enhanced recovery after surgery in gynecological operations: a randomized controlled trial

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Amr Nady Abdelrazik ◽  
Ahmad Sameer Sanad
Keyword(s):  
Hospital Stay ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Gynecologic Surgery ◽  
Complication Rates ◽  
Control Groups ◽  
Analog Scale ◽  
Randomized Controlled

Abstract Background To investigate the effects of enhanced recovery after surgery (ERAS) in patients undergoing gynecologic surgery on length of hospital stay, pain management, and complication rate. Results The length of hospital stay was reduced in ERAS groups when compared with the control groups (3.46 days vs 2.28 days; P < 0.0001; CI − 1.5767 to − 0.7833 for laparotomy groups and 2.18 vs 1.76 days; P = 0.0115; CI − 0.7439 to − 0.0961 for laparoscopy groups respectively). Intraoperative fluid use was reduced in both ERAS groups compared to the two control groups (934 ± 245 ml and 832 ± 197 ml vs 1747 ± 257 ml and 1459 ± 304 respectively; P < 0.0001) and postoperative fluid use was also less in the ERAS groups compared to the control groups (1606 ± 607 ml and 1210 ± 324 ml vs 2682 ± 396 ml and 1469 ± 315 ml respectively; P < 0.0001). Pain score using visual analog scale (VAS) on postoperative day 0 was 4.8 ± 1.4 and 4.1 ± 1.2 (P = 0.0066) for both laparotomy control and ERAS groups respectively, while in the laparoscopy groups, VAS was 3.8 ± 1.1 and 3.2 ± 0.9 (P = 0.0024) in control and ERAS groups respectively. Conclusion Implementation of ERAS protocols in gynecologic surgery was associated with significant reduction in length of hospital stay, associated with decrease intravenous fluids used and comparable pain control without increase in complication rates.

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