ABSTRACT
Background: Chronic groin pain (inguinodynia) following inguinal hernia repair is a significant, though under-reported problem. Mild pain lasting for a few days is common following mesh inguinal hernia repair. However, moderate to severe pain persisting more than 3 months after inguinal herniorrhaphy should be considered as pathological. The main aim of this study was to assess the incidence of inguinodynia in inguinal hernia repair patients at a tertiary centre.Methods: This non-randomized retrospective study was undertaken in the department of general surgery, SMIMER Hospital, Surat, Gujarat, India from August 2016 to July 2019. Total 940 patients were operated for inguinal hernia repair during this period. Out of these 940 patients, only 460 patients could be traced for clinical evaluation as Surat is an industrial city with very high percentage of migrant population and so only, they were included in the study.Results: In this study, total 460 patients were included, in which 310 patients were operated for open inguinal hernia repair and 150 patients were operated for laparoscopic hernia repair. Total 102 (22.17%) patients has developed inguinodynia out of 460 patients evaluated in this series. Incidence of inguinodynia is more in open inguinal hernia repair than laparoscopic inguinal hernia repair i.e., 24.83% versus 16.67%. Incidence of testicular complication in inguinodynia patients is more in open inguinal hernia repair and non in laparoscopic repair.Conclusions: Authors conclude that overall incidence of inguinodynia is 22.17% and incidence of inguinodynia is higher in open hernia repair in comparison to laparoscopic hernia repair (24.83% versus 16.67%). The incidence of mild inguinodynia is approximately eight times more common than severe inguinodynia.
ABSTRACT
Objective To investigate the effect of laparoscopic total extraperitoneal tension-free hernia repair (TEP) in the treatment of inguinal hernia with absorbable biological mesh.Methods A retrospective analysis of the clinical data of 19 patients with inguinal hernia with biological mesh was performed from September 2015 to September 2016 in Shengjing Hospital of China Medical University.The average operative time,average incision pain time,average postoperative venting time,average hospital stay,average operative cost,and long-term chronic pain,postoperative complications,and recurrence rate were observed.Results All the 19 patients were successfully operated.The average operation time was (35.0 ± 4.0) min,the average incision pain time was (1.5 ± 0.6) d,and the average postoperative venting time was (1.5 ± 1.2) d.The average hospital stay was (4.5 ±0.9) d,the average surgery cost was (23 534.6 ± 1 259.9) yuan.Two patients developed swelling of the scrotum after surgery,and one patient developed postoperative fat liquefaction.All patients were followed up for 1 year by telephone,with no recurrence,no serious complications,and chronic pain discomfort.Conclusions The application of absorbable biopsy TEP is a good and reliable way to treat inguinal hernia.Postoperative patients have mild pain and low complication rate.There is no recurrence in recent follow-up,and the short-term effect is satisfactory.It is a reliable method for the treatment of inguinal hernia.The cost is high,and can be selected according to age and individual needs.
ABSTRACT
Objective To summarize the clinical experience of laparoscopic total extraperitoneal hernia repair (TEP) combined with varicocele ligation for treating inguinal hernia combining with varicocele (VC).Methods Clinical data of 22 patients of inguinal hernia complicated with varicocele from April 2011 to April 2016 was retrospectively analyzed. All the patients were treated by TEP combined with high ligation of spermatic vein. Then monitor and analyzed clinical indexes intra- and postoperatively.Results The mean operation time was (55.0 ± 9.0) min, mean intraoperative blood loss was (5.5 ± 2.8) ml, all patients can eat after anesthesia recovery and off-bed after staying in bed for 24 hours; all patients don’t need postoperative analgesia; only 1 case suffered seroma postoperative; the average hospitalization time was (4.7 ± 0.9) days; postoperative follow-up of 1 to 5 year without recurrence.Conclusion The surgical effect of TEP combined with varicocele ligation is confirmed with less invasive, faster postoperative recovery and achieving an obvious social and economical effect, it is worthy of deserving further clinical application.
ABSTRACT
PURPOSE: Single port laparoscopic inguinal hernia repair has been performed to further reduce port related morbidities and to improve the cosmetic outcome. However, the cosmetic result of single port laparoscopic totally extraperitoneal inguinal hernia repair (TEP) has not been superior to that of transabdominal preperitoneal hernia repair (TAPP). The aim of this study is to introduce and assess the Single Umbilical Tangential Incision (SUTI) for Lap-TEP repair. METHODS: Forty one hernia repairs of 34 patients were performed using SUTI-TEP method. SUTI was made all along the inferolateral skin of the umbilical pit and a vertical incision of less than one centimeter was made in the supra- or infraumbilical skin if needed; the total length of the incision was 2~2.5 cm. SILS(TM) port and conventional instruments were used for the procedure. RESULTS: All procedures were completed without conversion to the conventional TEP procedure. Mean operation time was 73 minutes for unilateral primary hernia, 119 minutes for bilateral primary hernia, 88.5 minutes for unilateral recurrent hernia, and 120 minutes for bilateral recurrent hernia. There were two cases of wound seroma and four cases of urinary retention postoperatively. Other significant complications were not noted. There was no recurrence of hernia during the follow-up period of one to 24 months. At routine follow-up visit at three months postoperative, the scar was barely visible and overall level of patient satisfaction was very high. CONCLUSION: The SUTI-TEP inguinal hernia repair is safe and shows superior cosmetic results. Further studies are required in order to assess the long-term outcome.
Subject(s)
Humans , Cicatrix , Follow-Up Studies , Hernia , Hernia, Inguinal , Herniorrhaphy , Patient Satisfaction , Recurrence , Seroma , Skin , Urinary Retention , Wounds and InjuriesABSTRACT
PURPOSE: Laparoscopic totally extraperitoneal (TEP) herniorrhaphy is an effective surgical technique for recurrent inguinal hernia. The recent introduction of various types of prosthetic mesh and the technical improvements in laparoscopic herniorrhaphy have allowed this modality to be used for various types of recurrent inguinal hernias, although careful selection of surgical techniques is required according to the patient's condition and the type of previous surgery. METHODS: One thousand and thirty cases were scheduled to undergo laparoscopic TEP herniorrhaphies from December of 2000 to August of 2008. We retrospectively collected and analyzed the data on the patient characteristics, the types of hernia, the number of previous recurrences, the operating technique, the operating time, the postoperative hospital stay and the postoperative complications. RESULTS: A total of 86 herniorrhaphies were performed in 83 patients with recurrent inguinal hernias. The mean patient age was 50.4 years. The total number of recurrences among the 83 patients was 118 cases and the number of recurrences was as follows: 1st in 65 patients, 2nd in 12 patients, 3rd in 7 patients and 4th in 2 patients. Eighty one laparoscopic TEP herniorrhaphies were performed, and 5 cases were performed by laparoscopic transabdominal preperitoneal repair or laparoscopic intraperitoneal onlay mesh repair. The mean operative time was 29.9 minutes, and there was no statistical correlation between the type of prior herniorrhaphy and the operative time. The mean postoperative hospital stay was 0.9 days and no major complications occurred. CONCLUSION: Selecting the type of surgery to perform for treating recurrent inguinal hernia has become complicated due to many recent diversified techniques of herniorrhaphy. Although laparoscopic TEP herniorhaphy is effective for treating recurrent inguinal hernia, a meticulous approach and various surgical techniques are required when prosthetic mesh has been previously placed on the preperitoneal space.
Subject(s)
Humans , Hernia , Hernia, Inguinal , Herniorrhaphy , Inlays , Length of Stay , Operative Time , Postoperative Complications , Pyrazines , Recurrence , Retrospective StudiesABSTRACT
Objective To evaluate the clinical experience and skills of laparoscopic totally extraperitoneal hernia repair with non-stapling of mesh and without using a balloon dissection in order to spread and popularize this kind of operation.MethodsUnder general anesthesia,32 patients(42 sides)with inguinal hernias were repaired by laparoscopic totally extraperitoneal hernia repair with non-stapling of mesh and without using a dissection balloon from August 2005 to December 2007.ResultsAll of operations were successfully performed.The operative time was 60-120 minutes,the blood loss was 20-60 ml,and the length of postoperative hospitalization was 3 days.All cases were followed up for 8 to 18 months and found no recurrence.ConclusionLaparoscopic totally extraperitoneal hernia repair with non-stapling of mesh and without using a balloon dissection is feasible,reliable and effective,offering a low recurrence rate,while its price is higher than tension-free herniorrhaphy by traditional method.