ABSTRACT
Background: Hernia is a common problem of the modern world with an incidence ranging from 5 to 7%. Of all groin hernias, around 75% are inguinal hernias. Recently with the advancement in laparoscopy, endoscopic repairs seem to offer better quality of life, decreasing hospital stay and early return to work. Aim of the work was to evaluate a new technique for mesh fixation by Zein method of suturing and compare it with stapled mesh fixation in laparoscopic inguinal hernia repair transabdominal preperitoneal approach.Methods: The study is a randomized, prospective single group study. The study was conducted after the approval of the ethical committee of the surgical department, Menoufia University. It was conducted in Menoufia University Hospital on 50 patients with inguinal hernia who were operated upon between September 2018 and September 2019 with a minimal follow-up of 6 months.Results: Age of studied patients ranged from 27 to 55 years with mean 42.82±7.90 age/years. Regarding sex of studied patients, more than half (74%) of studied patients were males and (26%) were females. Regarding comparsion between high and low overall cost burden on the patient, it was interestingly found that high cost is associated with presence of complication like hematoma, prolonged stay in the hospital and prolonged use of antibiotics.Conclusions: Both the use of sutures and fixation of mesh by absorbable tacks approaches are similarly effective in terms of operative time, the incidence of recurrence, complications, and chronic pain coinciding with all the available literature.
ABSTRACT
Laparoscopic inguinal hernia repair (LIHR) is a surgical procedure of preperitoneal repair under laparoscope.It is well suited for young patients due to the advantages of postoperative slighter pain,faster resuming non-restrictive activities and better cosmetic effect.Total extraperitoneal and transabdominal preperitoneal (TAPP) are alternative for experienced surgeons and TAPP is recommended for complicated hernias or beginners.Most of the inguinal hernias in young males are congenital indirect hernias,accompanied with varicocele or cryptorchid.Varicocele can be handled simultaneously during LIHR and treatment scheme for cryptorchid should be formulated before LIHR according to different situations.Cryptorchid located in abdominal cavity or inner mouth can be resected in LIHR for resectable cryptorchid.Incaecerated scrotal hernia is common in young males and can be treated by hybridization technique.Femoral hernia should be paid attention in young females.Femoral hernia of most patients can be excised completely under laparoscope if combined with cyst of uterus round ligament.If possible,young females are suggested to preserve round ligament of uterus.Keyhole surgery and T-dissection are available for selected.