RESUMEN
Background: Incisional hernias repair being done in large numbers there is still not a consensus about the best repair. Very few studies have been done on comparison open and laparoscopic incisional hernia repair.Methods: A prospective, cross-sectional study was undertaken in Department of Surgery of Civil Hospital. The study included total 50 patients, out of which 25 patients underwent open approach and rest of 25 patients, underwent laparoscopic approach. Patients were assigned to both the groups randomly.Results: Pain, duration of post-operative stay, and return to routine work is earlier in patients with laparoscopic repair mainly due to decreased pain, fewer complications, early mobility and faster return of bowel movements. Laparoscopic repair is more expensive and operative time is more as compared to open method.Conclusions: Keeping in view the advantages and limitations of laparoscopic repair, the choice among two surgical modalities should be made on a case to case basis depending on patient preference and characteristics.
RESUMEN
Objective@#To study the efficacy of relieving the postoperation pain by using mesh to stuture and fixate tissue during transabdominal preperitoneal hernioplasty (TAPP) in inguinal hernia patients.@*Metholds@#A retrospective analysis of 156 patients with inguinal hernia who underwent TAPP in Nanhai Hospital Affiliated to Southern Medical University from January 2016 to January 2017 was conducted, they were males, the average age was 50.84 years and the age range was from 33 to 62 years. Patients were divided into sacral nail group (n=120) and absorbable line group (n=36) according to the different methods of fixation of the iliac crest. Among them, the patients in the sacral nail group were fixed with iliac screws, and the patients in the absorbable line group were sutured with absorbable sutures. Pain visual analog scale (VAS) was used to compare the extent of postoperative pain in both groups. After the operation, through the outpatient review and telephone follow-up for 1 year, observed the recurrence of inguinal hernia in both groups. Measurement data were expressed as mean ± standard deviation (Mean±SD), t-test was used for comparison between groups; the Chi-square test was used to compare the count data between the two groups.@*Results@#Among them, 19 patients with moderate pain after operation in the nail group had an incidence of 15.8%. Two patients with moderate pain in the absorbable line group had an incidence of 5.6%. The difference between the two groups was statistically significant (χ2=2.511, P=0.013). The pain VAS of the patients in the sacral nail group was (3.08±1.36), and the absorbable line group was (2.50±0.91), the difference between the two groups was statistically significant (t=2.973, P=0.001). All patients had no recurrence after outpatient review and telephone follow-up for 1 year.@*Conclusion@#In TAPP, the application of absorbable suture fixed patch can effectively reduce postoperative pain.
RESUMEN
Objective To study the efficacy of relieving the postoperation pain by using mesh to stuture and fixate tissue during transabdominal preperitoneal hernioplasty (TAPP) in inguinal hernia patients.Metholds A retrospective analysis of 156 patients with inguinal hernia who underwent TAPP in Nanhai Hospital Affiliated to Southern Medical University from January 2016 to January 2017 was conducted,they were males,the average age was 50.84 years and the age range was from 33 to 62 years.Patients were divided into sacral nail group (n =120) and absorbable line group (n =36) according to the different methods of fixation of the iliac crest.Among them,the patients in the sacral nail group were fixed with iliac screws,and the patients in the absorbable line group were sutured with absorbable sutures.Pain visual analog scale (VAS) was used to compare the extent of postoperative pain in both groups.After the operation,through the outpatient review and telephone follow-up for 1 year,observed the recurrence of inguinal hernia in both groups.Measurement data were expressed as mean ± standard deviation (Mean ±-SD),t-test was used for comparison between groups;the Chi-square test was used to compare the count data between the two groups.Results Among them,19 patients with moderate pain after operation in the nail group had an incidence of 15.8％.Two patients with moderate pain in the absorbable line group had an incidence of 5.6％.The difference between the two groups was statistically significant (x2 =2.511,P =0.013).The pain VAS of the patients in the sacral nail group was (3.08-± 1.36),and the absorbable line group was (2.50 ±0.91),the difference between the two groups was statistically significant (t =2.973,P =0.001).All patients had no recurrence after outpatient review and telephone follow-up for 1 year.Conclusion In TAPP,the application of absorbable suture fixed patch can effectively reduce postoperative pain.
RESUMEN
Background: Hernia repairs, both inguinal and ventral/ incisional, are some of the most common surgeries performed in the world. Over the last 5 years, the field of hernia surgery has had a significant transformation thanks to many new and innovative surgical techniques as well as exponential growth in mesh and mesh technology. The aim of the study: To compare the intraoperative complications of TEP vs TAPP vs open hernioplasty in terms of operative time, major visceral or vessel injury and conversion rates. Materials and methods: This study was conducted in the Department of General Surgery, Government Stanley Medical College, and Chennai in 2018. 75 patients (25 cases of open hernioplasty, 25 cases of TAPP, 25 cases of TEP). Post-operative pain was recorded based on Visual Analog Scale and requirement of analgesics. Post-operative complications like urinary retention, wound seroma, wound hematoma, wound infection, port site infection, recurrence, mesh infection, bowel complication was collected with clinical examination and complications recorded. Results: The study involved 75 male patients who satisfied the inclusion criteria. 25 patients were subjected to Lichtenstein tension-free open hernioplasty, 25 treated with TEP, and another 25 subjected to TAPP. Among the 75 cases studied 21 cases were found to have left sided inguinal hernia, whereas 54 cases were having right sided hernia. Intraoperative complications like major vessel injury or bladder injury were observed. No intraoperative complications were encountered Rosy Adhaline Selvi, Manimegalai. Comparative study of complications following laparoscopic TEP versus TAPP versus open hernioplasty in inguinal hernia repair. IAIM, 2019; 6(3): 223-230. Page 224 during the study period in any of the groups. Post-operative urinary retention was found only in two cases of Lichtenstein tension-free open hernioplasty and this required bladder catheterization. All cases of laparoscopic hernioplasty were catheterized intraoperatively and catheter retained till postoperative day 1, hence urinary retention could not be assessed. The post-operative pain was measured using the Visual Analog Scale (VAS) 6 hours after the surgery. The patient was given a dose of Injection Tramadol 100mg in after the surgery. The pain scores were analyzed with Chi-square and the difference found to be statistically significant. Lichtenstein tension-free open hernioplasty was found to have increased postoperative pain when compared to laparoscopic repair. Among the laparoscopic repair, TAPP was found to have increased postoperative compared to TEP. The postoperative hematoma was observed in a single case of Lichtenstein open hernioplasty. The hematoma was in the subcutaneous plain and required drainage. Conclusion: Primary unilateral inguinal hernia without complications can be treated with Lichtenstein tension-free open hernioplasty or laparoscopic transabdominal preperitoneal hernioplasty or laparoscopic totally extraperitoneal hernioplasty. Lichtenstein open hernioplasty has an advantage over laparoscopic repair in terms of shorter duration of surgery and learning curve.