ABSTRACT
Objective To study the feasibility and the efficacy of total extraperitoneal repair (TEP) under two laparoscopes.Methods Clinical data of 51 patients with inguinal hernia who underwent TEP under two laparoscopes from July 2015 to March 2016 in our hospital were analyzed retrospectively.During TEP,we added a 5-mm laparoscope for monitoring and exploration in the abdominal cavity.Results All the operations of TEP under two laparoscopes were successful.The operation time lasted 42-176 min with a mean of (74 ±27) min.The intraoperative blood loss was 5-30 ml with a mean of (12.8 ±5.9) ml.The length of postoperative hospital stay was 2-7 days with a mean of (4.0 ± 1.1) days.The percentage of postoperative complications was 11.8％ (6/51),including inguinal area seroma which accounted for 2.0％ (1/51),inguinal region pain accounting for 3.9％ (2/51),and postoperative urinary retention for 5.9％ (3/51).No infection was found.The follow-up period ranged from 3 to 11 months (mean,7 months),no recurrence was observed during this period.Conclusions TEP under two laparoscopes can treat inguinal hernia precisely.It is also helpful to find compound inguinal hernia and occult inguinal hernia.
ABSTRACT
PURPOSE: Laparoscopic herniorrhaphy (LH) has an advantage for evaluating the viability of incarcerated bowel. In this retrospective study, we aimed to review the data for use of the TEP technique in treating incarcerated hernias in order to document the feasibility of the laparoscopic procedure. METHODS: During a 2-year period from January 2008 to December 2009, one surgeon (C.S) at our institution operated on 27 patients with acutely (n=3) or chronically (n=24) incarcerated hernia. Incarcerated hernias were divided into acute or chronic types arbitrarily, based on who had symptoms of acute abdominal pain and signs of intestinal obstruction. For acute cases, the TEP procedure was done following laparoscopic transperitoneal evaluation to assess viability of the incarcerated bowel. RESULTS: All patients except one having a femoral hernia were male. Mean age was 41 years old (range, 25~75). No case converted from a laparoscopic to an open procedure. Two acute incarcerated cases contained a segment of small bowel and the other contained small bowel and omentum. All acute cases were operated on successfully on an emergency basis by laparoscopic TEP repair. All chronic cases contained omentum without bowel. In one case of acute and seven cases of chronic type, a small inguinal incision was made to reduce hernia contents. No recurrence was noticed at a mean of 13 months of follow-up. CONCLUSION: If there is no entrapment of bowel in chronic incarcerated cases, the TEP procedure will be satisfactory. It may be reasonable, however, to evaluate viability of bowel transperitoneally before doing a TEP procedure in acute cases.
Subject(s)
Humans , Male , Abdominal Pain , Emergencies , Hernia , Hernia, Femoral , Hernia, Inguinal , Herniorrhaphy , Imidazoles , Intestinal Obstruction , Laparoscopy , Nitro Compounds , Omentum , Pyrazines , Recurrence , Retrospective StudiesABSTRACT
Objective To summarize the clinical experiences and efficacy of laparoscopic total extraperitoneal repair(TEP) for inguinal hernia.Methods From April 2004 to August 2006,294 TEP operations was performed on 269 patients with inguinal hernia by using laparoscopy under epidural or general anesthesia.Among the patients,175 had indirect hernia,40 direct hernias,25 bilateral hernias,and 29 recurrent hernias.Results The operation was completed without converting to open surgeries in all the cases.The mean operation time was(63.1?37.5) min,blood loss(12.3 ?8.2) ml,and hospital stay(3.7 ?1.4) d.Of the patients,24 had peritoneal tearing(8.2%,24/269),4 had groin hematoma(2.4%,4/269),and 2 had foreign body sensation(0.7%,2/269).The patients were followed up for 6-12 months(median,9 months),the recurrence rate was 1.0%(3/294). Conclusion Laparoscopic TEP is safe and effective for patients with inguinal hernia.