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Sample records for laparoscopic hernia repair

  1. Laparoscopic lumbar hernia repair.

    Science.gov (United States)

    Madan, Atul K; Ternovits, Craig A; Speck, Karen E; Pritchard, F Elizabeth; Tichansky, David S

    2006-04-01

    Lumbar hernias are rare clinical entities that often pose a challenge for repair. Because of the surrounding anatomy, adequate surgical herniorraphy is often difficult. Minimally invasive surgery has become an option for these hernias. Herein, we describe two patients with lumbar hernias (one with a recurrent traumatic hernia and one with an incisional hernia). Both of these hernias were successfully repaired laparoscopically.

  2. Laparoscopic repair of femoral hernia

    OpenAIRE

    Yang, Xue-Fei; Liu, Jia-Lin

    2016-01-01

    Laparoscopic repair of inguinal hernia is mini-invasive and has confirmed effects. Femoral hernia could be repaired through the laparoscopic procedures for inguinal hernia. These procedures have clear anatomic view in the operation and preoperatively undiagnosed femoral hernia could be confirmed and treated. Lower recurrence ratio was reported in laparoscopic procedures compared with open procedures for repair of femoral hernia. The technical details of laparoscopic repair of femoral hernia, ...

  3. Laparoscopic Repair of Morgagni Hernia

    Directory of Open Access Journals (Sweden)

    ilker murat arer

    2015-03-01

    Full Text Available Morgagni hernia is a congenital herniation of abdominal contents into the thoracic cavity through a retrosternal diaphragmatic defect and make up about 1 % - 5 % of all types of congenital diaphragmatic hernias. Surgical repair of Morgagni hernias is usually indicated when patients are symptomatic and have a high risk of strangulation or incarceration of the contained viscera. 71-year-old male patient admitted to emergency department with a 2-day history of abdominal pain, vomiting and obstipation. Laparoscopic repair for Morgagni hernia was performed. Laparoscopic repair for Morgagni hernia with mesh repair is secure, satisfactory and easily performed. [Cukurova Med J 2015; 40(Suppl 1: 71-74

  4. Laparoscopic repair of incisional hernia.

    Science.gov (United States)

    Lau, H; Lee, F; Patil, N G

    2001-09-01

    A 75-year-old man developed an incisional hernia over the upper abdomen following a wedge resection of a gastric stromal tumour in 1996. This is the first published report of a successful repair of an incisional hernia via a laparoscopic intraperitoneal on-lay technique using GORE-TEX DualMesh material in Hong Kong. Compared with conventional open repair of incisional hernia, long incisions and wound tension are avoided using the laparoscopic approach. This translates into a reduced risk of wound-related complications and facilitates recovery. In selected cases, minimally invasive surgery is a safe technique for the repair of incisional hernias.

  5. Revisional laparoscopic parastomal hernia repair.

    Science.gov (United States)

    Zacharakis, Emmanouil; Shalhoub, Joseph; Selvapatt, Nowlan; Darzi, Ara; Ziprin, Paul

    2008-01-01

    We herein report a laparoscopically performed re-do operation on a patient who had previously undergone a laparoscopic parastomal hernia repair. We describe the case of a 71-year-old patient who presented within 3 months of her primary laparoscopic parastomal hernia repair with recurrence. On relaparoscopy, dense adhesions to the mesh were found, and the mesh had migrated into the hernia sac. This had allowed loops of small bowel to herniate into the sac. The initial part of the procedure involved the lysis of adhesions. A piece of Gore-Tex DualMesh with a central keyhole and a radial slit was cut so that it could provide at least 3 cm to 5 cm of overlap of the fascial defect. The tails of the mesh were wrapped around the bowel, and the mesh was secured to the margins of the hernia with circumferential metal tacking and 4 transfascial sutures. The patient remains in satisfactory condition and no recurrence or any surgery-related problem has been observed during 8 months of follow-up. Revisional laparoscopic repair of parastomal hernias seems feasible and has been shown to be safe and effective in this case. The success of this approach depends on longer follow-up reports and standardization of the technical elements.

  6. Laparoscopic repair of left lumbar hernia after laparoscopic left nephrectomy.

    Science.gov (United States)

    Gagner, Michel; Milone, Luca; Gumbs, Andrew; Turner, Patricia

    2010-01-01

    Lumbar hernias, rarely seen in clinical practice, can be acquired after open or laparoscopic flank surgery. We describe a successful laparoscopic preperitoneal mesh repair of multiple trocar-site hernias after extraperitoneal nephrectomy. All the key steps including creating a peritoneal flap, reducing the hernia contents, and fixation of the mesh are described. A review of the literature on this infrequent operation is presented. Laparoscopic repair of lumbar hernias has all the advantages of laparoscopic ventral hernia repair.

  7. Laparoscopic repair of postoperative perineal hernia.

    LENUS (Irish Health Repository)

    Ryan, Stephen

    2010-01-01

    Perineal hernias are infrequent complications following abdominoperineal operations. Various approaches have been described for repair of perineal hernias including open transabdominal, transperineal or combined abdominoperineal repairs. The use of laparoscopic transabdominal repair of perineal hernias is not well-described. We present a case report demonstrating the benefits of laparoscopic repair of perineal hernia following previous laparoscopic abdominoperineal resection (APR) using a nonabsorbable mesh to repair the defect. We have demonstrated that the use of laparoscopy with repair of the pelvic floor defect using a non absorbable synthetic mesh offers an excellent alternative with many potential advantages over open transabdominal and transperineal repairs.

  8. Pain characteristics after laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Tolver, Mette A; Strandfelt, Pernille; Rosenberg, Jacob;

    2011-01-01

    Previous studies have shown different pain characteristics in different types of laparoscopic operations, but pain pattern has not been studied in detail after laparoscopic inguinal hernia repair. To optimise preoperative patient information and postoperative analgesic treatment the present study...

  9. Pain characteristics after laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Tolver, Mette A; Strandfelt, Pernille; Rosenberg, Jacob;

    2011-01-01

    Previous studies have shown different pain characteristics in different types of laparoscopic operations, but pain pattern has not been studied in detail after laparoscopic inguinal hernia repair. To optimise preoperative patient information and postoperative analgesic treatment the present study...... investigated postoperative pain in terms of time course, pain intensity and individual pain components during the first 4 days after transabdominal preperitoneal hernia repair (TAPP)....

  10. Laparoscopic Inguinal Hernia Repair

    Science.gov (United States)

    ... hernia occurs when the inside layers of the abdominal muscle have weakened, resulting in a bulge or tear. ... is a technique to fix tears in the abdominal wall (muscle) using small incisions, telescopes and a patch (mesh). ...

  11. Convalescence after laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Tolver, Mette Astrup; Rosenberg, Jacob; Bisgaard, Thue

    2016-01-01

    BACKGROUND: Duration of convalescence after inguinal hernia repair is of major socio-economic interest and an often reported outcome measure. The primary aim was to perform a critical analysis of duration of convalescence from work and activity and secondary to identify risk factors for unexpected...... prolonged convalescence after laparoscopic inguinal hernia repair. METHODS: A qualitative systematic review was conducted. PubMed, Embase and the Cochrane database were searched for trials reporting convalescence after laparoscopic inguinal hernia repair in the period from January 1990 to January 2016...... factors for prolonged convalescence extending more than a few days after laparoscopic inguinal hernia repair. CONCLUSIONS: Patients should be recommended a duration of 1-2 days of convalescence after laparoscopic inguinal hernia repair. Short and non-restrictive recommendations may reduce duration...

  12. Laparoscopic Ventral and Incisional Hernia Repair

    NARCIS (Netherlands)

    Wassenaar, E.B.

    2009-01-01

    Ventral and incisional hernia repair is one of the most frequently performed operations in daily surgical practice. Laparoscopic ventral and incisional hernia repair (LVIHR) is gaining increasing adoption in surgical practice. It has theoretical advantages but improvements in technique can still be

  13. Laparoscopic transabdominal extraperitoneal repair of lumbar hernia

    Directory of Open Access Journals (Sweden)

    Sharma A

    2005-01-01

    Full Text Available Lumbar hernias need to be repaired due to the risk of incarceration and strangulation. A laparoscopic intraperitoneal approach in the modified flank position causes the intraperitoneal viscera to be displaced medially away from the hernia. The creation of a wide peritoneal flap around the hernial defect helps in mobilization of the colon, increased length of margin is available for coverage of mesh and more importantly for secure fixation of the mesh under vision to the underlying fascia. Laparoscopic lumbar hernia repair by this technique is a tensionless repair that diffuses total intra-abdominal pressure on each square inch of implanted mesh. The technique follows current principles of hernia repair and appears to confer all benefits of a minimal access approach.

  14. Radiologic investigation after laparoscopic inguinal hernia repair

    Energy Technology Data Exchange (ETDEWEB)

    Larmark, Martin; Ekberg, Olle [Department of Diagnostic Radiology, Malmoe University Hospital, 205 02, Malmoe (Sweden); Montgomery, Agneta [Department of Surgery, Malmoe University Hospital, 205 02, Malmoe (Sweden)

    2003-12-01

    Laparoscopic instead of open surgical repair of inguinal hernias is becoming more frequent. Radiologists may expect different postoperative findings depending on the technique used. We studied how radiology had been used postoperatively and what findings were encountered after laparoscopic herniorraphy. Postoperative radiologic examinations related to hernia repair of all consecutive patients that had had laparoscopic herniorraphy in Malmoe University hospital between 1992 and 1998 were retrospectively evaluated. A total of 538 groins were included, 3.9% (n=21) of these were postoperatively examined with ultrasound (n=10), herniography (n=7), plain abdominal films (n=2), CT (n=1), or fistulography (n=1). Significant findings were found in five groins, namely, one sinus tract, two hematomas, one small bowel obstruction, and one recurrence of hernia. Four insignificant seromas were found. The characteristics of the findings and pitfalls are described. Symptoms resulting in radiologic examination are rare after laparoscopic herniorraphy. The radiologist must be familiar with the spectrum of such findings. (orig.)

  15. Laparoscopic repair of large incisional hernias.

    Science.gov (United States)

    Parker, Harris H; Nottingham, James M; Bynoe, Raymond P; Yost, Michael J

    2002-06-01

    Incisional hernias after abdominal operations are a significant cause of long-term morbidity and have been reported to occur in 3 to 20 per cent of laparotomy incisions. Traditional primary suture closure repair is plagued with up to a 50 per cent recurrence rate. With the introduction of prosthetic mesh repair recurrence decreased, but complications with mesh placement emerged ushering in the development of laparoscopic incisional herniorrhaphy. The records of patients who underwent laparoscopic incisional hernia repair between June 1, 1995 and September 1, 2001 were reviewed. Patient demographics, hernia defect size, recurrence, operative time, and procedure-related complications were evaluated. Fifty patients (22 male and 28 female, mean age 57 years with range of 24-83) were scheduled for laparoscopic incisional hernia repair between June 1, 1995 and September 1, 2001. The average patient was obese with a mean body mass index of 35.8 kg/m2 (range 16-57 kg/m2). Two patients (4%) had primary ventral hernias. Forty-eight patients (96%) had incisional hernias with 22 (46%) of these previously repaired with prosthetic mesh. Mean defect size was 206.1 cm2 (range 48-594 cm2). The average mesh size was 510.2 cm2 (range 224-1050 cm2). Gore-Tex DualMesh and Bard Composite Mesh were used in 84 and 16 per cent of the repairs, respectively. Mean operating time was 97 minutes. There were no deaths. Complications were seen in 12 per cent patients (six occurrences) and included two small bowel enterotomies, a symptomatic seroma requiring aspirate, a mesh reaction requiring a short course of intravenous antibiotics, and trocar site pain (two patients). There were no recurrences during a mean follow-up of 41 months (range 3-74 months). We conclude that laparoscopic incisional herniorrhaphy offers a safe and effective repair for large primary and recurrent ventral hernia with low morbidity.

  16. Total Extraperitoneal Preperitoneal Laparoscopic Hernia Repair Using Spinal Anesthesia

    OpenAIRE

    Molinelli, Bruce M.; Tagliavia, Alfonso; Bernstein, David

    2006-01-01

    Background: Laparoscopic herniorrhaphy is a well-debated approach to inguinal hernia repair. Multiple technical and outcome variables have been compared with those of traditional open inguinal hernia repairs. One of these variables is the choice of anesthesia. To date, no reports describe the use of spinal anesthesia for laparoscopic hernia repairs. We present herein a review of our experience with spinal anesthesia for the total extraperitoneal preperitoneal laparoscopic hernia repair (TEP)....

  17. Total Extraperitoneal Preperitoneal Laparoscopic Hernia Repair Using Spinal Anesthesia

    OpenAIRE

    2006-01-01

    Background: Laparoscopic herniorrhaphy is a well-debated approach to inguinal hernia repair. Multiple technical and outcome variables have been compared with those of traditional open inguinal hernia repairs. One of these variables is the choice of anesthesia. To date, no reports describe the use of spinal anesthesia for laparoscopic hernia repairs. We present herein a review of our experience with spinal anesthesia for the total extraperitoneal preperitoneal laparoscopic hernia repair (TEP)....

  18. Outcome of laparoscopic inguinal hernia repair in a South African ...

    African Journals Online (AJOL)

    Outcome of laparoscopic inguinal hernia repair in a South African private practice setting. ... South African Journal of Surgery ... hernia recurrence, chronic pain and technique preference if they had previously undergone an open repair.

  19. Laparoscopic hernia repair--when is a hernia not a hernia?

    National Research Council Canada - National Science Library

    Bunting, David; Szczebiot, Lukasz; Cota, Alwyn

    2013-01-01

    A wide range of diagnoses can present as inguinal hernia. Laparoscopic techniques are being increasingly used in the repair of inguinal hernias and offer the potential benefit of identifying additional pathology...

  20. Laparoscopic repair of a bilateral internal inguinal hernia with supravesical hernia – a case report

    Science.gov (United States)

    Kawaguchi, Tsutomu; Itoh, Tadao; Yoshii, Kazuhiro; Otsuji, Eigo

    2015-01-01

    Introduction Supravesical hernia is an exceptional subtype of internal inguinal hernia, and it is located between the median umbilical ligament and the medial umbilical ligament. The hernia is classified as two types: internal supravesical hernia and external supravesical hernia. Presentation of case Herein we report a rare case of external supravesical hernia successfully treated by laparoscopic procedure. The patient who complained right inguinal protrusion and mild frequent urination was diagnosed as right inguinal hernia and potential of left inguinal hernia using computed tomography. He underwent laparoscopic bilateral hernia repair, and intraoperative findings revealed right external supravesical hernia and left internal inguinal hernia. Discussion Laparoscopic hernia repair may make it possible to avoid overlooking of internal hernia such as supravesical hernia. Moreover it was possible to cover the hernia orifice and dissected layer of the dorsal site of urine bladder using bilateral approach in the current case. Conclusion In conclusions, laparoscopic hernia repair might be a surgical option for supravesical hernia. PMID:26263448

  1. Laparoscopic lumbar hernia repair in a child with lumbocostovertebral syndrome.

    Science.gov (United States)

    Jones, Sarah L; Thomas, Iona; Hamill, James

    2010-02-01

    Lumbocostovertebral syndrome is the association of a congenital lumbar hernia with rib and vertebral anomalies. We report the first case of a laparoscopic repair of a lumbar hernia in a child with lumbocostovertebral syndrome. Laparoscopic lumbar hernia repair appears to be safe and feasible in children.

  2. Laparoscopic repair of a Morgagni hernia

    Directory of Open Access Journals (Sweden)

    Sherigar J

    2005-01-01

    Full Text Available We report a case of laparoscopic repair of symptomatic Morgagni hernia (MH in an adult. A tension-free closure of the defect was carried out using a polypropylene mesh. The recovery was quick and uneventful. Two years after surgery, the patient is doing well. A search of the English-language surgical literature revealed a total of 55 cases of laparoscopic repair of MH reported: 40 in adults and 15 in children. The various modalities of diagnosis, operative techniques, and disease presentation are discussed.

  3. Laparoscopic Incisional Hernia Repair in Obese Patients

    Science.gov (United States)

    2005-01-01

    Background and Objectives: Laparoscopic incisional hernia repair is coming to the forefront as a preferred method of repair due to the advantages offered by minimally invasive techniques. To evaluate safety and feasibility of this approach in obese patients when performed by a general surgeon trained in basic laparoscopy with no prior experience in this technique, we reviewed our early experience in the first 18 patients. Methods: All patients with incisional hernias presenting to a single surgeon from 2000 to 2002 were offered laparoscopic repair. Patients were informed about the limited experience of the surgeon in this particular field. Those who consented were repaired laparoscopically using a standard 4-port technique, one 12-mm port and three 5-mm ports. All patients with body mass index ≥30 were included in this review. A retrospective review of the data included demographics, operative time, blood loss, hospital stay, postoperative complications, and patient satisfaction. Results: Nineteen laparoscopic repairs were completed in 18 patients. No conversions to open repair were necessary. All patients were females except for 2. All hernia sacs were left in place, some of which were empty while others required extensive lysis of adhesions to release sac contents. Mean fascial defect was 102.5 cm2. One defect was closed primarily without mesh, while the rest were closed using Composix mesh in 1 and Dual Plus Gore-Tex mesh in the rest. Three patients were discharged from the recovery room. Mean follow-up was 24 months. No wound or mesh infections occurred. Eight patients had no complications. Eight patients had asymptomatic seromas. Two patients had hematomas; none of them required drainage. One patient had nonspecific dizziness. One patient presented with bowel obstruction secondary to early recurrence (within a week). The repair was salvaged laparoscopically. Upon evaluation by telephone calls, all patients indicated extreme satisfaction with the results

  4. Controversies in laparoscopic repair of incisional hernia

    Directory of Open Access Journals (Sweden)

    Sarela Abeezar

    2006-01-01

    Full Text Available Background: Incisional hernias can be a significant problem after open abdominal surgery. Laparoscopic incisional hernia repair (LIHR is conceptually appealing: a large, abdominal wall re-incision with potential wound-related ill effects is avoided and an intra-peritoneal onlay mesh is expected to provide security that is equivalent to open, retro-muscular mesh repair. As such, LIHR has gained substantial popularity despite sparse, randomised clinical data to compare with conventional, open repair. Aim: To enumerate and discuss important, controversial issues in patient-selection, technique and early post-operative care for LIHR. Materials and Methods: Pragmatic summary of comprehensive review of English language literature, discussion with experts and personal experience. Outcomes: Six important areas of some dispute were identified: 1. Size of abdominal-wall defect that is suitable for LIHR: Generally, defect-diameter > 10 cm is better served by open retromuscular repair with tension-free re-approximation of the edges of the defect. 2. Extent of adhesiolysis: Complete division of adhesions to the anterior abdominal wall may identify sub-clinical "Swiss-cheese" defects but incurs some risk of additional complications. 3. Intra-operative recognition of enterotomy: Possible options are either laparoscopic suture of bowel injury and simultaneous completion of LIHR, or staged LIHR or conversion to open suture-repair. 4. Choice of mesh: "Composite" meshes are regarded as the current standard of care but there is paucity of data regarding potential dangers of intra-peritoneal polypropylene mesh. 5. Technique of mesh-fixation: Trans-parietal sutures are more secure than tacks, with limited data to correlate with post-operative pain. 6. Alarm over post-operative pain: Unlike other advanced laparoscopic operations, the specificity of pain as a marker of intra-abdominal sepsis after LIHR remains unclear. Conclusion : Recognition of and attention to

  5. Laparoscopic mesh repair of parahiatal hernia: a case report.

    Science.gov (United States)

    Lew, Pei Shi; Wong, Andrew Siang Yih

    2013-08-01

    We report a case of a primary parahiatal hernia that was repaired laparoscopically with a composite mesh. A 51-year-old woman presented with vomiting and epigastric pain. CT scan showed a giant paraesophageal hernia with intrathoracic gastric volvulus. Intraoperatively, a diaphragmatic muscular defect was found lateral to an attenuated left crus of the diaphragm, distinct from the normal esophageal hiatus. The defect ring was fibrotic, making a tension-free primary repair difficult. A laparoscopic mesh repair was performed with a composite mesh, which was covered with the hernia sac to prevent potential erosion into the esophagus or stomach. Recovery was uneventful and the patient was discharged on the 5 days postoperatively. She remained asymptomatic at subsequent follow-up. Laparoscopic repair of parahiatal hernia can be safely performed. In circumstances where a large or fibrotic defect prevents a tension-free primary repair, the use of a composite mesh can provide effective repair of the hernia.

  6. Scarless laparoscopic repair of epigastric hernia in children

    OpenAIRE

    2015-01-01

    Background Despite the small size of the incision, the scar left by open repair of epigastric hernia in children is unaesthetic. Few laparoscopic approaches to epigastric hernia repair have been previously proposed, but none has gain wide acceptance from pediatric surgeons. In this study, we present our experience with a scarless laparo- scopic approach using a percutaneous suturing technique for epigastric hernia repair in children. Methods Ten consecutive patients presenting with ep...

  7. Two Ports Laparoscopic Inguinal Hernia Repair in Children

    Directory of Open Access Journals (Sweden)

    Medhat M. Ibrahim

    2015-01-01

    Full Text Available Introduction. Several laparoscopic treatment techniques were designed for improving the outcome over the last decade. The various techniques differ in their approach to the inguinal internal ring, suturing and knotting techniques, number of ports used in the procedures, and mode of dissection of the hernia sac. Patients and Surgical Technique. 90 children were subjected to surgery and they undergone two-port laparoscopic repair of inguinal hernia in children. Technique feasibility in relation to other modalities of repair was the aim of this work. 90 children including 75 males and 15 females underwent surgery. Hernia in 55 cases was right-sided and in 15 left-sided. Two patients had recurrent hernia following open hernia repair. 70 (77.7% cases were suffering unilateral hernia and 20 (22.2% patients had bilateral hernia. Out of the 20 cases 5 cases were diagnosed by laparoscope (25%. The patients’ median age was 18 months. The mean operative time for unilateral repairs was 15 to 20 minutes and bilateral was 21 to 30 minutes. There was no conversion. The complications were as follows: one case was recurrent right inguinal hernia and the second was stitch sinus. Discussion. The results confirm the safety and efficacy of two ports laparoscopic hernia repair in congenital inguinal hernia in relation to other modalities of treatment.

  8. Fibrin sealant for mesh fixation in laparoscopic umbilical hernia repair

    DEFF Research Database (Denmark)

    Eriksen, J R; Bisgaard, T; Assaadzadeh, S;

    2013-01-01

    Fibrin sealant for mesh fixation has significant positive effects on early outcome after laparoscopic ventral hernia repair (LVHR) compared with titanium tacks. Whether fibrin sealant fixation also results in better long-term outcome is unknown.......Fibrin sealant for mesh fixation has significant positive effects on early outcome after laparoscopic ventral hernia repair (LVHR) compared with titanium tacks. Whether fibrin sealant fixation also results in better long-term outcome is unknown....

  9. Single-Incision Laparoscopic Repair of Spigelian Hernia

    Science.gov (United States)

    Tran, Kim; Zajkowska, Marta; Lam, Vincent; Hawthorne, Wayne J.

    2015-01-01

    Introduction: Spigelian hernias represent only 1% to 2% of all abdominal wall hernias. The treatment, however, remains controversial but depends on institutional expertise. This case series reports the first experience with single-incision laparoscopic totally extraperitoneal (SILTEP) repair of Spigelian hernias with telescopic extraperitoneal dissection in combination with inguinal hernia repair. Methods: From February 2013 to April 2014, all patients referred with inguinal or Spigelian hernias, without histories of extraperitoneal intervention, underwent SILTEP repair with telescopic extraperitoneal dissection. A single-port device, 5.5 mm/52 cm/30° angled laparoscope, and conventional straight dissecting instruments were used for all cases. Extraperitoneal dissection was performed under direct vision with preservation of preperitoneal fascia overlying retroperitoneal nerves. Inguinal herniorrhaphy was performed with lightweight mesh that covered low-lying Spigelian defects. High-lying Spigelian defects were repaired with additional mesh. Results: There were 131 patients with 186 (92 direct) inguinal hernias and 7 patients with 8 Spigelian hernias (6 incidental, including 1 bilateral and 2 preoperatively diagnosed), with a mean age of 51.3 years and a mean body mass index of 25.1 kg/m2. An additional piece of mesh was used for 3 hernias. All Spigelian hernias were associated with direct inguinal hernias, and 8 combined inguinal and Spigelian hernias were successfully repaired with SILTEP repair with telescopic extraperitoneal dissection as day cases. There were no clinical recurrences during a mean follow-up period of 6 months (range, 1–15 months). Conclusions: Combined Spigelian and inguinal hernias can be successfully treated with SILTEP herniorrhaphy with telescopic extraperitoneal dissection. The high incidence of Spigelian hernias associated with direct inguinal hernias suggests a high index of suspicion for Spigelian hernias during laparoscopic inguinal

  10. Laparoscopic repair of abdominal wall hernia: one-year experience

    Science.gov (United States)

    Kavic, Michael S.

    1993-05-01

    In this study, 101 consecutive laparoscopic transabdominal preperitoneal hernia repairs (LTPR) were performed in 62 patients by a single surgeon. The series was begun in April 1991, and involved repair of 49 direct, 41 indirect, 4 femoral, 3 umbilical, 3 sliding, and 1 incisional hernias. Twelve cases were bilateral, eleven hernias were incarcerated, and fifteen hernias were recurrent. There were no intraoperative complications, and none of the procedures required conversion to open surgery. Patients experienced the following postoperative complications: transient testicular pain (1), transient anterior thigh paresthesias (2), urinary retention requiring TURP (1), and hernia recurrences (2). Follow up has ranged from 4 - 15 months and initial results have been encouraging.

  11. Laparoscopic and open incisional hernia repair: A prospective randomized study

    Directory of Open Access Journals (Sweden)

    Mehmet Zafer Sabuncuoğlu

    2015-07-01

    Full Text Available As the number of major surgical procedures has increased in recent years, so there has been an increase in incisional hernias. With gained experience and new materials, laparoscopic repair of incisional hernia is now applied. This study was aimed to compare the results of incisional hernia repair with the open surgery or laparoscopic approach at the only centre in the region for laparoscopic incisional hernia repair. A total of 55 cases of incisional hernia at the General Surgery Clinic of SDU between November 2012 and 2014 were underwent laparoscopic ventral hernia repair (L-VHR and conventional incisional hernia repair (C-VHR. From the L-VHR group 6 cases and from the C-VHR 9 cases were excluded from the study, as they did not meet the inclusion criteria or did not wish to participate in the study. The two techniques were compared in respect of operative time, length of hospital stay, postoperative pain scores, complications and recurrence. A total of 40 cases of incisional hernia repair were evaluated. The mean follow-up period was found as 12.75±4.19 months. No difference was determined between the characteristics of the patients due to age, body mass index, American Society of Anesthesiologists (ASA score, comorbidities, hernia size, and follow-up. In the laparoscopic repair group, the postoperative pain scores, complication rates and duration of hospital stay were found significantly superior to those of the open technique group. While there was no mortality seen and wound complications as a morbidity were 0 % in the L-VHR (n = 0 and 20 % in C-VHR group (n = 4. In the comparison of mean operative time, the duration of surgery was significantly shorter in the laparoscopic repair group (67.25±19.23 min compared to the open technique group (91.50±24.87 min (p=0.001. Laparoscopic repair was associated with less postoperative pain (4.35±1.03 vs 5.60±1.31, p=0.002, lesser postoperative complications (5% vs. 35%, p=0.044, and shorter

  12. Laparoscopic repair of diaphragmatic hernia after left ventricular assist device.

    Science.gov (United States)

    Farma, Jeffrey; Leeser, David; Furukawa, Satoshi; Dempsey, Daniel T

    2003-06-01

    This case report describes a patient with a symptomatic diaphragmatic hernia that developed after orthotopic heart transplantation and explantation of a left ventricular assist device. The hernia was repaired laparoscopically, and at 6-month follow-up, she is without evidence of recurrence.

  13. The clinical effects of closure of the hernia gap after laparoscopic ventral hernia repair:

    DEFF Research Database (Denmark)

    Christoffersen, Mette W; Westen, Mikkel; Assadzadeh, Sami;

    2014-01-01

    outcomes are patient-rated cosmesis and hernia-specific quality of life. METHODS: A randomised, controlled, double-blinded study is planned. Based on power calculation, we will include 40 patients in each arm. Patients undergoing elective laparoscopic umbilical, epigastric or umbilical trocar-site hernia......INTRODUCTION: Closure of the hernia gap in laparoscopic ventral hernia repair before mesh reinforcement has gained increasing acceptance among surgeons despite creating a tension-based repair. Beneficial effects of this technique have been reported sporadically, but no evidence is available from...... randomised controlled trials. The primary purpose of this paper is to compare early post-operative activity-related pain in patients undergoing laparoscopic ventral hernia repair with closure of the gap with patients undergoing standard laparoscopic ventral hernia repair (non-closure of the gap). Secondary...

  14. Systemic inflammatory responses during laparoscopic and open inguinal hernia repair: a randomised prospective study

    DEFF Research Database (Denmark)

    Jess, P; Schultz, Karen; Bendtzen, K

    2000-01-01

    To see if the inflammatory responses during and after laparoscopic and open inguinal hernia repairs differed.......To see if the inflammatory responses during and after laparoscopic and open inguinal hernia repairs differed....

  15. A Rare Case of Laparoscopic Repair of Simultaneously Occurring Morgagni and Paraesophageal Hernias.

    Science.gov (United States)

    Zhou, Zu-Li; Li, Hao; Li, Jian-Feng; Liu, Yan-Guo; Wang, Chong; Wang, Jun

    2016-01-01

    Simultaneously occurring Morgagni hernia and paraesophageal hernia is an extremely rare clinical condition with only six case reports in the English-language literature and only two laparoscopic repair reports. We report a 73-year-old woman with both Morgagni hernia and paraesophageal hernia who underwent successful laparoscopic repair of the hernia defects using transabdominal wall suturing. The laparoscopic operation can provide excellent exposure and repair the hernia defect easily with minimal invasiveness and fewer complications. This case report reported the concurring Morgagni and paraesophageal hernias and validated the feasibility of laparoscopic repair both hernias simultaneously.

  16. Occult hernias detected by laparoscopic totally extra-peritoneal inguinal hernia repair: a prospective study.

    Science.gov (United States)

    Dulucq, J-L; Wintringer, P; Mahajna, A

    2011-08-01

    One distinct advantage of laparoscopic inguinal hernia repair is the opportunity for clear visualization of the direct, indirect, femoral, obturator and other groin spaces. The aim of this study was to examine/assess the potential of the laparoscopic totally extraperitoneal (TEP) inguinal hernia repair method in detecting unexpected additional hernias. Patients who underwent an elective inguinal hernia repair, in the department of abdominal surgery at the institute of laparoscopic surgery (ILS, Bordeaux, France) between September 2003 and July 2005 were enrolled prospectively in the study. The patients' demographic data, operative, postoperative course and outpatient follow-up were studied. A total of 337 laparoscopic inguinal hernia repairs were performed in 263 patients. Of these, 189 patients had unilateral hernia (109 right and 80 left) and 74 patients had bilateral hernias. Indirect hernias were the most common, followed by direct and then femoral hernias. There were 218 male patients and 45 female patients with a mean age of 60 ± 15 years. There were 44 unexpected hernias: 6 spegilian hernias, 19 obturator hernias and another 19 femoral hernias. Two patients were converted to transabdominal preperitoneal (TAPP) due to surgical difficulties. There were no major intraoperative complications in all patients except for three cases of bleeding arising from the inferior epigastric artery. Only one patient had postoperative bleeding and was re-operated on several hours after the hernia repair. No recurrence occurred in the present series. The laparoscopic inguinal hernia repair approach allows viewing of the entire myopectineal orifice, facilitating repair of any unexpected hernias and thereby reducing the chance of recurrence.

  17. Laparoscopic repair of strangulated Morgagni hernia

    OpenAIRE

    2007-01-01

    Abstract A 73 year old man presented with vomiting and pain due to a strangulated Morgagni hernia containing a gastric volvulus. Laparoscopic operation allowed reduction of the contents, excision of necrotic omentum and the sac, with mesh closure of the large defect. A brief review of the condition is presented along with discussion of the technique used.

  18. Laparoscopic repair of strangulated Morgagni hernia

    Directory of Open Access Journals (Sweden)

    Kelly Michael D

    2007-10-01

    Full Text Available Abstract A 73 year old man presented with vomiting and pain due to a strangulated Morgagni hernia containing a gastric volvulus. Laparoscopic operation allowed reduction of the contents, excision of necrotic omentum and the sac, with mesh closure of the large defect. A brief review of the condition is presented along with discussion of the technique used.

  19. Video. Laparoscopic repair of congenital bilateral Morgagni hernia.

    Science.gov (United States)

    Khandelwal, Saurabh; Oelschlager, Brant K

    2011-06-01

    Morgagni hernia is a rare type of congenital diaphragmatic hernia found in the anterior aspect of the diaphragm. It typically presents in the pediatric population and rarely is diagnosed in adults. Only 3% of diaphragmatic hernias are the Morgagni type, and only 4% of these are found to present bilaterally. Surgical repair of Morgagni hernia has been performed through various approaches including open, laparoscopic, thoracotomy, and video-assisted thoracoscopic surgery (VATS), all with and without mesh. The optimal method of surgical repair is not known due to the rarity of this condition and the limitations of setting up a prospective, randomized trial to evaluate the different methods. Laparoscopic repair with mesh has been described with good short-term results. Few case reports exist in the world literature describing laparoscopic repair of a bilateral Morgagni hernia with mesh. At the University of Washington, the authors present a video showing their technique for laparoscopic repair of a congenital, bilateral Morgagni type hernia with mesh.

  20. Laparoscopic Morgagni hernia repair: how I do it.

    Science.gov (United States)

    Park, Adrian; Doyle, Courtney

    2014-10-01

    Surgical repair of Morgagni hernias is recommended given their historically high risk of incarceration. Traditionally, such repair has been undertaken via laparotomy or thoracotomy or more recently, thoracoscopically or laparoscopically using mesh. Here, we describe a laparoscopic approach to the management of Morgagni hernias achieving a primary tissue repair without mesh implantation. This technique allows for the general benefits of minimally invasive surgery, such as less postoperative pain, reduced wound complications, decreased duration of the hospital stay, as well as offering an alternative to mesh implantation and its associated potential complications.

  1. Current status of laparoscopic inguinal hernia repair in Denmark

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Bay-Nielsen, M

    2008-01-01

    BACKGROUND: Laparoscopic inguinal hernia repair is becoming more common in many countries, but the quality of care, experience of the operating surgeon, and details of the surgical technique are not known in detail on a national level in Denmark. In a period of expanding surgical volume for lapar......BACKGROUND: Laparoscopic inguinal hernia repair is becoming more common in many countries, but the quality of care, experience of the operating surgeon, and details of the surgical technique are not known in detail on a national level in Denmark. In a period of expanding surgical volume...... for laparoscopic inguinal hernia repair, it is important to know the typical indications for surgery, re-operation rates, details of surgical technique, and status of surgical training on a national level in order to rationalize interventions to improve outcome. METHODS: Data from the National Hernia Database...... for the last 8 years regarding laparoscopic inguinal hernia repair were used in combination with questionnaire data obtained from all surgical units in Denmark. The questionnaire included issues such as the number of operating surgeons in the department, number of residents training in the laparoscopic...

  2. Concurrent laparoscopic morgagni hernia repair and sleeve gastrectomy.

    Science.gov (United States)

    Chiou, Grace; Tedesco, Maureen; Eisenberg, Dan

    2012-12-01

    The Morgagni-type anterior diaphragmatic hernia is a congenital defect that is a very uncommon hernia presenting in an adult. Surgical repair is usually recommended upon diagnosis and often requires synthetic mesh for a durable, tension-free repair. The use of synthetic mesh concurrently with several of bariatric operations is controversial owing to the potential for mesh infection. In this report we describe a laparoscopic repair of a symptomatic Morgagni hernia with synthetic mesh, concurrently with sleeve gastrectomy, in a morbidly obese man. The patient was a 58-year-old man with a body mass index of 48 kg/m(2) and associated co-morbid conditions that included obstructive sleep apnea, hypertension, hyperlipidemia, impaired fasting glucose, and osteoarthritis. He was diagnosed with Morgagni hernia with exertional dyspnia. He underwent concurrent laparoscopic Morgagni hernia repair with mesh and sleeve gastrectomy. At 2 months after surgery the patient was doing well and tolerating solid foods, and his percentage excess weight loss was 35%. He was exercising regularly and had no exertional dyspnea. Laparoscopy is an attractive approach to performing multiple intra-abdominal procedures concurrently. The Morgagni hernia repair with mesh can be performed safely and effectively using a laparoscopic approach. This can be performed concurrently with bariatric surgery in the morbidly obese.

  3. The Burnia: Laparoscopic Sutureless Inguinal Hernia Repair in Girls.

    Science.gov (United States)

    Novotny, Nathan M; Puentes, Maria C; Leopold, Rodrigo; Ortega, Mabel; Godoy-Lenz, Jorge

    2017-04-01

    Laparoscopic inguinal hernia repair in children is in evolution. Multiple methods of passing the suture around the peritoneum at the level of the internal inguinal ring exist. Cauterization of the peritoneum at the internal ring is thought to increase scarring and decrease recurrence. We have employed a sutureless, cautery only, laparoscopic single port repair of inguinal hernias and patent processus vaginalis (PPV) in girls. After institutional ethical review was obtained, a retrospective review of sutureless laparoscopic inguinal hernia repairs in girls by 4 surgeons at separate institutions was performed. Patient demographics, intraoperative findings, and postoperative outcomes were recorded and analyzed. The technique involves an umbilical 30° camera and either a separate 3 mm stab incision in the midclavicular line or a 3 mm Maryland grasper placed next to the camera, and the distal most portion of the hernia sac is grasped and pulled into the abdomen and cauterized obliterating the sac. Eighty inguinal hernias were repaired using this technique in 67 girls between July 2009 and September 2015. The ages and weights ranged from 1 month to 16 years and from 2 to 69 kg, respectively. There was one conversion to open approach because an incarcerated ovary was too close to the ring. A single umbilical incision was utilized in 85%. Fifty-seven percent patients had hernias on the right whereas 42% had hernias on the left. Of the patients with presumed unilateral hernias, 22 patients were found to have PPV and were treated through the same incisions, 17/22 were found during a contralateral hernia surgery and 5/22 were found incidentally during appendectomy. Average operative time for unilateral and bilateral hernias was 22 minutes (5-38 minutes) and 31 minutes (11-65 minutes), respectively. No patient required a hospital stay because of the hernia repair. At an average of 25 months follow-up (1.6-75 months), there were no recurrences. The only complication was

  4. Laparoscopic repair of hiatal hernias: Experience after 200 consecutive cases

    Directory of Open Access Journals (Sweden)

    Bjelović Miloš

    2014-01-01

    Full Text Available Introduction. Repair of hiatal hernias has been performed traditionally via open laparotomy or thoracotomy. Since first laparoscopic hiatal hernia repair in 1992, this method had a growing popularity and today it is the standard approach in experienced centers specialized for minimally invasive surgery. Objective. In the current study we present our experience after 200 consecutive laparoscopic hiatal hernia repairs. Methods. A retrospective cohort study included 200 patients who underwent elective laparoscopic hiatal hernia repair at the Department for Minimally Invasive Upper Digestive Surgery, Clinic for Digestive Surgery, Clinical Center of Serbia in Belgrade from April 2004 to December 2013. Results. Hiatal hernia types included 108 (54% patients with type I, 30 (15% with type III, 62 (31% with giant paraesophageal hernia, while 27 (13.5% patients presented with a chronic gastric volvulus. There were a total of 154 (77% Nissen fundoplications. In 26 (13% cases Nissen procedure was combined with esophageal lengthening procedure (Collis-Nissen, and in 17 (8.5% Toupet fundoplications was performed. Primary retroesophageal crural repair was performed in 164 (82% cases, Cleveland Clinic Foundation suture modification in 27 (13.5%, 4 (2% patients underwent synthetic mesh hiatoplasty, 1 (0.5% primary repair reinforced with pledgets, and 4 (2% autologous fascia lata graft reinforcement. Poor result with anatomic and symptomatic recurrence (indication for revisional surgery was detected in 5 patients (2.7%. Conclusion. Based on the result analysis, we found that laparoscopic hiatal hernia repair was a technically challenging but feasible technique, associated with good to excellent postoperative outcomes comparable to the best open surgery series.

  5. Laparoscopic Repair of Sportman's Hernia - The Trinidad Experience.

    Science.gov (United States)

    Gopeesingh, Anyl; Dan, Dilip; Naraynsingh, Vijay; Hariharan, Seetharaman; Seetahal, Shiva

    2014-01-01

    Sportman's hernia: (Athletic pubalgia) is an uncommon and poorly understood condition afflicting athletic individuals. Sufferers complain of chronic groin pain and often present diagnostic dilemmas to physicians and physiotherapists. We present a series of cases illustrating the varying presentations of sportman's hernia and diagnostic approaches that can be utilized to exclude common differentials. We also describe laparoscopic mesh repair as an effective treatment option for this condition.

  6. Functional outcome after laparoscopic and open incisional hernia repair

    NARCIS (Netherlands)

    H.H. Eker (Hasan); D. den Hartog (Dennis); W.E. Tuinebreijer (Wim); G.J. Kleinrensink (Gert Jan); H.J. Stam (Henk); J.F. Lange (Johan)

    2010-01-01

    textabstractAbstract: Background: The debate about the advantages of laparoscopic versus open incisional hernia repair is still ongoing. The primary outcomes of already published studies are mainly recurrence, pain and quality of life. Data on postoperative abdominal wall function after these corre

  7. Burst strength of laparoscopic and open hernia repair.

    Science.gov (United States)

    Brockman, J B; Patterson, N W; Richardson, W S

    2004-03-01

    There are few reports of overall strength of laparoscopic and open incisional hernia repair. After anesthesia, a 2-inch circular defect was made in the abdominal wall of 28 female swine. Gore-Tex DualMesh Biomaterial (W. L. Gore & Associates, Flagstaff, AZ) was used for all repairs. Sixteen animals underwent open repair and 12 underwent laparoscopic repair. Burst strength was detected within 2 weeks and at 6 weeks by euthanizing the animals and insufflating the abdominal cavity with water while measuring the intraabdominal pressure until it could no longer be pressurized. Three events occurred after insufflation: rupture around patch (R), dissection from insufflation or pressure monitoring sites (D), or rectal prolapse (P). Failure after open early repair occurred at 289 (range 219-388) mmHg with 7-R, 1-P and late 289 (196-343) mmHg with 1-R, 6-P. Failure after laparoscopic early repair occurred at 259 (191-388) mmHg with 4-R, 1-P, 1-D and late 291 (140-330) mmHg with 2-R, 1-P, 3-D. Late groups were less likely to rupture. Both hernia repairs are durable at early and late periods. Tissue ingrowth adds to repair strength. We could not show that one repair was stronger than the other. Nonetheless, laparoscopic repair tended to degrade by dissection, which was our highest pressure event.

  8. Laparoscopic intraperitoneal onlay mesh repair of incisional hernia.

    Science.gov (United States)

    Tsimoyiannis, E C; Tassis, A; Glantzounis, G; Jabarin, M; Siakas, P; Tzourou, H

    1998-10-01

    Improvements in laparoscopic techniques and equipment have engendered many new intraabdominal procedures. Laparoscopic hernioplasty was used in 11 patients with 12 incisional abdominal hernias. All repairs were made with an intraperitoneal onlay patch of expanded polytef Gore-Tex DualMesh Biomaterial. The patch was secured by whole-thickness sutures, tied subcutaneously through stab holes, and staples between the sutures to cover the hernia defect without excision of the hernia sac. There were three postoperative complications: one seroma, one hematoma, and one infection. These complications successfully healed without reoperation. No recurrence was observed during a follow-up of 8-21 months (average 15 months). It is concluded that laparoscopic incisional hernioplasty using the new Gore-Tex DualMesh Biomaterial, which is securely sutured and stapled on the abdominal wall, is a promising minimally invasive procedure. Continued follow-up is necessary to determine the long-term results.

  9. [Laparoscopic inguinal hernia repair "IPOM" with Dual-Mesh].

    Science.gov (United States)

    Catani, M; De Milito, R; Materia, A; Chiaretti, M; Spaziani, E; Manili, G; Simi, M

    2003-01-01

    The authors report their experience on laparoscopic hernioplasty using the Intraperitoneal Onlay Mesh Repair (IPOM) in 56 patients. 34 patients had a bilateral hernia, 6 of which were recurrent and 22 had a monolateral hernia, of which 9 had recurrent hernia. Overall, a total of 90 hernias were treated. The hernia repair was performed utilizing "GORE-TEX DualMesh Plus biomaterial with holes" in the first 32 cases and the latest "...Corduroy" type in the remaining 24 cases. The prostheses were fixed with titanium spiral tacks (Protack, AutoSuture, Tyco Healthcare). No intraoperative complications occurred and no conversion was necessary. Five minor post-operative complications (5.5%), 2 seromas and 3 transient paresthesias, were observed. Four patients (7.1%) needed analgesics after the first 24 hours. Mean hospital stay was 36 hours, with a minimum of 24 and a maximum of 48. Mean resumption of normal activity was 8 days with return to work within two weeks. At an average 18 months follow-up, 3 recurrences were recorded (3.3%). The results of this study as well as the meta-analysis of the series presented in the Literature, indicate that the IPOM may be a feasible, safe and effective procedure in the treatment of recurrent and bilateral hernias or when a hernia repair is performed during other laparoscopic procedures. The IPOM has infact been shown to be faster and easier than the other more commonly performed laparoscopic hernioplasties (TAPP and TEP). These data may also suggest to utilize this technique in particular cases of primitive hernia such as very active young males or heavy duty workers. However the limited series and the short follow-up ask for randomized prospective long term studies to definitely ascertain the true incidence of recurrence and therefore the effectiveness of this attractive procedure.

  10. Laparoscopic Repair of Giant Bochdalek Hernia in Adults.

    Science.gov (United States)

    Moser, Federico; Signorini, Franco José; Maldonado, Pablo Sergio; Gorodner, Veronica; Sivilat, Arturo Lopez; Obeide, Lucio Ricardo

    2016-11-01

    Bochdalek hernia is a congenital diaphragmatic defect that results from improper fusion of the septum transversum and the pleuroperitoneal folds. It rarely persists asymptomatic until adulthood. The reported incidence is as low as 0.17%. Surgical repair of the defect can be performed through the abdomen or through the chest, and in both cases open or through laparoscopy/thoracoscopy. We present 2 cases of fully laparoscopic repair of giant Bochdalek hernia in adults. In both cases we used a GORE(®) DUALMESH(®) and we had neither complications nor recurrence. It is worthy of mention that hernia sac was not found in any of the cases. This has been described as a distinct characteristic that confirms diagnosis. Bochdalek hernia in the adult is a rare entity that requires surgical treatment to avoid complications. CT scan of the abdomen and chest with oral and IV contrast is the gold standard for diagnosis.

  11. Laparoscopic vs open incisional hernia repair a randomized clinical trial

    NARCIS (Netherlands)

    H.H. Eker (Hasan); B.M. Hansson; M. Buunen (Mark); I.M.C. Janssen (Ignace); R.E.G.J.M. Pierik (Robert); W.C.J. Hop (Wim); H.J. Bonjer (Jaap); J. Jeekel (Hans); J.F. Lange (Johan)

    2013-01-01

    textabstractImportance: Incisional hernia is the most frequent surgical complication after laparotomy. Up to 30% of all patients undergoing laparotomy develop an incisional hernia. Objective: To compare laparoscopic vs open ventral incisional hernia repairwith regard to postoperative pain and

  12. Reoperation Rates for Laparoscopic vs Open Repair of Femoral Hernias in Denmark

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Bisgaard, Thue; Kehlet, Henrik

    2014-01-01

    IMPORTANCE: In Denmark approximately 10 000 groin hernias are repaired annually, of which 2% to 4% are femoral hernias. Several methods for repair of femoral hernias are used including sutured repair and different types of mesh repair with either open or laparoscopic techniques. The use of many...... laparoscopic vs open femoral hernia repair, analyzing data from a nationwide database. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort study was conducted. Data on femoral hernia repairs registered in the Danish Hernia Database from January 1998 until February 2012 were extracted and analyzed. All...... repairs were followed in the database and analyzed for reports of reoperation, which were used as a proxy for recurrence. Femoral hernia recurrence and inguinal hernia occurrence after the index repair were analyzed. EXPOSURE: Repair of a femoral hernia. MAIN OUTCOMES AND MEASURES: Reoperation...

  13. Surgical tension pneumothorax during laparoscopic repair of massive hiatus hernia: a different situation requiring different management

    National Research Council Canada - National Science Library

    Phillips, S; Falk, G L

    2011-01-01

    During laparoscopic repair of massive hiatus hernia, surgical dissection can breach the parietal pleura allowing insufflating carbon dioxide to rapidly expand the pleural space, causing a tension pneumothorax...

  14. Pros and cons of tacking in laparoscopic hernia repair.

    Science.gov (United States)

    Reynvoet, Emmelie; Berrevoet, Frederik

    2014-11-01

    Present available fixation devices in laparoscopic hernia repair include transfascial sutures, (permanent or absorbable) tacks, and fibrin or synthetic sealants, all of which have advantages and disadvantages. Tack fixation has been applied since the introduction of laparoscopic inguinal and ventral hernia repair during the end of the 1980s and the beginning of the 1990s, respectively. However, although this type of penetrating fixation offers a reliable method to keep the mesh in place, several negative aspects have been highlighted in recent years. Permanent metallic fixation devices such as helical titanium tacks (Protack™ ) provide greater fixation strength than absorbable fixation devices (AbsorbaTack™, Permasorb™, or SorbaFix™), but as the titanium tacks remain in the body permanently, they have been associated with serious adverse events. Dense adhesion formation and erosion of tacks in hollow viscera have been reported as well as the formation of so-called "tack hernias." However, the most clinically important negative aspect might be the increased acute and chronic postoperative pain. As pain and quality of life, rather than recurrence rate, gained the attention of clinicians, researchers, and patients, recent developments have been focusing on different types of absorbable materials. However, studies that investigated these issues comparing different tack materials for mesh fixation did not show any benefit from any type of fixation. Despite the postoperative short- and long-term sequellae, tack fixation is still the most widely applied technique for laparoscopic mesh fixation.

  15. [Laparoscopic incisional hernia repair as first therapeutic choice].

    Science.gov (United States)

    Verbo, A; Petito, L; Pedretti, G; Manno, A; Rizzo, G; Masi, A; Coco, C

    2005-08-01

    Incisional hernias are one of the most frequent complications of open abdominal surgery. Historically, the best results have been obtained with the open rives-stoppa approach. This is done by fixing a large piece of prosthetic mesh behind the rectus muscle. Laparoscopic approach allows similar mesh placement with minimal dissection and lower recurrence rate compared to the open mesh repair. Between October 2001 to September 2003, 75 consecutive patients were scheduled to undergo laparoscopic incisional hernia repair with ePTFE mesh (Gore-Tex Dualmesh Plus). Postoperative complications were recorded and analysed. Most were obese affected by multiple wall defects Conversion to open surgery was required in 1 case Postoperative complications occurred 13.3%. Recurrence occurred in one only case. The key to the success of this procedure is avoidance of complications. The laparoscopic approach is safe, effective and relatively complication-free option in the management of patients presenting with a first time or recurrent incisional hernia and recommended as the treatment of choice.

  16. Initial outcomes of laparoscopic paraesophageal hiatal hernia repair with mesh.

    Science.gov (United States)

    Gebhart, Alana; Vu, Steven; Armstrong, Chris; Smith, Brian R; Nguyen, Ninh T

    2013-10-01

    The use of mesh in laparoscopic paraesophageal hiatal hernia repair (LHR) may reduce the risk of late hernia recurrence. The aim of this study was to evaluate initial outcomes and recurrence rate of 92 patients who underwent LHR reinforced with a synthetic bioabsorbable mesh. Surgical approaches included LHR and Nissen fundoplication (n = 64), LHR without fundoplication (n = 10), reoperative LHR (n = 9), LHR with a bariatric operation (n = 6), and emergent LHR (n = 3). The mean length of hospital stay was 2 ± 3 days (range, 1 to 30 days). There were no conversions to open laparotomy and no intraoperative complications. One of 92 patients (1.1%) required intensive care unit stay. The 90-day mortality was zero. Minor complications occurred in 3.3 per cent, major complications in 2.2 per cent, and late complications in 5.5 per cent of patients. There were no perforations or early hernia recurrence. The 30-day reoperation rate was 1.1 per cent. For patients with available 1-year follow-up, the overall recurrence rate was 18.5 per cent with a mean follow-up of 30 months (range, 12 to 51 months). LHR repair with mesh is associated with low perioperative morbidity and no mortality. The use of bioabsorbable mesh appears to be safe with no early hiatal hernia recurrence or late mesh erosion. Longer follow-up is needed to determine the long-term rate of hernia recurrence associated with LHR with mesh.

  17. Postoperative Comparison In Open Vs. Laparoscopic Ventral Hernia Repair In Obese Patients

    Directory of Open Access Journals (Sweden)

    Dogaru Iuliana

    2017-02-01

    Full Text Available Introduction: Obesity is an important problem in our society. Recent studies shows that laparoscopic ventral hernia repair has advantages in obese patients comparing with the standard open approach. This study wants to compare length of stay (LOS, hospitalization costs (HC and operative time (OT in laparoscopic and open ventral hernia repair.

  18. Use of mesh in laparoscopic paraesophageal hernia repair

    DEFF Research Database (Denmark)

    Müller-Stich, Beat P.; Kenngott, Hannes G.; Gondan, Matthias;

    2015-01-01

    Introduction. Mesh augmentation seems to reduce recurrences following laparoscopic paraesophageal hernia repair (LPHR). However, there is an uncertain risk of mesh-associated complications. Risk-benefit analysis might solve the dilemma. Materials and Methods. A systematic literature search...... was performed to identify randomized controlled trials (RCTs) and observational clinical studies (OCSs) comparing laparoscopic mesh-augmented hiatoplasty (LMAH) with laparoscopic mesh-free hiatoplasty (LH) with regard to recurrences and complications. Random effects meta-analyses were performed to determine...... potential benefits of LMAH. All data regarding LMAH were used to estimate risk of mesh-associated complications. Risk-benefit analysis was performed using a Markov Monte Carlo decision-analytic model. Results. Meta-analysis of 3 RCTs and 9 OCSs including 915 patients revealed a significantly lower...

  19. Laparoscopic Repair of a Right Paraduodenal Hernia

    OpenAIRE

    Bittner, James G; Edwards, Michael A.; Harrison, Steven J.; Li, Kelvin; Karmin, Paul N.; Mellinger, John D.

    2009-01-01

    Background and Objectives: Right paraduodenal hernia (PDH) results from a primitive gut malrotation. The resultant jejunal mesenteric defect posterior to the superior mesenteric vessels allows decompressed jejunum to herniate retroperitoneally. PDH make up 53% of all internal hernias, but account for only 0.2% to 5.8% of all cases of intestinal obstruction. In addition, PDH exhibits male and left-sided predominance. Ours is the second report to describe the preoperative diagnosis and totally ...

  20. Causes of recurrence in laparoscopic inguinal hernia repair

    Directory of Open Access Journals (Sweden)

    Kukleta Jan

    2006-01-01

    Full Text Available Aim: The analysis of possible mechanisms of repair failure is a necessary instrument and the best way to decrease the recurrence rate and improve the overall results. Avoiding historical errors and learning from the reported pitfalls and mistakes helps to standardize the relatively new laparoscopic techniques of trans-abdominal preperitoneal and total extraperitoneal. Materials and Methods: The video tapes of all primary laparoscopic repairs done by the author that led to recurrence were retrospectively analyzed and compared with findings at the second laparoscopic repair. A review of the available cases of recurrences occurring between 1994 and 2003 is the basis of this report. Summary: Adequate mesh size, porosity of mesh material, slitting of the mesh, correct and generous dissection of preperitoneal space and wrinkle-free placement of the mesh seem to be the more important factors in avoiding recurrence rather than strength of the material or strong penetrating fixation. Special attention should be paid to preperitoneal lipoma as a possible overlooked herniation or potential future pseudorecurrence despite nondislocated correctly positioned mesh. Conclusion: Laparoscopic hernia repair is a complex but very efficient method in experienced hands. To achieve the best possible results, it requires an acceptance of a longer learning curve, structured well-mentored training and high level of standardization of the operative procedure.

  1. Laparoscopic repair of Morgagni′s hernia: An innovative approach

    Directory of Open Access Journals (Sweden)

    Rasik S Shah

    2015-01-01

    Full Text Available Aim: To review our experience of laparoscopic repair of Morgagni′s hernia (MH using transfascial sutures. Materials and Methods: This is a retrospective review of patients presenting to the first author with the diagnosis of MH over a 15-year period. The variables analyzed included demographic data, clinical presentation, and operative details. Results: In all there were five male with a median age of 2 years. They were asymptomatic and MH was detected incidentally by observing an air-filled density in the right cardiophrenic angle on plain X-ray of the chest. Computed tomography (CT confirmed the diagnosis in all patients. All patients underwent laparoscopic repair of MH using transfascial sutures. The average operative time was 75 min. Oral feeding was started 6 h after surgery and patients were discharged on either 3 rd or 4 th postoperative day. Postoperative follow-up X-ray confirmed the intact repair. Conclusions: Laparoscopic repair of MH using transfascial sutures is an easy and effective solution. Multiple horizontal mattress sutures taking full thickness of abdominal wall muscles with the edge of the diaphragm leads to a strong repair. As sutures are tied extracorporeally, the technique is easily reproducible.

  2. Laparoscopic repair of Morgagni's hernia: An innovative approach

    Science.gov (United States)

    Shah, Rasik S.; Sharma, Pradeep Chandra; Bhandarkar, Deepraj S.

    2015-01-01

    Aim: To review our experience of laparoscopic repair of Morgagni's hernia (MH) using transfascial sutures. Materials and Methods: This is a retrospective review of patients presenting to the first author with the diagnosis of MH over a 15-year period. The variables analyzed included demographic data, clinical presentation, and operative details. Results: In all there were five male with a median age of 2 years. They were asymptomatic and MH was detected incidentally by observing an air-filled density in the right cardiophrenic angle on plain X-ray of the chest. Computed tomography (CT) confirmed the diagnosis in all patients. All patients underwent laparoscopic repair of MH using transfascial sutures. The average operative time was 75 min. Oral feeding was started 6 h after surgery and patients were discharged on either 3rd or 4th postoperative day. Postoperative follow-up X-ray confirmed the intact repair. Conclusions: Laparoscopic repair of MH using transfascial sutures is an easy and effective solution. Multiple horizontal mattress sutures taking full thickness of abdominal wall muscles with the edge of the diaphragm leads to a strong repair. As sutures are tied extracorporeally, the technique is easily reproducible. PMID:25829669

  3. First laparoscopic totally extraperitoneal repair of Laugier's hernia: a case report.

    Science.gov (United States)

    Ates, M; Dirican, A; Kose, E; Isik, B; Yilmaz, S

    2013-02-01

    An atypical femoral hernia developing through the lacunar ligament is called Laugier's hernia. Preoperative diagnosis of these atypical hernias is very difficult because of their rarity and similar clinical appearance to conventional femoral hernias. A 52-year-old female presented with right groin swelling. During laparoscopic totally extraperitoneal (TEP) inguinal hernia repair, a hernia sac through an opening in the lacunar ligament was diagnosed and repaired with mesh covering the inguinal floor. The surgeon should be alert to the possibility of an atypical femoral hernia when examining patients with inguinal hernias. A laparoscopic approach should be chosen instead of a conventional approach for the treatment of femoral hernias because of its high diagnostic and therapeutic capacity for all types of femoral hernia, including Laugier's.

  4. Laparoscopic vs open incisional hernia repair a randomized clinical trial

    NARCIS (Netherlands)

    H.H. Eker (Hasan); B.M. Hansson; M. Buunen (Mark); I.M.C. Janssen (Ignace); R.E.G.J.M. Pierik (Robert); W.C.J. Hop (Wim); H.J. Bonjer (Jaap); J. Jeekel (Hans); J.F. Lange (Johan)

    2013-01-01

    textabstractImportance: Incisional hernia is the most frequent surgical complication after laparotomy. Up to 30% of all patients undergoing laparotomy develop an incisional hernia. Objective: To compare laparoscopic vs open ventral incisional hernia repairwith regard to postoperative pain and nausea

  5. Primary fascial closure with laparoscopic ventral hernia repair: systematic review.

    Science.gov (United States)

    Nguyen, Duyen H; Nguyen, Mylan T; Askenasy, Erik P; Kao, Lillian S; Liang, Mike K

    2014-12-01

    Laparoscopic ventral hernia repair (LVHR) has grown in popularity. Typically, this procedure is performed with a mesh bridge technique that results in high rates of seroma, eventration (bulging), and patient dissatisfaction. In an effort to avoid these complications, there is growing interest in the role of laparoscopic primary fascial closure with intraperitoneal mesh placement. This systematic review evaluated the outcomes of closure of the central defect during LVHR. A literature search of PubMed, Cochrane databases, and Embase was conducted using PRISMA guidelines. MINORS was used to assess the methodologic quality. Primary outcome was hernia recurrence. Secondary outcomes were surgical-site infection, seroma formation, bulging, and patient-centered items (satisfaction, chronic pain, functional status). Eleven studies were identified, eight of which were case series (level 4 data). Three comparative studies examined the difference between closure and nonclosure of the fascial defect during laparoscopic ventral incisional hernia repairs (level 3 and 4 data). These studies suggested that primary fascial closure (n = 138) compared to nonclosure (n = 255) resulted in lower recurrence rates (0-5.7 vs. 4.8-16.7 %) and seroma formation rates (5.6-11.4 vs. 4.3-27.8 %). Follow-up periods for both groups were similar (1-108 months). Only one study evaluated patient function and clinical bulging. It showed better outcomes with primary fascial closure. Closure of the central defect during LVHR resulted in less recurrence, bulging, and seroma than nonclosure. Patients with closure were more satisfied with the results and had better functional status. The quality of the data was poor, however. A randomized controlled trial to evaluate the role of closure of the central defect during LVHR is warranted.

  6. Outcomes of robot-assisted versus laparoscopic repair of small-sized ventral hernias.

    Science.gov (United States)

    Chen, Y Julia; Huynh, Desmond; Nguyen, Scott; Chin, Edward; Divino, Celia; Zhang, Linda

    2017-03-01

    The aim of the study is to investigate the outcomes of the da Vinci robot-assisted laparoscopic hernia repair of small-sized ventral hernias with circumferential suturing of the mesh compared to the traditional laparoscopic repair with trans-fascial suturing. A retrospective review was conducted of all robot-assisted umbilical, epigastric and incisional hernia repairs performed at our institution between 2013 and 2015 compared to laparoscopic umbilical or epigastric hernia repairs. Patient characteristics, operative details and postoperative complications were collected and analyzed using univariate analysis. Three primary minimally invasive fellowship trained surgeons performed all of the procedures included in the analysis. 72 patients were identified during the study period. 39 patients underwent robot- assisted repair (21 umbilical, 14 epigastric, 4 incisional), and 33 patients laparoscopic repair (27 umbilical, 6 epigastric). Seven had recurrent hernias (robot: 4, laparoscopic: 3). There were no significant differences in preoperative characteristics between the two groups. Average operative time was 156 min for robot-assisted repair and 65 min for laparoscopic repair (p robot group [3.07 cm (1-9 cm)] than that for the laparoscopic group [2.02 cm (0.5-5 cm)] (p robot-assisted technique versus the standard laparoscopic repair.

  7. Seroma after laparoscopic repair of hernia with PTFE patch: is it really a complication?

    Science.gov (United States)

    Susmallian, S; Gewurtz, G; Ezri, T; Charuzi, I

    2001-09-01

    We evaluated the true incidence of seroma formation after laparoscopic repair of incisional hernia with polytetrafluoroethylene (PTFE) patch. In a prospective study, 20 patients who underwent laparoscopic repair of incisional hernia with PTFE were evaluated clinically and with ultrasound examination for seroma formation up to the 90th postoperative day. Seroma was diagnosed clinically in only 35% of cases, while ultrasound examination revealed the presence of seroma in 100% of patients. Ultrasound examination is a reliable tool for diagnosis of early or delayed postoperative seroma formation following laparoscopic repair of incisional hernia with Gore-Tex Dualmesh.

  8. Emergent Laparoscopic Repair of a Spigelian Hernia: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Reid Barker

    2013-01-01

    Full Text Available A spigelian hernia is a protrusion through an anterior abdominal wall defect along the linea semilunaris. The traditional method of repair consists of an open surgical technique requiring a lengthy abdominal incision to allow visualization of the defect. However, with the emergence and availability of laparoscopic techniques, a minimally invasive approach is feasible. Only eight prior case reports have documented emergent laparoscopic repair of a spigelian hernia. We describe the first successful laparoscopic repair of a spigelian hernia in an emergent setting at our institution.

  9. Non-intubated laparoscopic repair of giant Morgagni’s hernia for a young man

    Science.gov (United States)

    Zhang, Miao; Wang, Heng; Liu, Dong; Pan, Xuefeng; Wu, Wenbin; Hu, Zhengqun

    2016-01-01

    An asymptomatic patient was admitted as his chest photograph and computed tomography scans showed a giant Morgagni’s hernia (MH). And it was repaired by laparoscopic approach under epidural anesthesia without endotracheal intubation. The hernia content of omentum was repositioned back into the abdominal cavity, and the diaphragmatic defect was repaired with composite mesh. Which indicated that non-intubated laparoscopic mesh repair via epidural anesthesia is reliable and satisfactory for MH. PMID:27621903

  10. Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Using Memory-Ring Mesh: A Pilot Study

    OpenAIRE

    2016-01-01

    Purpose. To evaluate the feasibility, safety, and effectiveness of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair using a memory-ring patch (Polysoft™ mesh). Patients and Methods. Between April 2010 and March 2013, a total of 76 inguinal hernias underwent TAPP repair using Polysoft mesh in 67 adults under general anesthesia. Three different senior resident surgeons performed TAPP repair under the instruction of a specialist surgeon. Nine patients had bilateral hernias...

  11. Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Using Memory-Ring Mesh: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Takeshi Matsutani

    2016-01-01

    Full Text Available Purpose. To evaluate the feasibility, safety, and effectiveness of laparoscopic transabdominal preperitoneal (TAPP inguinal hernia repair using a memory-ring patch (Polysoft™ mesh. Patients and Methods. Between April 2010 and March 2013, a total of 76 inguinal hernias underwent TAPP repair using Polysoft mesh in 67 adults under general anesthesia. Three different senior resident surgeons performed TAPP repair under the instruction of a specialist surgeon. Nine patients had bilateral hernias. The 76 hernias included 37 indirect inguinal hernias, 29 direct hernias, 1 femoral hernia, 1 pantaloon hernia (combined direct/indirect inguinal hernia, and 8 recurrent hernias after open anterior hernia repair. The immediate postoperative outcomes as well as the short-term outcomes (mainly recurrence and incidence of chronic pain were studied. Results. There was no conversion from TAPP repair to anterior open repair. The mean operation time was 109 minutes (range, 40–132 for unilateral hernia repair. Scrotal seroma was diagnosed at the operation site in 5 patients. No patient had operation-related orchitis, testicle edema, trocar site infection, or chronic pain during follow-up. Conclusions. The use of Polysoft mesh for TAPP inguinal hernia repair does not seem to adversely affect the quality of repair. The use of this mesh is therefore feasible and safe and may reduce postoperative pain.

  12. Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair Using Memory-Ring Mesh: A Pilot Study

    Science.gov (United States)

    Nomura, Tsutomu; Matsuda, Akihisa; Takao, Yoshimune

    2016-01-01

    Purpose. To evaluate the feasibility, safety, and effectiveness of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair using a memory-ring patch (Polysoft™ mesh). Patients and Methods. Between April 2010 and March 2013, a total of 76 inguinal hernias underwent TAPP repair using Polysoft mesh in 67 adults under general anesthesia. Three different senior resident surgeons performed TAPP repair under the instruction of a specialist surgeon. Nine patients had bilateral hernias. The 76 hernias included 37 indirect inguinal hernias, 29 direct hernias, 1 femoral hernia, 1 pantaloon hernia (combined direct/indirect inguinal hernia), and 8 recurrent hernias after open anterior hernia repair. The immediate postoperative outcomes as well as the short-term outcomes (mainly recurrence and incidence of chronic pain) were studied. Results. There was no conversion from TAPP repair to anterior open repair. The mean operation time was 109 minutes (range, 40–132) for unilateral hernia repair. Scrotal seroma was diagnosed at the operation site in 5 patients. No patient had operation-related orchitis, testicle edema, trocar site infection, or chronic pain during follow-up. Conclusions. The use of Polysoft mesh for TAPP inguinal hernia repair does not seem to adversely affect the quality of repair. The use of this mesh is therefore feasible and safe and may reduce postoperative pain. PMID:27635414

  13. Laparoscopic Hernia Repair With 3-Millimeter Instruments: A Point of Technique and Illustrative Case Video.

    Science.gov (United States)

    Kassir, Radwan; Tiffet, Olivier; Bourbon, Michel; Meyer, Alberto; Gugenheim, Jean; Debs, Tarek; Amor, Imed Ben; Blanc, Pierre

    2015-08-01

    The repair of inguinal hernia has been a controversial issue in surgical practice since its conception. The article demonstrates that use of 3 mm instruments can be incorporated in Laparoscopic hernia repair. The second aim of this article is that use of TAP block (Transverse abdominal plane block) without curare is efficient, safe and reproducible.

  14. Clinical outcomes of single incision laparoscopic surgery and conventional laparoscopic transabdominal preperitoneal inguinal hernia repair

    Science.gov (United States)

    Ece, Ilhan; Yilmaz, Huseyin; Yormaz, Serdar; Sahin, Mustafa

    2017-01-01

    BACKGROUND: Laparoscopic surgery has been a frequently performed method for inguinal hernia repair. Studies have demonstrated that the laparoscopic transabdominal preperitoneal (TAPP) approach is an appropriate choice for inguinal hernia repair. Single-incision laparoscopic surgery (SILS) was developed to improve the cosmetic effects of conventional laparoscopy. The aim of this study was to evaluate the safety and feasibility of SILS-TAPP compared with TAPP technique. MATERIALS AND METHODS: A total of 148 patients who underwent TAPP or SILS-TAPP in our surgery clinic between December 2012 and January 2015 were enrolled. Data including patient demographics, hernia characteristics, operative time, intraoperative and postoperative complications, length of hospital stay and recurrence rate were retrospectively collected. RESULTS: In total, 60 SILS-TAPP and 88 TAPP procedures were performed in the study period. The two groups were similar in terms of gender, type of hernia, and American Society of Anesthesiologists (ASA) classification score. The patients in the SILS-TAPP group were younger when compared the TAPP group. Port site hernia (PSH) rate was significantly high in the SILS-TAPP group, and all PSHs were recorded in patients with severe comorbidities. The mean operative time has no significant difference in two groups. All SILS procedures were completed successfully without conversion to conventional laparoscopy or open repair. No intraoperative complication was recorded. There was no recurrence during the mean follow-up period of 15.2 ± 3.8 months. CONCLUSION: SILS TAPP for inguinal hernia repair seems to be a feasible, safe method, and is comparable with TAPP technique. However, randomized trials are required to evaluate long-term clinical outcomes. PMID:27251835

  15. Simplified technique of mesh fixation during laparoscopic repair of abdominal ventral hernia.

    Science.gov (United States)

    Piskun, G; Shaftan, G; Fogler, R

    1999-04-01

    The current techniques for intraperitoneal mesh fixation are complex and time-consuming. We present here a simple technique for the fixation of the mesh during laparoscopic intraperitoneal ventral hernia repair.

  16. Randomized clinical trial of dexamethasone versus placebo in laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Tolver, M A; Strandfelt, P; Bryld, Clara E;

    2012-01-01

    The effect of dexamethasone on recovery and length of convalescence has not been evaluated in patients after laparoscopic groin hernia repair. It was hypothesized that preoperative intravenous dexamethasone would reduce postoperative pain....

  17. Laparoscopic Repair Reduces Incidence of Surgical Site Infections for All Ventral Hernias

    Science.gov (United States)

    Arita, Nestor A.; Nguyen, Mylan T.; Nguyen, Duyen H.; Berger, Rachel L.; Lew, Debbie F.; Suliburk, James T.; Askenasy, Erik P.; Kao, Lillian S.; Liang, Mike K.

    2014-01-01

    Background The role of laparoscopic repair of ventral hernias remains incompletely defined. We hypothesize that laparoscopy, compared to open repair with mesh, decreases surgical site infection (SSI) for all ventral hernia types. Methods MEDLINE, EMBASE, and Cochrane databases were reviewed to identify studies evaluating outcomes of laparoscopic versus open repair with mesh of ventral hernias and divided into groups (primary or incisional). Studies with high risk of bias were excluded. Primary outcomes of interest were recurrence and SSI. Fixed effects model was used unless significant heterogeneity, assessed with the Higgins I-square (I2), was encountered. Results There were five and fifteen studies for primary and incisional cohorts. No difference was seen in recurrence between laparoscopic and open repair in the two hernia groups. SSI was more common with open repair in both hernia groups: primary (OR 4.17, 95%CI [2.03–8.55]) and incisional (OR 5.16, 95%CI [2.79–9.57]). Conclusions Laparoscopic repair, compared to open repair with mesh, decreases rates of SSI in all types of ventral hernias with no difference in recurrence. This data suggests that laparoscopic approach may be the treatment of choice for all types of ventral hernias. PMID:25294541

  18. Laparoscopic repair of congenital pleuroperitoneal hernia using a polypropylene mesh in a dog

    Directory of Open Access Journals (Sweden)

    H.F. Hartmann

    2015-12-01

    Full Text Available ABSTRACT Pleuroperitoneal hernias are the most uncommon type of diaphragmatic hernias in dogs and cats. The treatment of choice is surgery and may involve the use of prosthetic implant through celiotomy. In the current report, laparoscopic repair of a congenital pleuroperitoneal hernia using polypropylene mesh in a dog is described. The surgery was feasible. Appropriate reduction of the hernia was carried out and no complications were noted.

  19. Prospective nationwide analysis of laparoscopic versus Lichtenstein repair of inguinal hernia

    DEFF Research Database (Denmark)

    Ware, P; Bay-Nielsen, M; Juul, P

    2005-01-01

    BACKGROUND: According to a Cochrane review, laparoscopic inguinal hernia repair compares favourably with open mesh repair, but few data exist from surgical practice outside departments with a special interest in hernia surgery. This study compared nationwide reoperation rates after laparoscopic...... and Lichtenstein repair, adjusting for factors predisposing to recurrence. METHODS: Some 3606 consecutive laparoscopic repairs were compared with 39 537 Lichtenstein repairs that were prospectively recorded in a nationwide registry between 1998 and 2003. Patients were subgrouped according to type of hernia......: primary or recurrent and unilateral or bilateral. Overall reoperation rates and 95 per cent confidence intervals were calculated. Long-term reoperation rates were estimated using the Kaplan-Meier method. RESULTS: The overall reoperation rates after laparoscopic and Lichtenstein repair of unilateral...

  20. Single-Port Onlay Mesh Repair of Recurrent Inguinal Hernias after Failed Anterior and Laparoscopic Repairs

    Science.gov (United States)

    Tran, Kim; Zajkowska, Marta; Lam, Vincent; Hawthorne, Wayne J.

    2015-01-01

    Background and Objectives: Despite the exponential increase in the use of laparoscopic inguinal herniorrhaphy, overall recurrence rates have remained unchanged. Therefore, a growing number of patients are presenting with recurrent hernias after conventional anterior and laparoscopic repairs have failed. This study reports our experience with single-incision laparoscopic (SIL) intraperitoneal onlay mesh (IPOM) repair of these hernias. Methods: Patients referred with two or more recurrences of inguinal hernia underwent SIL-IPOM from November 1, 2009, to June 24, 2014. A 2.5-cm infraumbilical incision was made, and an SIL port was placed intraperitoneally. Modified dissection techniques were used: chopstick and inline dissection, 5.5-mm/52-cm/30° angled laparoscope, and conventional straight dissecting instruments. The peritoneum was incised above the pubic symphysis, and dissection was continued laterally and proximally, raising the inferior flap below the previous extraperitoneal mesh while reducing any direct, indirect, femoral, or cord lipoma before placement of antiadhesive mesh, which was fixed to the pubic ramus, as well as superiorly, with nonabsorbable tacks before the inferior border was fixed with fibrin sealant. The inferior peritoneal flap was then tacked back onto the mesh. Results: Nine male patients underwent SIL-IPOM. Their mean age was 53 years and mean body mass index was 26.8 kg/m2. Mean mesh size was 275 cm2. Mean operation time was 125 minutes, with a hospital stay of 1 day. The umbilical scar length was 23 mm at the 6-week follow-up. There were no intra-/postoperative complications, port-site hernias, chronic groin pain, or recurrence of the hernia during a mean follow-up of 24 months. Conclusion: Inguinal hernias recurring after two or more failed conventional anterior and laparoscopic repairs can be safely and efficiently treated with SIL-IPOM. PMID:25848186

  1. The laparoscopic repair of a morgagni hernia in a child.

    Science.gov (United States)

    Ra, Yong Joon; Huh, Up; Lee, Sang-Gwon; Je, Hyung Gon

    2011-02-01

    A 12-year-old female presented with the abnormal findings on the chest PA. The chest CT revealed a retrosternal defect of the diaphragm and a fatty opacity in the pleural cavity, resulting in a diagnosis of Morgagni hernia. It was decided to undergo a laparoscopic surgery. The retrosternal defect of the diaphragm measuring 3.5 cm in diameter was found, through which a portion of the greater omentum and the fatty tissue connected with the falciform ligament were herniated into the pleural cavity. The greater omentum was pushed back into the peritoneal cavity and the fatty tissue connected with falciform ligament was excised. The mediastinal pleura was plicated and the defect of the diaphragm was repaired primarily. Immediately after the operation, the patient developed a right pneumothorax for which a chest tube was inserted. She was discharged at the post-operative third day without any further complications.

  2. Laparoscopic repair of hiatal hernia with mesenterioaxial volvulus of the stomach.

    Science.gov (United States)

    Inaba, Kazuki; Sakurai, Yoichi; Isogaki, Jun; Komori, Yoshiyuki; Uyama, Ichiro

    2011-04-21

    Although mesenterioaxial gastric volvulus is an uncommon entity characterized by rotation at the transverse axis of the stomach, laparoscopic repair procedures have still been controversial. We reported a case of mesenterioaxial intrathoracic gastric volvulus, which was successfully treated with laparoscopic repair of the diaphragmatic hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication. A 70-year-old Japanese woman was admitted to our hospital because of sudden onset of upper abdominal pain. An upper gastrointestinal series revealed an incarcerated intrathoracic mesenterioaxial volvulus of the distal portion of the stomach and the duodenum. The complete laparoscopic approach was used to repair the volvulus. The laparoscopic procedures involved the repair of the hiatal hernia using polytetrafluoroethylene mesh and Toupet fundoplication. This case highlights the feasibility and effectiveness of the laparoscopic procedure, and laparoscopic repair of the hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication may be useful for preventing postoperative recurrence of hiatal hernia, volvulus, and gastroesophageal reflux.

  3. Laparoscopic repair of a bilateral internal inguinal hernia with supravesical hernia – a case report

    OpenAIRE

    2015-01-01

    Introduction: Supravesical hernia is an exceptional subtype of internal inguinal hernia, and it is located between the median umbilical ligament and the medial umbilical ligament. The hernia is classified as two types: internal supravesical hernia and external supravesical hernia. Presentation of case: Herein we report a rare case of external supravesical hernia successfully treated by laparoscopic procedure. The patient who complained right inguinal protrusion and mild frequent urination ...

  4. A COMPARATIVE STUDY BETWEEN LAPAROSCOPIC TRANSABDOMINAL PREPERITONEAL REPAIR AND TOTAL EXTRAPERITONEAL REPAIR OF INGUINAL HERNIA

    Directory of Open Access Journals (Sweden)

    Narendra

    2016-05-01

    Full Text Available BACKGROUND Groin hernia surgeries have come a long way since knowledge of modern surgery. Among them laparoscopic hernia repair is the advanced and better method in terms of less pain and speedy recovery. AIMS AND OBJECTIVES To compare and assess the outcome between laparoscopic transabdominal preperitoneal repair and total extraperitoneal repair of inguinal hernia. 1. To compare the duration of procedure between two techniques. 2. To assess the complications encountered (Intraoperative and postoperative. 3. To evaluate the post-operative pain. MATERIALS AND METHODS 40 cases of groin hernia admitted in Sri Siddhartha Medical College, Tumkur, between 2013 and 2015 randomly picked for TAPP and TEP surgeries, assigning 20 for each, prospective analysis made results compared and evaluated using Fischer’s test and Chisquare test. RESULTS Comparatively TEP repair took more operative time and TAPP repair had more post-operative pain. CONCLUSION No major complications seen in both procedures. Laparoscopy repair has long learning curve, which demands skills. TEP is more technically demanding and takes more time than TAPP, but with postoperative pain in comparison.

  5. Fixation in laparoscopic incisional hernia repair: Suture versus tacks

    Directory of Open Access Journals (Sweden)

    Adil Bangash

    2013-01-01

    Full Text Available Aims and Objectives: To compare the frequency of complications of laparoscopic repair of incisional hernia using fixation of mesh with transabdominal sutures tacks. Materials and Methods: This study was conducted as part of an interventional multicenter trial at the Rehman Medical Institute, Peshawar, Peshawar Institute of Medical Sciences, and Pakistan Institute of Medical Science, Islamabad, from the 1 st of November 2008 till 31 st October 2011. The frequency of complications was calculated as the measure of comparing two methods of fixation in laparoscopic repair of incisional hernia using the IPOM technique. These patients were admitted via the outpatient department and their demographic data were collected on a pro forma basis. Forty-five patients were alternately placed in either group, and group I comprised patients with a ventral hernia that was fixed using spiral tacks whereas the other group was fixed with transabdominal sutures. A polytetraflouroethylene (Dual R mesh was applied in all cases. All data were collected onthe individual pro forma of each patient and was loaded on the SPSS R version 13.0. Results: The BMI in both groups was similar (P=0.94 The mean hospital stay was higher in the PTFE mesh group but the values were not significant (P=1.22.No perioperative death was observed in either group. One patient (2.2% from group I was readmitted with varying complaints and was diagnosed as having subacute intestinal obstruction (P>0.05. A higher but insignificant recurrence rate was observed in the polyester group over a one-year period of follow-up. Three patients (6.6% were diagnosed with recurrences in group I. Instead the PTFE group had a similar recurrence rate recurrence (P=1.00. Conclusion: The rate of recurrence in this study showed no significant difference by either mode of fixation. But statistically significant pain scores and increased operative time to fixation favors the use of tacks that limits to the few inner

  6. Laparoscopic Total Extraperitoneal (TEP) Inguinal Hernia Repair Using 3-dimensional Mesh Without Mesh Fixation.

    Science.gov (United States)

    Aliyazicioglu, Tolga; Yalti, Tunc; Kabaoglu, Burcak

    2017-08-01

    Approximately one fifth of patients suffer from inguinal pain after laparoscopic total extraperitoneal (TEP) inguinal hernia repair. There is existing literature suggesting that the staples used to fix the mesh can cause postoperative inguinal pain. In this study, we describe our experience with laparoscopic TEP inguinal hernia surgery using 3-dimensional mesh without mesh fixation, in our institution. A total of 300 patients who had undergone laparoscopic TEP inguinal hernia repair with 3-dimensional mesh in VKV American Hospital, Istanbul from November 2006 to November 2015 were studied retrospectively. Using the hospital's electronic archive, we studied patients' selected parameters, which are demographic features (age, sex), body mass index, hernia locations and types, duration of operations, preoperative and postoperative complications, duration of hospital stays, cost of surgery, need for analgesics, time elapsed until returning to daily activities and work. A total of 300 patients underwent laparoscopic TEP hernia repair of 437 inguinal hernias from November 2006 to November 2015. Of the 185 patients, 140 were symptomatic. Mean duration of follow-up was 48 months (range, 6 to 104 mo). The mean duration of surgery was 55 minutes for bilateral hernia repair, and 38 minutes for unilateral hernia repair. The mean duration of hospital stay was 0.9 day. There was no conversion to open surgery. In none of the cases the mesh was fixated with either staples or fibrin glue. Six patients (2%) developed seroma that were treated conservatively. One patient had inguinal hernia recurrence. One patient had preperitoneal hematoma. One patient operated due to indirect right-sided hernia developed right-sided hydrocele. One patient had wound dehiscence at the umbilical port entry site. Chronic pain developed postoperatively in 1 patient. Ileus developed in 1 patient. Laparoscopic TEP inguinal repair with 3-dimensional mesh without mesh fixation can be performed as safe as

  7. Evolution and advances in laparoscopic ventral and incisional hernia repair

    Institute of Scientific and Technical Information of China (English)

    Alan; L; Vorst; Christodoulos; Kaoutzanis; Alfredo; M; Carbonell; Michael; G; Franz

    2015-01-01

    Primary ventral hernias and ventral incisional hernias have been a challenge for surgeons throughout the ages. In the current era, incisional hernias have increased in prevalence due to the very high number of laparotomies performed in the 20 th century. Even though minimally invasive surgery and hernia repair have evolved rapidly, general surgeons have yet to develop the ideal, standardized method that adequately decreases common postoperative complications, such as wound failure, hernia recurrence and pain. The evolution of laparoscopy and ventral hernia repair will be reviewed, from the rectoscopy of the 4th century to the advent of laparoscopy, from suture repair to the evolution of mesh reinforcement. The nuances of minimally invasive ventral and incisional hernia repair will be summarized, from preoperative considerations to variations in intraoperative practice. New techniques have become increasingly popular, such as primary defect closure, retrorectus mesh placement, and concomitant component separation. The advent of robotics has made some of these repairs more feasible, but only time and well-designed clinical studies will tell if this will be a durable modality for ventral and incisional hernia repair.

  8. Laparoscopic morgagni hernia repair using single-site umbilical and full-thickness abdominal wall repair: Technical report of two cases

    Directory of Open Access Journals (Sweden)

    Martin L van Niekerk

    2013-01-01

    Full Text Available Single incision laparoscopic surgery is used in many centres for routine cases such as appendisectomy, splenectomy and cholecystectomy. Morgagni hernias are uncommon and account for 1-2% of all congenital diaphragmatic hernia. We report our first laparoscopic repair of two Morgagni hernias, using a single umbilical incision and full-thickness abdominal wall repair with standard straight laparoscopic instruments. Operative time was short and compared favourably with the laparoscopic repair.

  9. Laparoscopic Morgagni hernia repair using single-site umbilical and full-thickness abdominal wall repair: technical report of two cases.

    Science.gov (United States)

    van Niekerk, Martin L

    2013-01-01

    Single incision laparoscopic surgery is used in many centres for routine cases such as appendectomy, splenectomy and cholecystectomy. Morgagni hernias are uncommon and account for 1-2% of all congenital diaphragmatic hernia. We report our first laparoscopic repair of two Morgagni hernias, using a single umbilical incision and full-thickness abdominal wall repair with standard straight laparoscopic instruments. Operative time was short and compared favourably with the laparoscopic repair.

  10. Pain during sexual activity before and after laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Tolver, Mette A; Rosenberg, Jacob

    2015-01-01

    BACKGROUND: Sexual life may be impaired by pain during sexual activity in patients with inguinal hernia. On the other hand, inguinal hernia repair has also been reported to cause sexual dysfunction in terms of pain during sexual activity and ejaculation. The primary aim of this study...... was to estimate the prevalence of pain during sexual activity before and after laparoscopic inguinal hernia repair, and the secondary, to describe pain location, frequency of pain during sexual activity, and to which degree sexual life was affected by the pain. Furthermore, to examine whether preoperative pain...... during sexual activity was a risk factor for postoperative pain during sexual activity. METHODS: A prospective questionnaire study before and 6 months after hernia repair was conducted. Men (age 18-85 years) undergoing laparoscopic inguinal hernia repair were included. RESULTS: In total, 160 men were...

  11. Laparoscopic ventral hernia repair using a two (5-mm) port technique.

    Science.gov (United States)

    Abir, Farshad; Eisenberg, Dan; Bell, Robert

    2005-01-01

    High recurrence rates have been documented after primary repair of incisional hernias. Laparoscopic ventral and incisional hernia repairs have been performed with very low rates of recurrence. We have modified the standard technique of laparoscopic repair in patients with small incisional and ventral hernias. The purpose of this study was to document the technique utilizing only two 5-mm ports and demonstrate that it is safe, effective, and feasible. Three patients with small incisional or ventral hernias were examined. The standard laparoscopic ventral hernia repair technique was modified as follows: two 5-mm ports were inserted on opposite sides of the defect. The defects ranged from 2.5 cm to 4 cm in size. Expanded polytetrafluoroethylene mesh (DualMesh, WL Gore, Flagstaff, AZ) was used to cover the hernia defect, overlapping the defect margins circumferentially by 3 cm. The mesh diameter ranged from 8.5 cm to 10 cm. The mesh was inserted through a 5-mm skin incision site and affixed into position with transfascial sutures and spiral tacks. The operative time ranged from 53 minutes to 57 minutes. All patients were discharged home the day of surgery and reported minimal postoperative pain. Follow-up ranged from 6 months to 1 year; all patients were doing well without recurrence. Laparoscopic repair of ventral or incisional hernias can be performed using only two 5-mm ports. This technique can be done on an outpatient basis in a safe, timely fashion.

  12. Neurophysiological characterization of persistent pain after laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Linderoth, G; Kehlet, H; Aasvang, E K;

    2011-01-01

    About 2-5% of patients undergoing laparoscopic inguinal repair experience persistent pain influencing everyday activities. However, compared with persistent pain after open repair, the combined clinical and neurophysiological characteristics have not been described in detail. Thus, the aim...... of the study was to describe and classify patients with severe persistent pain after laparoscopic herniorrhaphy....

  13. Neurophysiological characterization of persistent pain after laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Linderoth, G; Kehlet, H; Aasvang, E K

    2011-01-01

    About 2-5% of patients undergoing laparoscopic inguinal repair experience persistent pain influencing everyday activities. However, compared with persistent pain after open repair, the combined clinical and neurophysiological characteristics have not been described in detail. Thus, the aim...... of the study was to describe and classify patients with severe persistent pain after laparoscopic herniorrhaphy....

  14. Determinants of a short convalescence after laparoscopic transabdominal preperitoneal inguinal hernia repair

    DEFF Research Database (Denmark)

    Tolver, Mette Astrup; Strandfelt, Pernille; Forsberg, Gert;

    2012-01-01

    Evidence-based recommendations for the expected duration of convalescence after laparoscopic groin hernia repair are not available, and objective reasons for prolonged convalescence are not clear. Our main aim was to establish the expected duration of convalescence using preoperative recommendati......Evidence-based recommendations for the expected duration of convalescence after laparoscopic groin hernia repair are not available, and objective reasons for prolonged convalescence are not clear. Our main aim was to establish the expected duration of convalescence using preoperative...... recommendations to the patient and to identify the limiting factors for early (postoperative) resumption of normal activities after laparoscopic transabdominal preperitoneal inguinal herniorraphy (TAPP)....

  15. Early pain after laparoscopic inguinal hernia repair. A qualitative systematic review

    DEFF Research Database (Denmark)

    Tolver, M A; Rosenberg, J; Bisgaard, T

    2012-01-01

    Early post-operative pain after laparoscopic groin hernia repair may, as in other laparoscopic operations, have its own individual pain pattern and patient-related predictors of early pain. The purpose of this review was to characterise pain within the first post-operative week after transabdomin...... pre-peritoneal repair (TAPP) and total extraperitoneal repair (TEP), and to identify patient-related predictors of early pain....

  16. Comparative study of open tension-free and laparoscopic inguinal hernia repair in hernioplasty and simultaneous laparoscopic cholecystectomy

    Institute of Scientific and Technical Information of China (English)

    JIANG Dao-zhen; QIU Ming; ZHENG Xiang-min; LU Lei; DONG Zhi-tao; HE Yan-fei; JIANG Hang

    2006-01-01

    Objective: To evaluate the clinical value of laparoscopic inguinal hernia repair in hernioplasty and simultaneous cholecystectomy. Methods: Twenty-eight patients with symptomatic chronic calculous cholecystitis and synchronous unilateral primary inguinal hernia were performed combined surgery between October 2001 and March 2005. Of them, 10 cases underwent laparoscopic totally extraperitoneal mesh hernia repair (TEP) and laparoscopic cholecystectomy (LC), 3 cases underwent laparoscopic transabdominal preperitoneal mesh hernia repair (TAPP) and LC, and 15 cases underwent LC and open tension-free hernia repair. Results: All the procedures were performed successfully, 2 patients occurred urinary retention in LC+open group and 1 patient occurred scrotum seroma in LC+TEP procedures. During the 6 to 24 months' follow-up, no hernia recurrences occurred in all patients. There were 6 Patients (40%) in LC +open group had discomfort pain in the inguinal region and lasted 1 to 3 months. The operating time was longer in the totally laparoscopic group (TEP+LC and TAPP+LC) (104±31 min) than in the LC+open group (80±28 min) (P<0.05). The intensity of postoperative pain at rest was greater in the LC+open group at 24 h (P<0.05) and 48 h (P<0.05). No differences between the 2 groups were found in the mean operating costs and oral intake of the postoperative period. But the time resume to walking (2.9 vs 1. 8 d) (P<0.01) and the mean hospital stay (8.2 vs 4.6 d) (P<0. 001) was longer in the LC+open group than in the totally laparoscopic group. Conclusion: In the same operating costs, the totally laparoscopic precedure has more advantages of low postoperative pain, quicker resume to walking and less hospital stay than open tension-free hernia repair in hernioplasty and simultaneous LC. Thus, the totally laparoscopic approach is considered to be advantage of the hernioplasty and simultaneous LC.

  17. Open versus laparoscopic unilateral inguinal hernia repairs: defining the ideal BMI to reduce complications.

    Science.gov (United States)

    Willoughby, Ashley D; Lim, Robert B; Lustik, Michael B

    2017-01-01

    Open inguinal hernia repair is felt to be a less expensive operation than a laparoscopic one. Performing open repair on patients with an obese body mass index (BMI) results in longer operative times, longer hospital stay, and complications that will potentially impose higher cost to the facility and patient. This study aims to define the ideal BMI at which a laparoscopic inguinal hernia repair will be advantageous over open inguinal hernia repair. The NSQIP database was analyzed for (n = 64,501) complications, mortality, and operating time for open and laparoscopic inguinal hernia repairs during the time period from 2005 to 2012. Bilateral and recurrent hernias were excluded. Chi-square tests and Fisher's exact tests were used to assess associations between type of surgery and categorical variables including demographics, risk factors, and 30-day outcomes. Multivariable regression analyses were performed to determine whether odds ratios differed by level of BMI. The HCUP database was used for determining difference in cost and length of stay between open and laparoscopic procedures. There were 17,919 laparoscopic repairs and 46,582 open repairs in the study period. The overall morbidity (across all BMI categories) is statistically greater in the open repair group when compared to the laparoscopic group (p = 0.03). Postoperative complications (including wound disruption, failure to wean from the ventilator, and UTI) were greater in the open repair group across all BMI categories. Deep incisional surgical site infections (SSI) were more common in the overweight open repair group (p = 0.026). The return to the operating room across all BMI categories was statistically significant for the open repair group (n = 269) compared to the laparoscopic repair group (n = 70) with p = 0.003. There was no difference in the return to operating room between the BMI categories. The odds ratio (OR) was found to be statistically significant when comparing the obese

  18. Preliminary experience with laparoscopic repair of associated inguinal and umbilical hernias in children.

    Science.gov (United States)

    Bertozzi, M; Magrini, E; Appignani, A

    2015-08-01

    The authors report their preliminary experience in laparoscopic repair of associated inguinal and umbilical hernias in children. Twenty-six patients affected by the association of inguinal and umbilical hernia with an umbilical defect larger than 5 mm underwent a laparoscopic procedure. A 5-mm trocar was placed through the umbilical defect for the optic. To fix the trocar to avoid loss of carboperitoneum, we fashioned and tightened a purse-string non-absorbable suture with a sliding knot around the defect. In this manner, we ensured the trocar, fixing it and avoiding any loss of CO2, proceeding safely to the laparoscopic IH repair, by means of two additional 3 mm operative trocars. At the end of the inguinal herniorrhaphy, the previously fashioned purse-string suture was tightened to repair the umbilical defect. The mean operative time for the repair of associated inguinal and umbilical hernias was 30.1 ± 7.4 min in cases of unilateral inguinal hernia and 39.5 ± 10.6 for bilateral inguinal hernia. Follow-up ranged from 8 to 32 months. Neither intra- nor post-operative complications nor recurrences were seen. This small sample suggests that this simple method is safe, effective and might be useful for pediatric surgeons performing laparoscopic repair for inguinal hernia in presence of an associated UH with a statistically significant decrease of operative time.

  19. A meta-analysis of surgical morbidity and recurrence after laparoscopic and open repair of primary unilateral inguinal hernia.

    LENUS (Irish Health Repository)

    O'Reilly, Elma A

    2012-05-01

    Laparoscopic inguinal hernia repair (LIHR), using a transabdominal preperitoneal (TAPP) or totally extraperitoneal (TEP) technique, is an alternative to conventional open inguinal hernia repair (OIHR). A consensus on outcomes of LIHR when compared with OIHR for primary, unilateral, inguinal hernia has not been reached.

  20. Laparoscopic repair of incisional and parastomal hernias after major genitourinary or abdominal surgery.

    Science.gov (United States)

    Kozlowski, P M; Wang, P C; Winfield, H N

    2001-03-01

    Abdominal wall or parastomal hernias following major genitourinary or abdominal surgery are a significant surgical problem. Open surgical repair is difficult because of adhesion formation and poor definition of the hernia fascial edges. Laparoscopic intervention has allowed effective correction of these abdominal wall hernias. From November 1997 to June 2000, 14 male and 3 female patients underwent laparoscopic abdominal wall herniorrhaphy at our institution. Of these, 13 patients received incisional and 4 parastomal hernia repair. All hernia defects were repaired using a measured piece of Gore-Tex DualMesh. A retrospective review of each patient's history and operative characteristics was undertaken. All repairs were successful. No patient required conversion to an open procedure, and there were no intraoperative complications. The average operative time was 4 (range 2.5-6.5) and 4.3 (range 3.75-5.5) hours in the incisional and parastomal group, respectively. The average hospital stay was 4.9 days (range 2-12) for the incisional group and 3.8 (range 3-4) days for the parastomal group. To date, two patients experienced a recurrence of incisional hernias, at 5 and 8 months postoperatively. No recurrences have developed in the parastomal hernia repairs at 2 to 33 months. Laparoscopic repair of abdominal wall incisional or parastomal hernias provides an excellent anatomic correction of such defects. Adhesions are lysed under magnified laparoscopic vision, and the true limits of the fascial defects are clearly identified. The DualMesh is easy to work with and has yielded excellent results. A comparison with open repair with respect to perioperative factors and long-term success is currently under way.

  1. Laparoscopic repair of Morgagni hernia with composite mesh in an elderly woman: Report of a case.

    Science.gov (United States)

    Ikarashi, Masahito; Matsuda, Minoru; Murayama, Isao; Fujii, Masashi; Takayama, Tadatoshi

    2015-05-01

    A 78-year-old woman was admitted to another hospital with vomiting. Chest X-ray showed an abnormal shadow in the lower right lung field, and CT indicated a Morgagni hernia containing the stomach and transverse colon. The patient was transferred to our hospital and underwent laparoscopic surgery. After the hernia contents were repositioned into the abdominal cavity, we repaired the hernia orifice with a prosthetic mesh to achieve a tension-free repair. There were no complications after the surgery, and there has been no recurrence. The patient has remained free of clinical symptoms since 10 months after the surgery. Laparoscopic repair with a prosthetic mesh for Morgagni hernia is a simple and safety procedure for elderly patients.

  2. Percutaneous suturing technique and single-site umbilical laparoscopic repair of a Morgagni hernia: Review of three cases.

    Science.gov (United States)

    Zouari, M; Jallouli, M; Bendhaou, M; Zitouni, H; Mhiri, R

    2015-12-01

    Morgagni hernias are uncommon, accounting for only 1-2% of all congenital diaphragmatic hernia. Minimally invasive surgery is today the gold standard treatment. We present a technique using percutaneous suturing and single-site umbilical laparoscopic repair of Morgagni hernia in three children. Recovery was uneventful in all three patients. There was no recurrence and the chest radiograph remained normal during the postoperative follow-up. The percutaneous suturing technique and single-site umbilical laparoscopic repair of a Morgagni hernia is an easy and effective alternative to standard laparoscopic repair.

  3. Laparoscopic ventral hernia repair: outcomes in primary versus incisional hernias: no effect of defect closure.

    Science.gov (United States)

    Lambrecht, J R; Vaktskjold, A; Trondsen, E; Øyen, O M; Reiertsen, O

    2015-06-01

    Supposing divergent aetiology, we found it interesting to investigate outcomes between primary (PH) versus incisional (IH) hernias. In addition, we wanted to analyse the effect of defect closure and mesh fixation techniques. 37 patients with PH and 70 with IH were enrolled in a prospective cohort-study, treated with laparoscopic ventral hernia repair (LVHR) and randomised to ± transfascial sutures. In addition, we analysed results from a retrospective study with 36 PH and 51 IH patients. Mean follow-up time was 38 months in the prospective study and 27 months in the retrospective study. 35 % of PH's and 10 % of IH's were recurrences after previous suture repair. No late infections or mesh removals occurred. Recurrence rates in the prospective study were 0 vs. 4.3 % (p = 0.55) and the complication rates were 16 vs. 27 % (p = 0.24) in favour of the PH cohort. The IH group had a mesh protrusion rate of 13 vs. 5 % in the PH group (p = 0.32), and significantly (p hernias and adhesion score, longer operating time (100 vs. 79 min) and admission time (2.8 vs. 1.6 days). Closure of the hernia defect did not influence rate of seroma, pain at 2 months, protrusion or recurrence. An overall increased complication rate was seen after defect closure (OR 3.42; CI 1.25-9.33). With PH, in comparison to IH treated with LVHR, no differences were observed regarding recurrence, protrusion or complication rates. Defect closure (raphe), when using absorbable suture, did not benefit long-term outcomes and caused a higher overall complication rate. (ClinicalTrials.gov number: NCT00455299).

  4. Laparoscopic Repair of Morgagni Hernia Using Polyvinylidene Fluoride (PVDF) Mesh.

    Science.gov (United States)

    Godazandeh, Gholamali; Mortazian, Meysam

    2012-10-01

    We report the cases of two patients diagnosed with Morgagni hernia who presented with nonspecific abdominal symptoms. Both underwent laparoscopic surgery that used a dual-sided mesh, polyvinylidene fluoride (PVDF; Dynamesh IPOM®). The procedures were successful and both patients were discharged with no complications. There was no recurrence in 18 months of follow up.Herein is the report of these cases and a literature review.

  5. Laparoscopic features and repair of a combined left Spigelian hernia and left Morgagni diaphragmatic hernia.

    Science.gov (United States)

    Chamary, S L; Chamary, V L

    2015-03-01

    Both Spigelian and Morgagni hernias cause serious morbidity so early diagnosis and timely treatment are necessary. These two types of hernia are more commonly found on the right side of patients. They are rare individually in adults and even rarer in combination. So far, an association between the two hernias has only been reported on the right. We describe the first case of a Spigelian hernia and a Morgagni hernia in a 62-year-old woman, both occurring on the left side. Our accompanying video describes several laparoscopic features that will help lead to early detection and diagnosis.

  6. Late mesh rejection as a complication to transabdominal preperitoneal laparoscopic hernia repair

    DEFF Research Database (Denmark)

    Hofbauer, C; Andersen, P V; Juul, P;

    1998-01-01

    BACKGROUND: The use of a mesh in transabdominal preperitoneal laparoscopic hernia repair (TAPP) caries the risk of late rejection or infectious complications related to the mesh. The aim of this study was to describe the extent of these complications. METHODS: We performed a retrospective study...... repair had been done. CONCLUSION: Late mesh rejection is a potential complication of TAPP and has to be considered when choosing the surgical method of hernia repair....... of 500 consecutive patients with TAPP for inguinal hernia. RESULTS: Late mesh rejection was observed in three patients at 5-19 months after surgery. The mesh was removed via a suprapubic midline incision. At 3-4 month's follow-up, none of the patients had recurrence of the hernia, even though no hernia...

  7. Laparoscopic inguinal hernia repair in children: The early learning curve of the trainer and trainees

    Directory of Open Access Journals (Sweden)

    Manoharan S

    2006-01-01

    Full Text Available Aims: To report our experience with laparoscopic inguinal hernia repair in children. Materials and Methods: A total of 45 children, who underwent laparoscopic inguinal hernia repair between November 2003 and June 2005 were included in the study. Data were obtained by retrospective review of the case notes. Results: A total of 63 laparoscopic inguinal hernia repairs (18 right, 9 left and 18 bilateral were performed on 45 children (29 boys and 16 girls. Age of the children ranged from 4 weeks to 4 years. The operative time ranged from 30 to 70 minutes for unilateral repair and 38 to 95 minutes for bilateral repair (median for unilateral was 48 minutes and for bilateral 55 minutes. This time decreased with surgeon experience, though not reflecting directly due to the fact that the training registrars performed part of the procedures in the last 23 patients. There were no intraoperative complications. The follow up period ranged from 3 to 15 months. One child developed umbilical port site infection, which was treated with appropriate antibiotics. Conclusions: Laparoscopic inguinal hernia repair in children is safe, with minimal complications. With experience operative time decreases.

  8. Laparoscopic repair of giant paraesophageal hernia with synthetic mesh: 45 consecutive cases.

    Science.gov (United States)

    Stavropoulos, George; Flessas, Ioannis I; Mariolis-Sapsakos, Theodoros; Zagouri, Flora; Theodoropoulos, George; Toutouzas, Konstantinos; Michalopoulos, Nikolaos V; Triantafyllopoulou, Ioanna; Tsamis, Dimitrios; Spyropoulos, Basilios G; Zografos, George C

    2012-04-01

    Giant paraesophageal hernias (PEHs) are associated with progression of symptoms in up to 45 per cent of patients. Recently, many series have reported that laparoscopic repair of PEH is technically feasible, effective, and safe. A retrospective review of the University of Athens tertiary care hospitals patient database and the patient medical records identified 45 patients who underwent elective repair of a giant PEH between 2002 and 2009. Elective laparoscopic repair of a giant PEH was attempted in 45 patients who were treated with Gore-Tex dual mesh with or without Nissen fundoplication. They all had a mesh repair. Intraoperative complications included one pulmonary embolism and one recurrent hernia. The use of a mesh seems to be effective in the treatment of large hernias. It appears to offer the benefit of a shorter hospital stay and a quicker recovery.

  9. A case of de Garengeot hernia: the feasibility of laparoscopic transabdominal preperitoneal hernia repair

    Directory of Open Access Journals (Sweden)

    Saud Al-Subaie

    2015-01-01

    Conclusion: We were able to obtain an accurate diagnosis of an appendix within a long-standing irreducible femoral hernia through diagnostic laparoscopy followed by transabdominal preperitoneal (TAPP approach for hernia repair. We would like to underline the usefulness of laparoscopy as a valuable tool in the diagnosis and treatment of this unusual presentation of groin hernias.

  10. Laparoscopic umbilical hernia repair in a cirrhotic patient with a peritoneovenous shunt.

    Science.gov (United States)

    Umemura, Akira; Suto, Takayuki; Sasaki, Akira; Fujita, Tomohiro; Endo, Fumitaka; Wakabayashi, Go

    2015-05-01

    A 62-year-old Japanese woman who had developed massive cirrhotic ascites was referred to our hospital for a peritoneovenous shunt implant. However, CT examination revealed an umbilical hernia that had not been observed before the peritoneovenous shunt was implanted. We decided to perform laparoscopic umbilical hernia repair to keep carbon dioxide from flowing backward into the central circulatory system. We first clamped the catheter and set the upper limit of the pneumoperitoneum pressure to 6 mmHg. The central venous pressure was also measured simultaneously. Mesh was then applied over the hernia and fixed by the double-crown technique. Finally, 1000-mL physiological saline was infused into the abdominal cavity while the pneumoperitoneum was slowly released. In this case, we safely performed laparoscopic umbilical hernia repair while making some alterations, specifically catheter clamping, reducing pneumoperitoneum pressure, monitoring central venous pressure, and infusing physiological saline.

  11. Comparison of robotic versus laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair.

    Science.gov (United States)

    Waite, Kimberly E; Herman, Mark A; Doyle, Patrick J

    2016-09-01

    Despite growing popularity and potential advantages of robotics in general surgery, there is very little published data regarding robotic inguinal hernia repair. This study examines a single surgeon's early experience with robotic TAPP inguinal hernia repair compared with laparoscopic TAPP repair in terms of feasibility and cost. We performed a retrospective review of 63 consecutive patients (24 laparoscopic and 39 robotic) who underwent inguinal hernia repair between December 2012-December 2014 at a single institution by a single surgeon. Data examined included gender, age, BMI, operative times, recovery room times, pain scale ratings, and cost. Patient groups were the same in terms of age and BMI. The mean operative time (77.5 vs 60.7 min, p = 0.001) and room time (109.3 vs 93.0 min, p = 0.001) were significantly longer for the robotic vs the laparoscopic patients. Recovery room time (109.1 vs 133.5 min, p = 0.026) and average pain scores in recovery (2.5 vs 3.8, p = 0.02) were significantly less for the robotic group. The average direct cost of the laparoscopic group was $3216 compared with $3479 for the robotic group. The average contribution margin for the laparoscopic group was $2396 compared with $2489 for the robotic group. Robotic TAPP inguinal hernia repair had longer operative times, but patients spent less time in recovery and noted less pain than patients who underwent laparoscopic TAPP inguinal hernia repair. The direct cost and contribution margin are nearly equivalent. These results should allow the continued investigation of this technique without concern over excess cost.

  12. Female gender is a risk factor for pain, discomfort, and fatigue after laparoscopic groin hernia repair

    DEFF Research Database (Denmark)

    Strandfelt, P; Tolver, M A; Rosenberg, Jacob;

    2013-01-01

    Female gender is a risk factor for early pain after several specific surgical procedures but has not been studied in detail after laparoscopic groin hernia repair. The aim of this study was to compare early postoperative pain, discomfort, fatigue, and nausea and vomiting between genders undergoing...

  13. Large inatrabdominal meshes at laparoscopic insicional hernia repair, tricks and tips

    Directory of Open Access Journals (Sweden)

    V. Santa María

    2014-11-01

    Full Text Available In conducting a laparoscopic incisional hernia repair when is necessary to place a mesh larger than 10 cm diameter, introducing it into the abdominal cavity becomes difficult. The aim of this paper is to present a technique that improves and standardizes the placement of large intra-abdominal mesh, thus achieving a more neat and safe surgical technique for the patient.

  14. Robot-Assisted Laparoscopic Hiatal Hernia Repair : Promising Anatomical and Functional Results

    NARCIS (Netherlands)

    Brenkman, Hylke J F; Parry, Kevin; Van Hillegersberg, Richard; Ruurda, Jelle P.

    2016-01-01

    Background: There is no consensus on the optimal technique for hiatal hernia (HH) repair, and considerable recurrence rates are reported. The aim of this study was to evaluate the perioperative outcomes, quality of life (QoL), and recurrence rate in patients undergoing robot-assisted laparoscopic HH

  15. Transabdominal preperitoneal laparoscopic approach for incarcerated inguinal hernia repair

    Science.gov (United States)

    Yang, Shuo; Zhang, Guangyong; Jin, Cuihong; Cao, Jinxin; Zhu, Yilin; Shen, Yingmo; Wang, Minggang

    2016-01-01

    Abstract To investigate the efficacy, key technical points, and complication management of the transabdominal preperitoneal (TAPP) approach for incarcerated inguinal hernia repair. Seventy-three patients with incarcerated inguinal hernias underwent TAPP surgery in our department between Jan 2010 and Dec 2015. A retrospective review was performed by analyzing the perioperative data from these patients. The operation was successfully completed in all 73 patients. Operation time was 54.0 ± 18.8 minutes (range, 35–100 minutes). Length of stay was 3.9 ± 1.1 days (range, 3–9 days). There was 1 case of incisional infection, 32 cases of seroma, and 3 cases of postoperative pain during follow-up. All patients recovered after the appropriate treatment. No recurrence or fistula was observed. The TAPP approach represents a safe and effective technique for incarcerated inguinal hernia repair because of its potential in assessment of hernia content and decreasing incisional infection rate. However, it requires experienced surgeons to ensure safety with special attention paid to the key technical points as well as complication management. PMID:28033260

  16. Laparoscopic repair of hiatal hernia with mesenterioaxial volvulus of the stomach

    Institute of Scientific and Technical Information of China (English)

    Kazuki Inaba; Yoichi Sakurai; Jun Isogaki; Yoshiyuki Komori; Ichiro Uyama

    2011-01-01

    Although mesenterioaxial gastric volvulus is an uncom-mon entity characterized by rotation at the transverse axis of the stomach, laparoscopic repair procedures have still been controversial. We reported a case of mesente-rioaxial intrathoracic gastric volvulus, which was success-fully treated with laparoscopic repair of the diaphrag-matic hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication. A 70-year-old Japanese woman was admitted to our hospital because of sudden onset of upper abdominal pain. An upper gas-trointestinal series revealed an incarcerated intrathoracic mesenterioaxial volvulus of the distal portion of the stomach and the duodenum. The complete laparoscopic approach was used to repair the volvulus. The laparo-scopic procedures involved the repair of the hiatal hernia using polytetrafluoroethylene mesh and Toupet fundopli-cation. This case highlights the feasibility and effective-ness of the laparoscopic procedure, and laparoscopic repair of the hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication may be use-ful for preventing postoperative recurrence of hiatal her-nia, volvulus, and gastroesophageal reflux.

  17. Concurrent Mesh Repair of a Morgagni and Umbilical Hernia during a Laparoscopic Sleeve Gastrectomy in a Morbidly Obese Individual

    Directory of Open Access Journals (Sweden)

    N.R Kosai

    2016-10-01

    Full Text Available Morgagni Hernia is a rare form of diaphragmatic hernia. It is mainly asymptomatic and often identified incidentally during surgery. Tension-free synthetic mesh repair is the preferred treatment modality. However, the use of synthetic mesh concurrently during a clean-contaminated surgery such as sleeve gastrectomy remains controversial due to the remote possibility of mesh infection. A middle-aged female 2 with BMI of 47 Kg/m was admitted electively for laparoscopic sleeve gastrectomy with concurrent umbilical hernia repair. Intra-operatively, a left Morgagni Hernia containing omentum and a segment of transverse colon was noted. She underwent a laparoscopic sleeve gastrectomy and simultaneous laparoscopic tension-free composite mesh repair of both Morgagni and umbilical hernia. Outpatient review three months later revealed excess weight loss of almost 30% with no recurrence of either hernia. In conclusion, the advantages of concurrent hernia repair during bariatric surgery outweigh the risk of mesh infection and should be performed to prevent future risk of visceral herniation and strangulation. Laparoscopic mesh repair of a Morgagni Hernia and umbilical hernia in the setting of an electively planned sleeve gastrectomy is feasible, effective and safe in the hands of a trained laparoscopic surgeon.

  18. Laparoscopic repair of a lumbar hernia: report of a case and extensive review of the literature.

    Science.gov (United States)

    Suarez, Sebastian; Hernandez, Juan D

    2013-09-01

    Lumbar hernias are a protrusion of intra-abdominal contents through a weakness or rupture in the posterior abdominal wall. They are considered to be a rare entity with approximately 300 cases reported in the literature since it was first described by Barbette in 1672. Petit described the inferior lumbar triangle in 1783 and Grynfeltt described the superior lumbar triangle in 1866; both are anatomical boundaries where 95% of lumbar hernias occur, whereas the other 5% are considered to be diffuse. Twenty percent of lumbar hernias are congenital and the other 80% are acquired; the acquired lumbar hernias can be further classified into either primary (spontaneous) or secondary. The typical presentation of lumbar hernias is a patient with a protruding semispherical bulge in the back with a slow growth. However, they may present with an incarcerated or strangulated bowel, so it is recommended that all lumbar hernias must be repaired as soon as they are diagnosed. The "gold standard" for diagnosing a lumbar hernia is a CT scan, because it is able to delineate muscular and fascial layers, detect a defect in one or more of these layers, evaluate the presence of herniated contents, differentiate muscle atrophy from a real hernia, and serve as a useful tool in the differential diagnosis, such as tumors. Recent studies have demonstrated the advantages of a laparoscopic repair instead of the classic open approach as the ideal treatment option for lumbar hernias. We report a case of a spontaneous lumbar hernia initially diagnosed as a lipoma and corrected with the open approach, but after relapsing 2 years later it was corrected using a laparoscopic approach. It is followed by an extensive review of lumbar hernias literature regarding history, anatomy, and surgical techniques.

  19. Short- and mid-term outcome after laparoscopic repair of large incisional hernia.

    Science.gov (United States)

    Baccari, P; Nifosi, J; Ghirardelli, L; Staudacher, C

    2013-10-01

    To compare the outcome after laparoscopic incisional and ventral herniorrhaphy (LIVH) for fascial defect larger or equal than 15 cm in width with the outcome after LIVH in patients with hernia defect smaller than 15 cm. From 2003 through 2010, 350 patients were submitted to LIVH. In 70 cases, hernia defect was ≥15 cm in width and in 280 was hernias were often recurrent, double or multiorificial. In the group of larger hernias, the rate of obesity, recurrent hernia and multiorificial hernia was 27.1, 24.2 and 12.8 %, respectively, and in the group of smaller hernias 27.3, 16.1 and 2.8 %, respectively. Patients were interviewed using McGill pain score test to measure postoperative quality of life (QoL) in the mid-term. LIVH for hernia ≥15 cm required longer surgical time (p = 0.034) and postoperative hospital stay (p = 0.0001). Besides, there were higher rate of postoperative prolonged ileus (p = 0.035) and polmonitis (p = 0.001). Overall recurrence rate was 2.6, 8.6 % for larger and 1.1 % for smaller incisional hernias, p = 0.045. Mc Gill pain test revealed no significant difference in the two groups of patients in postoperative QoL within 36 months. Laparoscopic approach seems safe and effective even to repair large incisional hernia, the rate of recurrence was higher, but acceptable, if compared to smaller hernias. To the best of our knowledge, this is the largest reported series of incisional hernias ≥15 cm managed by laparoscopy.

  20. Laparoscopic-assisted Ventral Hernia Repair: Primary Fascial Repair with Polyester Mesh versus Polyester Mesh Alone.

    Science.gov (United States)

    Karipineni, Farah; Joshi, Priya; Parsikia, Afshin; Dhir, Teena; Joshi, Amit R T

    2016-03-01

    Laparoscopic-assisted ventral hernia repair (LAVHR) with mesh is well established as the preferred technique for hernia repair. We sought to determine whether primary fascial closure and/or overlap of the mesh reduced recurrence and/or complications. We conducted a retrospective review on 57 LAVHR patients using polyester composite mesh between August 2010 and July 2013. They were divided into mesh-only (nonclosure) and primary fascial closure with mesh (closure) groups. Patient demographics, prior surgical history, mesh overlap, complications, and recurrence rates were compared. Thirty-nine (68%) of 57 patients were in the closure group and 18 (32%) in the nonclosure group. Mean defect sizes were 15.5 and 22.5 cm(2), respectively. Participants were followed for a mean of 1.3 years [standard deviation (SD) = 0.7]. Recurrence rates were 2/39 (5.1%) in the closure group and 1/18 (5.6%) in the nonclosure group (P = 0.947). There were no major postoperative complications in the nonclosure group. The closure group experienced four (10.3%) complications. This was not a statistically significant difference (P = 0.159). The median mesh-to-hernia ratio for all repairs was 15.2 (surface area) and 3.9 (diameter). Median length of stay was 14.5 hours (1.7-99.3) for patients with nonclosure and 11.9 hours (6.9-90.3 hours) for patients with closure (P = 0.625). In conclusion, this is one of the largest series of LAVHR exclusively using polyester dual-sided mesh. Our recurrence rate was about 5 per cent. Significant mesh overlap is needed to achieve such low recurrence rates. Primary closure of hernias seems less important than adequate mesh overlap in preventing recurrence after LAVHR.

  1. Laparoscopic Fenestration of a Giant Pseudocyst after Totally Extra Peritoneal Inguinal Hernia Repair

    Science.gov (United States)

    Ibelings, Maaike S.

    2016-01-01

    A giant pseudocyst is a rare complication after hernioplasty and is seldom seen. The pathophysiology is unclear; it characteristically does not contain epithelial lining and can be considered giant if the diameter exceeds 10 cm. Pseudocysts are mostly described after incisional hernia repairs and are usually treated with surgical resection. We report a case of a giant pseudocyst three years after totally extra peritoneal inguinal hernia repair. Laparoscopic fenestration without removing the pseudocyst with or without removal of the polypropylene mesh is a safe and effective minimal invasive approach to the treatment of a symptomatic pseudocyst and should also be considered in the approach of other large symptomatic cysts. PMID:28018702

  2. Randomized clinical trial of fibrin sealant versus titanium tacks for mesh fixation in laparoscopic umbilical hernia repair

    DEFF Research Database (Denmark)

    Eriksen, J R; Bisgaard, T; Assaadzadeh, S;

    2011-01-01

    The use of tacks for mesh fixation may induce pain after surgery for ventral hernia. The aim of this study was to compare postoperative pain after laparoscopic ventral hernia repair (LVHR) with conventional mesh fixation using titanium tacks versus fibrin sealant (FS).......The use of tacks for mesh fixation may induce pain after surgery for ventral hernia. The aim of this study was to compare postoperative pain after laparoscopic ventral hernia repair (LVHR) with conventional mesh fixation using titanium tacks versus fibrin sealant (FS)....

  3. Laparoscopic repair of paraesophageal hernia with anterior gastropexy

    DEFF Research Database (Denmark)

    Daigle, Christopher R; Funch-Jensen, Peter; Calatayud, Dan

    2015-01-01

    despite significant dysphagia rates. We present our multicenter prospective data on laparoscopic PEH repairs using a modified Boerema anterior gastropexy without fundoplication. METHODS: We prospectively followed patients after modified Boerema PEH repair at three institutions. Patient demographics...... reflux necessitating PPI as needed, and 10 (9.9 %) had reflux requiring daily PPI. Our recurrence rate, assessed at postoperative endoscopy/barium swallow, was 16.8 %. Of these, 10 (9.9 %) were small segmental recurrences and 7 (6.9 %) were large recurrences. CONCLUSION: Herein, we demonstrate...

  4. Full laparoscopic incisional hernia repair using a 2-port route technique.

    Science.gov (United States)

    Dai, Li-Hua

    2007-06-01

    The incidence of incisional hernia repair is increasing each year throughout the world. We created a full laparoscopic herniorrhaphy by means of an easy, reliable, and minimally invasive (two trocars) intraperitoneal onlay technique, using different sizes of a DualMesh (W. L. Gore & Associates; Flagstaff, AZ) with the soft side against the adherence material. A group of patients with an incisional hernia and other ventral hernias underwent a laparoscopic herniorrhaphy using this technique. By combining simple extra- and endocorporeal manipulation, a mesh, prior to being inserted into peritoneal cavity through a trocar port was completed with four sutures between the corner of the mesh and the abdominal wall, so that when pulling the strands outside the abdomen, the furled intraperitoneal mesh being unfurled flat, was lifted from and overlapped the hernial defect at the top of the abdomen spontaneously and exactly. The mesh was anchored by nonabsorbable surtures and endo-Helical Fasteners. The sutures were either tied and the knots buried subcutaneously, or were eventually removed. It is by employing only two trocars applying this technique to a complete full laparoscopic intraperitoneal onlay of different sizes of a DualMesh incisional and ventral hernia repair. The mesh overlapped all hernial margins nicely and was anchored firmly. Postoperative courses were uneventful, without any complications. During the longest follow-up period of 2 years and 1 month, there was no recurrent evidence of the hernia in this group. This technique, which applies to almost every laparoscopic ventral hernia repair procedure for use against an adherence mesh, can help to carry out an ideal, easy, and quick orientation and intraperitoneal anchoring of the mesh.

  5. Pain and convalescence following laparoscopic ventral hernia repair

    DEFF Research Database (Denmark)

    Eriksen, Jens Ravn

    satisfaction. This issue must have first priority in future ventral hernia repair research. It is now documented, that the simple application of fibrin glue instead of titanium tacks for mesh fixation in LVHR of defects ...) assess the intensity and impact of postoperative pain by detailed patient-reported description of pain and convalescence after LVHR (Study I), 2) evaluate the feasibility of fibrin sealant (FS) for mesh fixation in an experimental pig model (Study II), and 3) investigate FS vs. tacks for mesh fixation...

  6. Single-Incision Laparoscopic Intraperitoneal Onlay Mesh Repair for the Treatment of Multiple Recurrent Inguinal Hernias

    Science.gov (United States)

    Tran, Kim; Zajkowska, Marta; Lam, Vincent; Hawthorne, Wayne

    2014-01-01

    Introduction: Despite an exponential rise in laparoscopic surgery for inguinal herniorrhaphy, overall recurrence rates have remained unchanged. Therefore, an increasing number of patients present with recurrent hernias after having failed anterior and laparoscopic repairs. This study reports our experience with single-incision laparoscopic (SIL) intraperitoneal onlay mesh (IPOM) repair for these hernias. Materials and methods: All patients referred with multiply recurrent inguinal hernias underwent SIL-IPOM from November 1 2009 to October 30 2013. A 2.5-cm infraumbilical incision was made and a SIL surgical port was placed intraperitoneally. Modified dissection techniques, namely, “chopsticks” and “inline” dissection, 5.5 mm/52 cm/30° angled laparoscope and conventional straight dissecting instruments were used. The peritoneum was incised above the symphysis pubis and dissection continued laterally and proximally raising an inferior flap, below a previous extraperitoneal mesh, while reducing any direct/indirect/femoral/cord lipoma before placement of antiadhesive mesh that was fixed into the pubic ramus as well as superiorly with nonabsorbable tacks before fixing its inferior border with fibrin sealant. The inferior peritoneal flap was then tacked back onto the mesh. Results: There were 9 male patients who underwent SIL-IPOM. Mean age was 55 years old and mean body mass index was 26.8 kg/m2. Mean mesh size was 275 cm2. Mean operation time was 125 minutes with hospital stay of 1 day and umbilical scar length of 21 mm at 4 weeks' follow-up. There were no intraoperative/postoperative complications, port-site hernias, chronic groin pain, or recurrence with mean follow-up of 20 months. Conclusions: Multiply recurrent inguinal hernias after failed conventional anterior and laparoscopic repairs can be treated safely and efficiently with SIL-IPOM. PMID:25392643

  7. Two-stage laparoscopic treatment for strangulated inguinal, femoral and obturator hernias: totally extraperitoneal repair followed by intestinal resection assisted by intraperitoneal laparoscopic exploration.

    Science.gov (United States)

    Sasaki, A; Takeuchi, Y; Izumi, K; Morimoto, A; Inomata, M; Kitano, S

    2016-06-01

    Total extraperitoneal preperitoneal (TEP) repair is widely used for inguinal, femoral, or obturator hernia treatment. However, mesh repair is not often used for strangulated hernia treatment if intestinal resection is required because of the risk of postoperative mesh infection. Complete mesh repair is required for hernia treatment to prevent postoperative recurrence, particularly in patients with femoral or obturator hernia. We treated four patients with inguinocrural and obturator hernias (a 72-year-old male with a right indirect inguinal hernia; an 83-year-old female with a right obturator hernia; and 86- and 82-year-old females with femoral hernias) via a two-stage laparoscopic surgery. All patients were diagnosed with intestinal obstruction due to strangulated hernia. First, the incarcerated small intestine was released and then laparoscopically resected. Further, 8-24 days after the first surgery, bilateral TEP repairs were performed in all patients; the postoperative course was uneventful in all patients, and they were discharged 5-10 days after TEP repair. At present, no hernia recurrence has been reported in any patient. The two-stage laparoscopic treatment is safe for treatment of strangulated inguinal, femoral, and obturator hernias, and complete mesh repair via the TEP method can be performed in elderly patients to minimize the occurrence of mesh infection.

  8. Laparoscopic mesh repair of a Morgagni hernia using the double-crown technique: A case study.

    Science.gov (United States)

    Kaida, Takeshi; Ikeda, Atsushi; Shimoda, Hirofumi; Sako, Hiroyuki; Uchida, Hiroshi; Wada, Masahiro; Ikeda, Ken; Okusawa, Seijiro; Watanabe, Masahiko

    2014-11-01

    We report a case of Morgagni hernia in which the patient underwent laparoscopic mesh repair. A 65-year-old woman presented with an abnormal shadow in the right lower lung field on a routine medical checkup. CT showed that the transverse colon passed between the liver and abdominal wall, and herniated into the thoracic cavity. Simple closure was precluded by the large hernial orifice. We therefore performed laparoscopic repair using a Parietex Optimized Composite Mesh. The double-crown technique was used to fix the margin of the mesh to the region around the hernial orifice. Our procedure for repair of a Morgagni hernia with a large hernial orifice is safe and minimally invasive, and it may effectively prevent recurrence.

  9. Laparoscopic umbilical hernia repair in the presence of extensive paraumbilical collateral veins: a case report.

    Science.gov (United States)

    Lases, Seilenna S; Eker, Hasan H; Pierik, Engelbertus G J M; Klitsie, Pieter J; de Goede, Barry; Peeters, Mark P F M Vrancken; Kazemier, Geert; Lange, Johan F

    2011-12-01

    A patient with an umbilical hernia presenting with collateral veins in the abdominal wall and umbilicus is a case that every hernia surgeon has to deal with occasionally. Several underlying diseases have been described to provoke collateral veins in the abdominal wall. However, the treatment strategy should be uniform. We herein report a case of a successful laparoscopic umbilical hernia repair in a patient with collateral veins in the abdominal wall and umbilicus. A 63-year-old man was referred to the surgical outpatient clinic with a large symptomatic umbilical hernia and collateral veins in the abdominal wall, secondary to an occlusion of both common iliac veins. Because of collateral veins in the umbilicus and the size of the hernial defect, he was offered laparoscopic hernia repair without compromising these veins. Because of the extensive abdominal wall collaterals, duplex sonography vein mapping was performed preoperatively to mark a safe collateral-free area for trocar introduction. The defect was repaired by mesh prosthesis.

  10. Randomized Clinical Trial on the postoperative use of an abdominal binder after laparoscopic umbilical and epigastric hernia repair

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Olsen, B H; Rosenberg, J;

    2015-01-01

    -reducing effect of an abdominal binder in patients undergoing laparoscopic umbilical or epigastric hernia repair. METHODS: Based on power analysis, a minimum of 54 patients undergoing laparoscopic umbilical and epigastric hernia repair were to be included. Patients were randomized to abdominal binders vs......PURPOSE: Application of an abdominal binder is often part of a standard postoperative regimen after ventral hernia repair to reduce pain and seroma formation. However, there is lack of evidence of the clinical effects. The aim of the present study was to investigate the pain- and seroma...

  11. Laparoscopic repair of a Morgagni diaphragmatic hernia in a child, using a trans-sternal technique

    Directory of Open Access Journals (Sweden)

    Shah Amar

    2005-01-01

    Full Text Available Laparoscopic repair of Morgagni hernia has been described in adults and children. In the published reports, the crux of the repair consists of suturing the posterior part of the diaphragmatic defect to the undersurface of the sternum or the posterior rectus sheath. The tissue on the undersurface of the sternum is variable is in its nature and may be inadequate for suturing, hence compromising the strength of the repair. A technique that circumvents this problem and offers a strong anatomical repair is described. A Morgagni hernia was diagnosed in a 2-year-old girl with trisomy 21, who presented with recurrent chest infections. She underwent laparoscopic repair of the hernia using three ports. The tissue on the undersurface of the sternum was inadequate for a conventional repair. The procedure was modified as follows: a small transverse incision was made over the lower end of the sternum. Three nonabsorbable mattress sutures were inserted through the sternum, the anterior edge of the diaphragmatic defect, and back through the sternum and tied with extracorporeal knots. The child was discharged home on the second postoperative day. At 6-month follow up, the child was asymptomatic, and had been infection free. A chest radiograph was normal. This is a simple, novel, noninvasive method, which offers a secure anatomical repair and it is not dependent on the adequacy of the tissue on the undersurface of the sternum.

  12. Congenital massive hiatus hernia type IV; initial experience with laparoscopic repair in young infant.

    Science.gov (United States)

    Bataineh, Z A; Rousan, L A; Abu Baker, A; Wahdow, H; Kiwan, R N; Saleem, M M

    2014-06-01

    Congenital massive hiatus hernia (CMHH) is an uncommon disorder during childhood. It can be associated with grave complications especially if presented in the highest grade; type IV, when the hernia contains other intra-peritoneal organ beside the stomach through a large hiatus defect. The insidious form of clinical presentation can be deceptive in diagnosis and may mimic congenital diaphragmatic hernia or other chest pathologies. The basic principle of surgical repair is to reduce the herniated organs, excise the hernia sac, and repair the crural defect and to add anti-reflux procedure with or without gastropexy. Traditionally, this has been done by open approach. Nowadays, the minimally invasive approach is the preferred method of treatment. A sixteen-month-old boy with history of recurrent respiratory symptoms was diagnosed with CMHH type IV for which laparoscopic repair was performed. Few reports in using minimally invasive technique in the management of CMHH in the pediatric age group are present in the literature, to the best of our knowledge type IV had never been described in young infants. We present a new case repaired by laparoscope in a young infant with CMHH type IV from the Middle East.

  13. Laparoscopic parastomal hernia repair: a description of the technique and initial results.

    Science.gov (United States)

    Zacharakis, Emmanouil; Hettige, Roland; Purkayastha, Sanjay; Aggarwal, Rajesh; Athanasiou, Thanos; Darzi, Ara; Ziprin, Paul

    2008-06-01

    In this study, the authors review their initial results with the laparoscopic approach for parastomal hernia repair. Between 2006 and 2007, 4 patients were treated laparoscopically at our institution. The hernia sac was not excised. A piece of Gore-Tex DualMesh with a central keyhole and a radial incision was cut so that it could provide at least 3 to 5 cm of overlap of the fascial defect. The mesh was secured to the margins of the hernia with circumferential metal tacking and trans-fascial sutures. No complications occurred in the postoperative period. After a median follow-up of 9 months, recurrence occurred in 1 patient. This was our first patient in whom mesh fixation was performed only with circumferential metal tacking. The laparoscopic repair of parastomal hernias seems to be a safe, feasible and promising technique offering the advantages of minimally-invasive surgery. The success of this approach depends on longer follow-up reports and standardization of the technical elements.

  14. Reversibility of cardiopulmonary impairment after laparoscopic repair of large hiatal hernia

    Directory of Open Access Journals (Sweden)

    Emanuele Asti

    2015-01-01

    Full Text Available Giant hiatus hernia with or without intrathoracic gastric volvulus often presents with symptoms suggestive of both cardiac and pulmonary compression. Cardiopulmonary impairment may be reversible in these patients by laparoscopic crural repair and fundoplication as shown in this case report. Cardiac magnetic resonance and the cardiopulmonary exercise test may help selecting patients for surgery. These preliminary findings led us to start a prospective study using this multimodality diagnostic approach.

  15. Anaesthesia for a Rare Case of Down’s Syndrome with Morgagni’s Hernia Undergoing Laparoscopic Repair

    Science.gov (United States)

    Marulasiddappa, Vinay

    2015-01-01

    Morgagni’s hernia is a type of congenital diaphragmatic hernia and it is rare in children. The association between Down’s syndrome and Morgagni’s hernia in children is also rare. Laparoscopic repair is a preferred surgical approach than open surgical procedures as laparoscopy offers a bilateral view of Morgagni’s hernia, minimal tissue damage and a faster recovery. When children with Down’s syndrome and associated Morgagni’s hernia present for laparoscopic repair, they pose several complex challenges to the anaesthetist due to the involvement of multiple organ systems, difficulties in airway management and effects of laparoscopic surgery on the organ systems. Therefore, such children need a very careful anaesthetic plan, including a thorough preoperative assessment and preparation for a successful perioperative outcome. PMID:26155537

  16. A COMPARATIVE STUDY IN LAPAROSCOPIC INGUINAL HERNIA REPAIR BETWEEN FIXATION VS NON-FIXATION OF MESH

    Directory of Open Access Journals (Sweden)

    Ayush

    2016-02-01

    Full Text Available INTRODUCTION An inguinal hernia is a weakness in the wall of the abdominal cavity that is large enough to allow escape of soft body tissue or internal organ, especially a part of the intestine. It usually appears as a lump and for some peoples can cause pain and discomfort, limit daily activities and the ability to work. If the bowel strangulates or becomes obstructed it can be life-threatening. A hernia is repaired generally using a synthetic mesh either with open surgery or increasingly using less invasive laparoscopic procedures. AIMS AND OBJECTIVES To compare and evaluate Laparoscopic hernia repair (trans-abdominal pre-peritoneal and total extra peritoneal repair (TAPP & TEP using Prolene mesh with or without fixation. MATERIAL AND METHODS Our study was conducted in dept. of surgery, Government Medical College and associated Dr. Susheela Tiwari Hospital. A total sample of 100 patients who underwent inguinal hernia repair as an elective surgery. 50 of whom underwent fixation of mesh (fixation will be done either by tacker or suture. Rest 5o underwent non fixation of mesh. RESULTS In our study Statistically there was non-significant heterogeneity in operating time (p = 0.15, post-operative pain (p = 0.45, post-operative complications (p = 0.55 and length of hospital stay (p = 0.11 were statistically comparable between two techniques of mesh fixation in LIHR. The risk of developing chronic groin pain (p = 0.67 and risk of hernia recurrence (p = 0.77 was also similar. CONCLUSION NMF in LIHR does not increase the risk of hernia recurrence. It is comparable with TMF in terms of operation time, post-operative pain, post-operative complications, length of hospital stay and chronic groin pain. Therefore, based upon the results of our study NMF approach may be adopted routinely and safely in LIHR.

  17. Laparoscopic Totally Extraperitoneal Groin Hernia Repair Using a Self-Gripping Mesh: Clinical Results of 235 Primary and Recurrent Groin Hernias.

    Science.gov (United States)

    Ozmen, John; Choi, Vincent; Hepburn, Kirsten; Hawkins, Will; Loi, Ken

    2015-11-01

    Compared with open surgery, laparoscopic groin hernia repair has been shown to significantly reduce postoperative pain. However, chronic pain remains a problem with the laparoscopic approach, affecting approximately 10% of patients. The purpose of this study was to evaluate clinical outcomes following the use of Parietex ProGrip™ (Covidien, Dublin, Ireland) self-gripping mesh during laparoscopic totally extraperitoneal groin hernia repair. Data were collected prospectively from 145 male and 15 female patients with 235 inguinal hernias. All patients underwent repair by the laparoscopic totally extraperitoneal approach using Parietex ProGrip mesh. During follow-up ranging from 5 to 24 months, complications, pain score, patient satisfaction, and recurrence were analyzed. All patients were discharged on the day of surgery or the next morning. There were no immediate complications or returns to the operating room. Delayed postoperative complications included minor bruising to the genital region (3 cases), hematoma/seroma (1 case), and wound infection (1 case). The mean follow-up was 15 months, at which time there were no reports of hernia recurrence and 99% of patients were satisfied with their hernia repair. One patient (0.63%) reported severe pain (numeric rating scale score of >7), and 4 patients (2.5%) reported intermittent mild pain on exertion. The results of this study suggest that the use of a self-gripping mesh during the laparoscopic totally extraperitoneal approach is a promising and effective technique for repairing both primary and recurrent inguinal hernias.

  18. Laparoscopic cholecystectomy accompanied by simultaneous umbilical hernia repair: A retrospective study

    Directory of Open Access Journals (Sweden)

    Kamer E

    2007-01-01

    Full Text Available Background : Umbilical defects may cause technical problems for general surgeons in patients during laparoscopic cholecystectomy (LC operations and may increase the incidence of incisional hernia. Aim : The objectives of this study were to determine the optimal repair method for umbilical hernias that already exist or are encountered incidentally and to present data regarding potential problems that may occur during LC. Settings and Design : Medical records of patients who had received simultaneous umbilical hernia repair (UHR with LC were investigated retrospectively. Materials and Methods : Cholelithiasis was accompanied by umbilical hernia in 64 (8.6% out of 745 patients who underwent LC and UHR simultaneously in our hospital between 2000 and 2004. Statistical Analysis Used : The Mann-Whitney U, Chi-square, One-Way Anova, Kaplan-Meier survival analysis, the log-rank test and t test were used for statistical analyses. Results : LC was followed by UHR using primary suture (Group 1, Mayo repair (Group 2 and flat mesh-based repair (Group 3 in 32 (50%, 18 (28.1% and 14 (21.9% patients, respectively. Mean body mass indexes (BMI of patients were 26.6 kg/m 2 , 29.2 kg/m 2 and 39.9 kg/m 2 in Groups 1, 2 and 3, respectively. Recurrence rates were 9.4%, 5.6% and none (0% in Groups 1, 2 and 3, respectively. Recurrence was observed in three (7.0% out of 43(67.2% patients with BMI≥30 kg/m 2 while umbilical hernia recurred in one (4.8% out of 21 (32.8% patients with BMI< 30 kg/m 2 . Overall morbidity and mortality rates were 14.1% and 0%, respectively. Conclusions : The outcomes of the UHR with mesh after laparoscopic surgeries appear to be better for either obese or non-obese patients than primary suture techniques in recurrence rates.

  19. Ultrasonic energy device versus monopolar energy device in laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair.

    Science.gov (United States)

    Otsuka, Shimpei; Kaneoka, Yuji; Maeda, Atsuyuki; Takayama, Yuichi; Fukami, Yasuyuki; Onoe, Shunsuke

    2017-03-01

    Laparoscopic transabdominal preperitoneal (TAPP) is gaining popularity as an approach to repairing of inguinal hernia. In many institutions, a disposable ultrasonic energy device is used in the TAPP repair procedure. However, the benefit and necessity of an ultrasonic device are unclear. We have switched to use of a reusable monopolar energy device, and we conducted a retrospective study comparing the surgical results obtained with each of the energy devices. Our study group comprised 241 adults who underwent TAPP repair for inguinal hernia between November 2012 and December 2014. We compared clinical characteristics, and surgical outcomes between patients in whom a disposable ultrasonic energy device was used (n = 116, U group) and those in whom a reusable monopolar energy device (n = 125, M group) was used. There was no statistically significant difference between the 2 groups in age, sex, body mass index, or hernia type. In cases of unilateral hernia, operation time was significantly longer in the U group than in the M group (71.4 vs. 59.4 min, respectively, p energy device lead us to conclude that the ultrasonic energy device is unnecessary for simple TAPP repair.

  20. Pain, quality of life and recovery after laparoscopic ventral hernia repair

    DEFF Research Database (Denmark)

    Eriksen, J R; Poornoroozy, P; Jørgensen, L N

    2009-01-01

    -being (r = -0.8, p satisfaction (r = -0.67, p life (r = -0.63, p ...BACKGROUND: Laparoscopic ventral hernia repair (LVHR) is a well established procedure in the treatment of ventral hernias. It is our clinical experience that patients suffer intense postoperative pain, but this issue and other recovery parameters have not been studied in detail. METHODS: Thirty......-five patients with hernias >3 cm prospectively underwent LVHR using "double-crown" titanium tack mesh fixation. Pre- and postoperative pain was measured on a 0-100-mm visual analogue scale (VAS) and health-related quality of life was measured using the Short Form 36 questionnaire (SF-36). Several other recovery...

  1. Laparoscopic Repair of Primary Inguinal Hernia Performed in Public Hospitals or Low-Volume Centers Have Increased Risk of Reoperation for Recurrence

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Friis-Andersen, Hans; Rosenberg, Jacob

    2016-01-01

    BACKGROUND: Inguinal hernia repair is traditionally carried out as either open or laparoscopic repair. Laparoscopic repair has been shown to be superior in terms of pain and discomfort, but has a higher risk of reoperation. Quality of inguinal hernia repair is related to factors such as method...... of care. METHODS: This study was based on data from the Danish Hernia Database covering the period from January 1, 1998, to December 31, 2013. Hernia repairs included in this study were laparoscopic repair of primary, inguinal hernias in the elective setting, performed on adult male patients. RESULTS...... reoperation rate compared with public centers: 5.36% versus 8.53%, P ≤ .0001. Type of center and center volume were both independent risk factors for reoperation in a Cox regression model. CONCLUSION: Hospital volume had an effect on the reoperation rate for recurrence after laparoscopic inguinal hernia...

  2. A modified laparoscopic hernioplasty (TAPP) is the standard procedure for inguinal and femoral hernias: a retrospective 17-year analysis with 1,123 hernia repairs.

    Science.gov (United States)

    Peitsch, Werner K J

    2014-02-01

    Laparoscopic and endoscopic procedures generally are accepted for repair of primary and recurrent hernias that follow conventional (anterior) repair. This report discusses transabdominal preperitoneal (TAPP) for incarcerated hernias, scrotal hernias, and hernias after radical prostatectomy, as well as hernia recurrences after TAPP and totally extraperitoneal (TEP) procedures (complex hernias). Studies with long-term results of hernia recurrences are missing. This study aimed to determine hernia recurrence rates for adults after a modified TAPP procedure. The records of patients who had hernia repair surgery at a general hospital 2, 7, 12, and 17 years earlier were analyzed. Living patients were requested to complete a questionnaire to complement information from their hospital records. A retrospective analysis was undertaken that included 5,764 patients who had undergone hernia repair surgery 2-17 years earlier at a single large center. Between 1993 and 2009, a modified TAPP procedure was performed for 5,764 patients (median age, 59.1 years) to repair 6,776 hernias (93.9% of all hernia repairs), including 6,126 primary hernias (87.4%) and 884 recurrent hernias (12.6%). These included 994 complicated hernias (14.2%) closed by a modified TAPP (89.3% of all femoral hernias, 85.9% of scrotal hernias, 79.1% of incarcerated hernias, and 92.7% of hernias after radical prostatectomy). Limited financial and staff resources did not permit a quantitative follow-up study within a reasonable time of all 5,764 patients who had hernia surgery 2-18 years earlier. To obtain quantitative results of hernia recurrences after a modified TAPP, the patients were divided into four subgroups and requested to complete a questionnaire. These four patient subgroups whose surgeries had been performed 2 years earlier (241 patients with 277 hernias), 7 years earlier (285 patients with 376 hernias), 12 years earlier (401 patients with 544 hernias), and 17 years earlier (181 patients with 222

  3. Acute Portomesenteric Venous Thrombosis following Laparoscopic Small Bowel Resection and Ventral Hernia Repair

    Directory of Open Access Journals (Sweden)

    Bhradeev Sivasambu

    2015-01-01

    Full Text Available Acute portomesenteric venous thrombosis is a rare but life-threatening complication of laparoscopic surgery that has been described in literature. Prompt diagnosis and early initiation of treatment are vital to prevent life-threatening complications such as mesenteric ischemia and infarction. A 51-year-old lady had laparoscopic small bowel resection and primary anastomosis with ventral hernia repair 4 weeks earlier for partial small bowel obstruction. Her postoperative period was uneventful and she was discharged home. Four weeks after surgery she developed watery diarrhea and generalized abdominal pain for four-day duration. A computed tomography of the abdomen revealed portomesenteric venous thrombosis although a computed tomography of abdomen before surgery 4 weeks back did not show any portomesenteric venous thrombosis. We are reporting a case of acute portomesenteric venous thrombosis as a complication of laparoscopic surgery.

  4. Laparoscopic repair of Morgagni diaphragmatic hernia in infants ...

    African Journals Online (AJOL)

    anterior abdominal wall without excision of the hernia sac is safe and effective ... Department of Pediatric Surgery, Maternity and Children's Hospital, Madinah,. Kingdom of .... mothorax, anterior mediastinal mass, or lung abscess secondary to ...

  5. Outcome of laparoscopic inguinal hernia repair in a South African ...

    African Journals Online (AJOL)

    herniorrhaphy in a large private practice healthcare setting. The primary outcome was hernia ... specifically designed, non-commercial practice management system contains a complete ..... Schwartz's Principles of Surgery. 8th ed. New York: ...

  6. Evaluation of port site hernias, chronic pain and recurrence rates after laparoscopic ventral hernia repair: a monocentric long-term study.

    Science.gov (United States)

    Liot, Emilie; Bréguet, Romain; Piguet, Valérie; Ris, Frédéric; Volonté, Francesco; Morel, Philippe

    2017-09-01

    The aim of this study was to evaluate hernia appearance at the trocar site after laparoscopic treatment of primary or incisional ventral hernias using an intraperitoneal prosthetic mesh. Chronic pain at the trocar site and primary hernia recurrence were also evaluated. Two-hundred and twenty-six consecutive patients who underwent a standardized laparoscopic hernia repair for primary or incisional ventral hernia at our centre between January 2000 and December 2008 were included. All patients had clinical and radiological examinations. Primary end points were port site hernia and the occurrence of chronic trocar site pain. Secondary end point was primary hernia recurrence. Seventy-eight patients were excluded: 6 declined to participate, 48 were unreachable, and 24 did not meet the inclusion criteria (nine underwent a single site laparoscopic approach, ten died of unrelated disease, three were unable to visit the hospital and two had relocated). After exclusion, 148 remained in our study. Mean follow-up was 49 ± 12.6 months. Mean age at the time of surgery was 60 years (range, 28-83) In total, 504 port sites were clinically and radiologically evaluated, and only one (0.02%) had secondary herniation. Three patients (2.0%) had a recurrent hernia, and 14 (9.5%) had developed chronic pain at time of assessment. Nine patients (6.1%) were re-operated for the recurrent hernia before the follow-up evaluation. The overall recurrence rate is, therefore, 8.1%. Only two minor complications and no major complications occurred after surgery. No mortality was observed. Laparoscopic repair for primary or incisional ventral hernias is a safe surgical approach, with low rates of hernia recurrence and a low morbidity rate. When fascial closure is maintained for 10 mm port sites, the incidence of port site hernias is very low. Five millimetre ports do not require closure.

  7. Recurrence in a Laparoscopically Repaired Traumatic Diaphragmatic Hernia: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Bhatt

    2016-02-01

    Full Text Available Introduction Traumatic diaphragmatic hernia (TDH develops infrequently following a traumatic diaphragmatic rupture (TDR. As TDR is frequently missed due to lack of sensitive and specific imaging modalities, a high index of suspicion for such injuries is essential, whether immediately posttraumatic, or even decades after the trauma. We describe a rare case of recurrence in a laparoscopically repaired TDH and review the current literature on the same. Case Presentation A 23-year-old male with a history of primary laparoscopic repair of left-sided TDR two years ago presented with symptoms of acute large bowel obstruction. His chest X-ray showed a left-sided pleural effusion and a loop of the bowel in the left hemithorax, but no signs of free gas. An abdominal X-ray (AXR demonstrated massively dilated large bowel with distension of the small bowel. At laparotomy, the obstructing lesion consisted of the large bowel with omentum herniated through the left hemidiaphragm, consistent with a left recurrent/chronic diaphragmatic hernia. The diaphragmatic defect was repaired with interrupted nylon. The patient made an uneventful recovery. Conclusions Recurrence after repair of TDH is a less reported condition (with only two published articles and little is known regarding the factors responsible for this. Laparoscopy is an excellent diagnostic tool, but currently management is probably best performed via an open technique using heavy non-absorbable suture material to prevent recurrence. Long term follow up of these patients should also be considered.

  8. Laparoscopic inguinal hernia repair in the Armed Forces: A 5-year single centre study

    Science.gov (United States)

    Jakhmola, C.K.; Kumar, Ameet

    2015-01-01

    Background Surgery for inguinal hernia continues to evolve. The most recent development in the field of surgery for inguinal hernia is the emergence of laparoscopic inguinal hernia surgery (LIHS) which is challenging the gold standard Lichtenstein's tension free mesh repair. Our centre has the largest series of LIHS from any Armed Forces hospital. The aim of this study was to analyze the short and long term outcomes at our center since its inception. Methods Retrospective review of prospectively maintained data base of 501 LIHS done in 434 patients by a single surgeon between April 2008 and October 2013. Preoperative, intraoperative, postoperative and follow-up data was analyzed with emphasis on the recurrence rates and the incidence of inguinodynia. Results 402 (92.6%) patients had primary hernias and 367 (84.6%) patients had unilateral hernias. Of the 501 repairs, 453 (90.4 %) were done totally extraperitoneal approach and 48 (9.6 %) were done by the transabdominal preperitoneal approach. The mean operative time for unilateral and bilateral repairs was 40.9 ± 11.2 and 76.2 ± 15.0 minutes, respectively. The conversion rate to open surgery was 0.6%. The intraoperative, and early and late postoperative complication rates were 1.7%, 6.2% and 3%, respectively. The incidence of chronic groin pain was 0.7% and the recurrence rate was 1.6%. The median hospital stay was 1 day (1–5 days). Conclusion We, in this series of over 500 repairs have demonstrated that feasibility as well as safety of LIHS at our centre with good short and long term outcomes. PMID:26663957

  9. Feasibility and outcome after laparoscopic ventral hernia repair using Proceed mesh

    DEFF Research Database (Denmark)

    Rosenberg, J.; Burcharth, J.

    2008-01-01

    BACKGROUND: There are many different meshes available for laparoscopic repair of ventral hernias. A relatively new product is the Proceed mesh with a bioresorbable layer against the bowels and a polypropylene layer against the abdominal wall. There are, however, no human data available. The aim...... study included 49 patients with a median age of 64 years (range 30-89) and body mass index of 27.8 (19.4-50.5). The dimensions of the mesh varied from 4 x 4 cm to 30 x 40 cm (median 15 x 15 cm). One patient developed an uncomplicated wound infection and none of the 49 patients developed mesh infections...

  10. Laparoscopic ventral hernia repair: postoperative antibiotics decrease incidence of seroma-related cellulitis.

    Science.gov (United States)

    Edwards, C; Angstadt, J; Whipple, O; Grau, R

    2005-11-01

    Seroma formation has been documented as a common complication in laparoscopic ventral herniorraphy. However, there are no recent studies documenting the incidence of or protective strategies against seroma-related cellulitis. The purpose of this study was to evaluate 65 laparoscopic ventral herniorraphies and to determine if seroma-related cellulitis can be prevented by the routine use of postoperative prophylactic antibiotics. A retrospective case review of 65 laparoscopic ventral herniorraphies was done at our institution from February 2002 to January 2004. All were performed using either Gore-Tex DualMesh or Bard Composix mesh and performed under the direct supervision of a single surgeon. Twenty patients received only preoperative third-generation cephalosporins or fluoroquinolones. All other patients received either 7 days of postoperative oral cephalosporins or fluoroquinolones in addition to preoperative antibiotics. Sixty-five patients underwent laparoscopic ventral hernia repair. There were 45 patients in the postoperative antibiotic group and 20 patients in the preoperative-only antibiotic group. Twenty-one patients developed seromas. Twelve of these developed cellulitis. The rates of seroma formation were similar in the two groups with 30 per cent in the preoperative only group and 33 per cent in the postoperative antibiotic group. However, 100 per cent of the seromas in the preoperative antibiotic group developed seroma-related cellulitis. Only 40 per cent of seromas in the postoperative antibiotic group developed cellulitis. In addition, two seromas in the preoperative antibiotics-only group progressed to frank mesh infection necessitating operative removal. There were no complications related to antibiotic administration. Laparoscopic ventral hernia repair is a safe and effective procedure. Our seroma rate is 30 per cent and compares equally with prior reported studies. Seroma-related cellulitis is a common problem that can lead to mesh infection

  11. Laparoscopic management of mesh erosion into small bowel and urinary bladder following total extra-peritoneal repair of inguinal hernia

    Directory of Open Access Journals (Sweden)

    Sandeep Aggarwal

    2016-01-01

    Full Text Available Mesh erosion into visceral organs is a rare complication following laparoscopic mesh repair for inguinal hernia with only 15 cases reported in English literature. We report the first case of complete laparoscopic management of mesh erosion into small bowel and urinary bladder. A 62-year-male underwent laparoscopic total extra-peritoneal repair of left inguinal hernia at another centre in April 2012. He presented to our centre 21 months later with persistent lower urinary tract infection (UTI. On evaluation mesh erosion into bowel and urinary bladder was suspected. At laparoscopy, a small bowel loop was adhered to the area of inflammation in the left lower abdomen. After adhesiolysis, mesh was seen to be eroding into small bowel. The entire infected mesh was pulled out from the pre-peritoneal space and urinary bladder wall using gentle traction. The involved small bowel segment was resected, and bowel continuity restored using endoscopic linear cutter. The resected bowel along with the mesh was extracted in a plastic bag. Intra-operative test for leak from urinary bladder was found to be negative. The patient recovered uneventfully and is doing well at 12 months follow-up with resolution of UTI. Laparoscopic approach to mesh erosion is feasible as the plane of mesh placement during laparoscopic hernia repair is closer to peritoneum than during open hernia repair.

  12. FASCIA LATA AS A SOURCE OF RECONSTRUCTION IN THE LAPAROSCOPIC REPAIR OF UMBILICAL HERNIAS

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    Dhamotharan

    2015-11-01

    Full Text Available AIMS AND OBJECTIVES: The aim of this study was to evaluate the versatility of tensor fascia lata flap for laparoscopic reconstruction of umbilical hernias. MATERIALS AND METHODS: In this study a total of 24 patients with defects over umbilical region were included. Reconstruction was performed using patients’ fascia lata. Patients were evaluated in terms of viability of the tissue and donor site morbidity, followed up for a period of 3 years. RESULTS: All the defects got effectively and adequately repaired using the autologous fascia lata. All the patients were followed up for an average period of 3 years. Donor site morbidity was minimal. CONCLUSION: It was concluded that the autologous fascia lata is a versatile, reliable, easy, and less time consuming procedure for the coverage of umbilical wall hernias via laparoscopy.

  13. Anaesthetic Management of Laparoscopic Morgagni Hernia Repair in a Patient with Coexisting Down Syndrome, Patent Foramen Ovale and Pectus Carinatum.

    Science.gov (United States)

    Kozanhan, Betül; Başaran, Betül; Aygın, Feride; Akkoyun, İbrahim; Özmen, Sadık

    2016-02-01

    Laparoscopic repair has several advantages with a minimally invasive surgical option for children with Morgagni hernias; however, a number of physiological sequelae results from pneumoperitoneum and insufflation. These physiological changes may be more significant in patients with a congenital heart disease. Perioperative detailed evaluation, meticulous monitorization and cooperation with a surgical team are important in cases with patent foramen ovale for the possible risk of the paradoxical gas embolism. We present the anaesthetic management of a patient with patent foramen ovale, Down syndrome and pectus carinatus who successfully underwent laparoscopic Morgagni hernia repair. Under a well-managed anaesthesia that prevented complications because of pneumoperitoneum, laparoscopic surgery would be safe enough for patients with Morgagni hernia having an associated congenital heart disease.

  14. Laparoscopic Repair of Morgagni Hernia: Three-Case Presentation and the Literature

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    Gholamali Godazandeh

    2016-01-01

    Full Text Available Introduction. Morgagni hernia is a rare form of congenital diaphragmatic hernia. Case Presentation. We present three cases of Morgagni hernia with GI symptoms treated by laparoscopic surgery. Discussion. Hernial sac was excised in two cases and left in situ in one case. There was no recurrence in symptoms after 30 months from surgery.

  15. Laparoscopic repair of a rare acquired abdominal intercostal hernia

    Directory of Open Access Journals (Sweden)

    Dilip Dan

    2014-01-01

    CONCLUSION: Although AIH is a rare condition, the pathophysiology seems relatively straightforward and the use of CT scan is recommended to confirm the diagnosis. The laparoscopic approach, with all its established benefits, appears to be a safe and feasible option in its management.

  16. Pseudoaneurysm of the inferior epigastric artery: a rare complication of laparoscopic ventral hernia repair.

    Science.gov (United States)

    Nichols-Totten, Kysha; Pollema, Travis; Moncure, Michael

    2012-02-01

    Pseudoaneurysm of the inferior epigastric artery (IEA) is a recognized complication of surgery; however, it is a very rare clinical occurrence. The anatomic position of the IEA subjects patients to possible IEA injury during abdominal wall procedures that are close to the artery, such as insertions of drains, Tenckhoff catheters, laparoscopic trocars, or paracentesis. Treatment options include open surgery, percutaneous coil embolization, embolization with N-butyl cyanoacrylate, sonographic-guided thrombin injection, or sonographic-guided compression. We report the first case of a pseudoaneurysm arising from the IEA after a laparoscopic ventral hernia repair. To our knowledge, 17 IEA pseudoaneurysms have been reported, only 3 of which were spontaneous. The pseudoaneurysm in our patient was successfully treated by percutaneous injection of thrombin by interventional radiology.

  17. Laparoscopic repair for recurrent parastomal hernia of an end stoma using the sandwich technique while preserving an ileal conduit: A case report

    Directory of Open Access Journals (Sweden)

    Toshiaki Wada

    2016-01-01

    Conclusion: We herein report a case of recurrent parastomal hernia treated laparoscopically while preserving an ileal conduit using the sandwich technique which combines the keyhole and Sugarbaker techniques. This is a quite rare case report of laparoscopic repair for recurrent parastomal hernia in a patient with an ileal conduit.

  18. Clinical Analysis of Laparoscopic Repair of Inguinal Hernia by Laparoscopic Repair of Inguinal Hernia%腹腔镜下经腹腔腹膜前疝修补术治疗腹股沟疝的临床分析

    Institute of Scientific and Technical Information of China (English)

    刘海滨; 陈蕴铂; 陈坤; 苏伟; 衣东升

    2016-01-01

    Objective To evaluate the clinical efficacy of retroperitoneal laparoscopic premenstrual abdominal cavity hernia repair of inguinal hernia.Methods 82 cases of inguinal hernia patients were randomized to the treatment group(n=41)under application of laparoscopic hernia repair before peritoneal peritoneum in the hospital,the control group(n=41)to adopt an open tension-free hernia repair,compared to the effect of two groups of surgery. ResultsThe treatment group the incidence of complications,recurrence rates were lower than the control group(P<0.05).Conclusion The clinical effect of laparoscopic repair of inguinal hernia by laparoscopic anterior abdominal hernia.%目的:探讨腹腔镜下经腹腔腹膜前疝修补术治疗腹股沟疝的临床疗效。方法将医院收治的82例腹股沟疝患者随机分组,治疗组(n=41)应用腹腔镜下经腹腔腹膜前疝修补术,对照组(n=41)采取开放无张力疝修补术,对比两组手术效果。结果治疗组并发症发生率、复发率均低于对照组(P<0.05)。结论腹腔镜下经腹腔腹膜前疝修补术治疗腹股沟疝的临床疗效确切。

  19. [Inguinal and femoral hernia repair].

    Science.gov (United States)

    Geissler, B; Anthuber, M

    2011-05-01

    With an incidence of 200,000 new cases per year in Germany, inguinal hernia has a significant socioeconomic impact. The 2009 guidelines from the European Hernia Society established treatment recommendations. Hernia repair is based on reinforcing the posterior wall of the inguinal canal by suture or mesh repair by an anterior or posterior approach. Lightweight mesh reduces recurrence rates and is the treatment of choice even in primary hernias. Laparoscopic hernia repair is associated with specific risks but is superior in postoperative pain and earlier return to work.

  20. Laparoscopic repair of an abdominal hernia using an expanded polytetrafluoroethylene patch secured by a four-corner tacking technique.

    Science.gov (United States)

    Tagaya, N; Mikami, H; Kogure, H; Ohyama, O

    1995-01-01

    An improved technique for performing laparoscopic repair of an abdominal hernia is described herein. To ensure a successful repair, it is most important that adequate tension of the expanded-polytetrafluoroethylene (e-PTFE) patch be achieved, and that the defect be completely covered and securely stapled. Our technique involves tacking the four corners of the patch to the abdominal wall with a 2-0 nylon suture using a straight needle, then stapling it to the anterior abdominal wall over the defect with a laparoscopic stapler. We believe that this technique is a safe and reliable method which will prove useful for laparoscopic surgery.

  1. [Laparoscopic inguinal hernia repair "IPOM" vs "open tension free". Preliminary results of a prospective randomized study].

    Science.gov (United States)

    Catani, M; De Milito, R; Spaziani, E; Chiaretti, M; Manili, G; Capitano, S; Di Filippo, A; Simi, M

    2003-12-01

    The authors report the preliminary results of a prospective comparison of IPOM (group A) and "open tension free" (group B) hernioplasty in 50 patients having a mono or bilateral primitive hernia. In group A (26 patients) hernia repair was performed using "Gore-Tex DualMesh Plus biomaterial with holes Corduroy" and in group B (24 patients) using the patch and plug technique with Marlex prosthesis. No intraoperative complications occurred and, in group A, no conversion was necessary. Four minor complications were obser-ved in group A (10.8%): 3 seromas and 1 transient paresthesia; 5 in group B (16%): 4 hematomas and 1 wound infection (p=n.s.). In group A only 2 patients (7.6%) needed analgesics after the first 24 hours and 12 patients (50%) in group B (p<0.001). Mean resumption of normal activity was 8 days in group A and 17 days in group B (p<0.001). At a 12-month-follow-up, no recurrence was reported in both groups. The results of this prospective randomized study show that IPOM may be not only a feasible and effective procedure in the treatment of recurrent and bilateral hernia or when hernia repair is performed during other laparoscopic procedures, but also in particular cases of primitive hernia such as in very active young males or heavy duty workers. However it is necessary to definitely ascertain the true incidence of recurrence in non limited series and in longer follow-up and the preliminary results of this study encourage the authors to complete the randomized study.

  2. A Contralateral Complication of Extra-peritoneal Laparoscopic Inguinal Hernia Repair

    Directory of Open Access Journals (Sweden)

    Jacob S

    2010-03-01

    Full Text Available A 63 year old female underwent an uncomplicated total extraperitoneal repair of a right direct inguinal hernia. One week later she presented with a strangulated left femoral hernia. We believe the dissection of the extraperitoneal space caused bleeding which tracked down through the femoral canal resulting in a femoral hernia. To date there are no reports of such a complication following total extraperitoneal inguinal hernia repair in the literature.

  3. Laparoscopic repair of Morgagni hernia in an adult: use of a porcine small intestine submucosa biocompatible prosthesis.

    Science.gov (United States)

    Puglisi, Francesco; Capuano, Palma; Iambrenghi, Onofrio Caputi; Armenise, Nicola; Carlucci, Francesco; Memeo, Maurizio; Memeo, Riccardo; Martines, Gennaro

    2009-01-01

    Morgagni hernia is a rare cause of diaphragmatic hernia. There are few reports of laparoscopic repair in the literature. Tension-free hernia closure with synthetic mesh reduces recurrence but occasionally results in complications, such as visceral stricture, erosion or perforation. We report a case of successful laparoscopic repair of a very large symptomatic Morgagni hernia in a 78-year-old patient, treated by positioning a gradually resorbable mesh made from porcine SIS (Surgisis Soft Tissue Graft device--Cook Inc, Bloomington, Ind). After surgery, the patient reported an immediate, marked improvement in clinical symptoms. During the postoperative course, pleural and pericardial leakage occurred. The pleural leakage was immediately drained with thoracentesis, and the pericardial leakage was treated conservatively. No other complications occurred after patient discharge. One year later, the patient was in very good general condition. No recurrence was documented with abdominal CT scan, which also demonstrated connective tissue proliferation that was progressively replacing the prosthesis. Laparoscopic repair is a safe, efficacious procedure for the treatment of diaphragmatic hernia, and presents all the advantages of minimally invasive surgery. The use of new types of material featuring marked biocompatibility and gradual reabsorbability characteristics offers considerable benefits.

  4. Laparoscopic repair of abdominal hernias using an ePTFE patch--a modification of a previously described technique.

    Science.gov (United States)

    Phillips, E; Dardano, A N; Saxe, A

    1997-01-01

    A variety of laparoscopic procedures for the repair of abdominal wall hernias have been described. The repair described in this paper represents a modification and improvement of one approach. Our technique employs an Origin Tacker (Origin Medsystems, Inc, Menlo Park, CA) and a Gore suture passer (W. L. Gore, Flagstaff, AZ) to secure an expanded polytetrafluoroethylene (ePTFE) patch, (DualMesh, W. L. Gore, Flagstaff, AZ) to the anterior abdominal wall. This approach simplifies the repair by minimizing the number of steps required to secure the ePTFE graft to the anterior abdominal. We have found this to be a safe and reliable technique that may be used in the laparoscopic repair of ventral, umbilical, or inguinal hernias.

  5. Laparoscopic Repair of Abdominal Hernias Using an ePTFE Patch—A Modification of a Previously Described Technique

    Science.gov (United States)

    Phillips, Eduardo; Dardano, Anthony N.; DO

    1997-01-01

    Background: A variety of laparoscopic procedures for the repair of abdominal wall hernias have been described. The repair described in this paper represents a modification and improvement of one approach. Methods: Our technique employs an Origin Tacker (Origin Medsystems, Inc, Menlo Park, CA) and a Gore suture passer (W. L. Gore, Flagstaff, AZ) to secure an expanded polytetrafluoroethylene (ePTFE) patch, (DualMesh, W. L. Gore, Flagstaff, AZ) to the anterior abdominal wall. Results: This approach simplifies the repair by minimizing the number of steps required to secure the ePTFE graft to the anterior abdominal. Conclusions: We have found this to be a safe and reliable technique that may be used in the laparoscopic repair of ventral, umbilical, or inguinal hernias. PMID:9876688

  6. ONSTEP versus laparoscopy for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-01

    INTRODUCTION: The optimal repair of inguinal hernias remains controversial. It is recommended that an inguinal hernia be repaired using a mesh, either with a laparoscopic or an open approach. In Denmark, the laparoscopic approach is used in an increasing number of cases. The laparoscopic repair has...... clinical trial described in this protocol is to evaluate chronic pain after inguinal hernia repair using the ONSTEP method versus the laparoscopic approach. METHODS: This study is designed as a non-inferiority, two-arm, multicentre, randomised clinical trial, with a 1:1 allocation to ONSTEP or laparoscopic...

  7. ONSTEP versus laparoscopy for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-01

    INTRODUCTION: The optimal repair of inguinal hernias remains controversial. It is recommended that an inguinal hernia be repaired using a mesh, either with a laparoscopic or an open approach. In Denmark, the laparoscopic approach is used in an increasing number of cases. The laparoscopic repair has...... clinical trial described in this protocol is to evaluate chronic pain after inguinal hernia repair using the ONSTEP method versus the laparoscopic approach. METHODS: This study is designed as a non-inferiority, two-arm, multicentre, randomised clinical trial, with a 1:1 allocation to ONSTEP or laparoscopic...

  8. Delayed recovery due to exaggerated acid, base and electrolyte imbalance in prolonged laparoscopic repair of diaphragmatic hernia

    Directory of Open Access Journals (Sweden)

    Rakesh Garg

    2011-01-01

    Full Text Available The acid, base and electrolyte changes are usually observed in the perioperative settings. We report a case of prolonged laparoscopic repair of left-sided diaphragmatic hernia which involved a lot of tissue handling and fluid replacement leading to acid, base and electrolyte imbalance. A 42-year-old male underwent prolonged laparoscopic repair under general anesthesia. Intraoperatively, surgeon reported that contents of hernia includes bowel along with mesentery, spleen and lot of fatty tissue The blood loss was about 2 L which was replaced with 1 L of colloid and 7.5 L of lactated ringer. Near the end of surgery arterial blood gas analysis revealed metabolic acidosis, hyperkalemia, and hypocalcemia leading to delayed recovery. We conclude prolonged laparoscopic surgery involving lot of tissue handling including gut and fat should be monitored for acid, base, electrolyte imbalance and corrected timely to have uneventful rapid recovery.

  9. Ventral hernia repair

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007661.htm Ventral hernia repair To use the sharing features on this page, please enable JavaScript. Ventral hernia repair is surgery to repair a ventral hernia. ...

  10. What happens to the rectus abdominus fascia after laparoscopic ventral hernia repair?

    Science.gov (United States)

    Sickle, K R Van; Baghai, M; Mattar, S G; Bowers, S P; Ramaswamy, A; Swafford, V; Smith, C D; Ramshaw, B J

    2005-12-01

    One criticism of laparoscopic ventral hernia repair (LVH) is that the rectus muscles are not re-approximated to the midline, and the effect of LVH repair on the fascial edges is unclear. Progressive migration of the fascial edges toward the midline has been observed anecdotally, but objective evidence remains limited. The purpose of this study is to observe the effect of LVH repair on the rectus abdominus fascia. Patients undergoing LVH repair with defects > 10 cm in horizontal diameter were identified prospectively and enrolled. All were repaired laparoscopically with intraperitoneal placement of mesh (DualMesh, W.L. Gore and Associates) using a standard approach. Radio-opaque clips were placed at the fascial edges intraoperatively to mark the defect, and plain abdominal films were taken postoperatively (Time 1) to establish the initial distance between clips (measured in cm). A subsequent follow-up film was taken (Time 2), and the difference in clip distance per patient was recorded. Results were analyzed using a chi-squared test. Twelve patients qualified for analysis and their results were compared. Mean fascial defect size was 15.1 cm (range 8.3-22.0). With respect to change in clip distance from Times 1 to 2, three events were observed: (1) Diminished (i.e. medialized), (2) Enlarged, or (3) No Change. Ten patients (83%) medialized, one patient enlarged, and one patient showed no change (chi2 (d.f. = 2) 9.17, p < 0.0023). Medialization of the rectus abdominus fascia occurs in the majority of patients undergoing LVH repair. Causes for this phenomenon are unclear: however eliminating intrabdominal pressure with intraperitoneal mesh placement likely plays a role.

  11. A standardized resident training program in endoscopic surgery in general and in laparoscopic totally extraperitoneal (TEP) inguinal hernia repair in particular

    DEFF Research Database (Denmark)

    Miserez, Marc; Arregui, Maurice; Bisgaard, Thue

    2009-01-01

    The need for acquisition of specific laparoscopic skills has emphasized the role of a preclinical laboratory-training program. However, for laparoscopic inguinal hernia repair with a steep learning curve, especially for totally extraperitoneal repair, preclinical skill training remains a challeng...

  12. Recurrence rate after absorbable tack fixation of mesh in laparoscopic incisional hernia repair

    DEFF Research Database (Denmark)

    Christoffersen, Mette W; Brandt, E; Helgstrand, F;

    2015-01-01

    absorbable or non-absorbable tacks for mesh fixation. METHODS: This was a nationwide consecutive cohort study based on data collected prospectively concerning perioperative information and clinical follow-up. Patients undergoing primary, elective, laparoscopic incisional hernia repair with absorbable or non......-absorbable tack fixation during a 4-year interval were included. Follow-up was by a structured questionnaire regarding recurrence and chronic pain, supplemented by clinical examination, and CT when indicated. Recurrence was defined as either reoperation for recurrence or clinical/radiological recurrence. RESULTS......: Of 1037 eligible patients, 84·9 per cent responded to the questionnaire, and 816 were included for analysis. The median observation time for the cohort was 40 (range 0-72) months. The cumulative recurrence-free survival rate was 71·5 and 82·0 per cent after absorbable and non-absorbable tack fixation...

  13. Technique of laparoscopic ventral hernia repair can be modified to successfully repair large defects in patients with loss of domain.

    Science.gov (United States)

    Baghai, Mercedeh; Ramshaw, Bruce J; Smith, C Daniel; Fearing, Nicole; Bachman, Sharon; Ramaswamy, Archana

    2009-03-01

    Laparoscopic ventral hernia repair (LVHR) can be challenging in patients with large abdominal wall defects and loss of domain (LOD). When hernia contents are reduced, the pneumoperitoneum preferentially fills the sac, leaving no space for mesh manipulation. This study presents a modification for LVHR in LOD patients, as well as outcomes for a series of patients. Between September 2002 and August 2004, 10 patients with large ventral hernias and LOD underwent attempts at LVHR. The technique is modified by placing additional trocars to allow for fixation from above the mesh. Patient data were harvested from a prospective database and analyzed. All hernias were recurrent in nature. Mean defect size was 626 cm(2), requiring 1 to 4 pieces of sutured Gore Dualmesh for a tension-free repair. Three patients' procedures were aborted after adhesiolysis, with concerns about missed enterotomies. All 3 underwent delayed mesh placement within the same hospitalization. Only 2 were successful. The third patient had significant bowel edema precluding mesh placement. Two patients were converted to open repairs (Rives-Stoppa and component separation). There were no mortalities, but there were 2 major complications: inferior vena cava thrombosis and transient abdominal compartment syndrome. In follow-up (7.7 months) there were 2 recurrences secondary to excision of infected mesh. It is possible to obtain a successful LVHR in patients with large defects and LOD. The technique is complex and is modified to allow for mesh fixation from above the mesh. Frequent change in patient positioning allows for visualization below the fascial defect.

  14. Inguinal hernia surgery in developing countries: should laparoscopic repairs be performed ?

    OpenAIRE

    Nsadi, Berthier; Detry, Olivier; Arung, Willy

    2017-01-01

    In conclusion, from our own experience of laparoscopic surgery in DRC, we strongly believe that there is no reason to develop inguinal laparoscopic repair in developing countries. Laparoscopic repairs are more expensive and more difficult to perform and to learn. The next step of abdominal wall repairs in the developing world should focus on teaching the surgeons to use either commercial or low-cost mosquito meshes in open repairs and assessing the results of these procedures in such challeng...

  15. Fibrin sealant for mesh fixation in laparoscopic groin hernia repair does not increase long-term recurrence

    DEFF Research Database (Denmark)

    Fenger, Andreas Qwist; Helvind, Neel Maria; Pommergaard, Hans-Christian;

    2016-01-01

    ) laparoscopic groin hernia repair using either fibrin sealant or tacks for mesh fixation. METHODS: This study used data from the Danish Hernia Database to create the following cohort: All patients operated laparoscopically for primary groin hernia with a TAPP procedure using fibrin sealant for mesh fixation....... These patients were matched 1:2 with patients, where the mesh was fixated using tacks. A validated questionnaire was sent to all included patients to determine recurrence, which was defined as reoperation or clinical diagnosis of recurrence by a physician. Follow-up was from index operation to either reoperation...... were found, of which 30 (5.8%) were in the fibrin sealant group and 84 (8.3%) in the tacks group (p = 0.084). The Cox regression analysis found no difference in recurrence with the use of tacks compared to fibrin sealant (hazard ratio 0.8) [95% CI (0.5-1.2)]. CONCLUSION: We found no significant...

  16. Traumatic lumbar hernia repair: a laparoscopic technique for mesh fixation with an iliac crest suture anchor.

    Science.gov (United States)

    Links, D J R; Berney, C R

    2011-12-01

    Traumatic lumbar hernia (TLH) is a rare presentation. Traditionally, these have been repaired via an open approach. Recurrence can be a problem due to the often limited tissue available for mesh fixation at the inferior aspect of the hernia defect. We report the successful use of bone suture anchors placed in the iliac crest during transperitoneal laparoscopy for mesh fixation to repair a recurrent TLH. This technique may be particularly useful after previous failed attempts at open TLH repair.

  17. Does expanded polytetrafluoroethylene mesh really shrink after laparoscopic ventral hernia repair?

    Science.gov (United States)

    Carter, P R; LeBlanc, K A; Hausmann, M G; Whitaker, J M; Rhynes, V K; Kleinpeter, K P; Allain, B W

    2012-06-01

    The shrinkage of mesh has been cited as a possible explanation for hernia recurrence. Expanded polytetrafluoroethylene (ePTFE) is unique in that it can be visualized on computed tomography (CT). Some animal studies have shown a greater than 40% rate of contraction of ePTFE; however, very few human studies have been performed. A total of 815 laparoscopic incisional/ventral hernia (LIVH) repairs were performed by a single surgical group. DualMesh Plus (ePTFE) (WL Gore & Associates, Newark, DE) was placed in the majority of these patients using both transfascial sutures and tack fixation. Fifty-eight patients had postoperative CTs of the abdomen and pelvis with ePTFE and known transverse diameter of the implanted mesh. The prosthesis was measured on the CT using the AquariusNet software program (TeraRecon, San Mateo, CA), which outlines the mesh and calculates the total length. Data were collected regarding the original mesh size, known linear dimension of mesh, seroma formation, and time interval since mesh implantation in months. The mean shrinkage rate was 6.7%. The duration of implantation ranged from 6 weeks to 78 months, with a median of 15 months. Seroma was seen in 8.6% (5) of patients. No relationship was identified between the percentage of shrinkage and the original mesh size (P = 0.78), duration of time implanted (P = 0.57), or seroma formation (P = 0.074). In 27.5% (16) of patients, no shrinkage of mesh was identified. Of the patients who did experience mesh shrinkage, the range of shrinkage was 2.6-25%. Our results are markedly different from animal studies and show that ePTFE has minimal shrinkage after LIVH repair. The use of transfascial sutures in addition to tack fixation may have an implication on the mesh contraction rates.

  18. 腔镜下联合医用胶与开放式无张力疝修补术治疗腹股沟复发疝的临床对比研究%A comparative study on laparoscopic hernia repairment and tension-free hernia repair in the management of recurrent inguinal hernia

    Institute of Scientific and Technical Information of China (English)

    李建忠

    2011-01-01

    Objective To investigate the safety and validity of laparoscopic hernia repairment in the treatment of recurrent inguinal hernia.Methods The retrospective analysis was used to analyze 70 cases of recurrent inguinal hernia repairment(43 cases of indirect hernia,20 cases of direct hernia) after treatment with laparoscopic hernia repairment (37 cases, including 23 cases of indirect hernia and 14 ca ses of direct hernia) or tension-free repairment (33 cases, including 20 cases of indirect hernia and 13 cases of direct hernia). All of them were followed up to 6-57 months and the median time of follow-up was 36.7 months. Results There was no significant difference in the operation time andlength of stay after surgery between the two groups (P>0.05).The complication rate of laparoscopic hernia repairment was lower than that of tension-free repairment(P0.05);腔镜组总的并发症发生率低于开放组,差异有统计学意义(P<0.05);腔镜组的住院费用高于开放组,差异有统计学意义(P<0.05).结论 腹腔镜联合医用胶腹股沟疝修补术治疗腹股沟复发性疝安全、有效、术后并发症少,值得临床推广.

  19. Short-term results for laparoscopic repair of large paraesophageal hiatal hernias with Gore Bio A® mesh.

    Science.gov (United States)

    Priego Jiménez, Pablo; Salvador Sanchís, José Luis; Angel, Vicente; Escrig-Sos, Javier

    2014-01-01

    The application of mesh-reinforced hiatal closure has resulted in a significant reduction in recurrence rates in comparison with primary suture repair. One of the most debated issues is the risk of complications related to the use of the prosthesis, such as esophageal erosion and postoperative dysphagia. The aim of this study is to present our short-terms results in the treatment of laparoscopic paraesophageal hiatal hernia (LPHH) with a synthetic polyglycolic acid:trimethylene carbonate mesh (Gore Bio A(®)). From January 2011 to December 2012, 10 patients with large paraesophageal hiatal hernias and hiatal defect over 5 cm were included. Primary simple suture of the crura and additional reinforcement with a Gore Bio A(®) mesh was performed. Hiatal hernia or gastroesophageal reflux disease (GERD) symptoms recurrence, dysphagia and mesh-related complications were investigated. Of the 10 patients undergoing mesh repair, there were 7 women and 3 men with a mean age of 65.5 years. All operations were completed laparoscopically. Median postoperative stay was 3 days. After a median follow-up of 20.3 months, one patient developed a recurrent hiatal hernia (10%). There were no mesh-related complications. The use of Gore Bio A(®) mesh for the laparoscopic repair of large paraesophageal hiatal hernias is safe and with a reasonably low recurrence rate in this short-term study. Additional long-term studies with ample numbers carried out for years will be necessary to see if this synthetic mesh is not only safe but also successful in the prevention of recurrences. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  20. Prosthetic mesh "slim-cigarette like" for laparoscopic repair of ventral hernias: a new technique without transabdominal fixation sutures.

    Science.gov (United States)

    Canton, S A; Merigliano, S; Pasquali, C

    2016-06-01

    Prosthetic mesh rolled up and fixed with stitches like a slim cigarette ("slim-mesh") for laparoscopic ventral hernia (VH) repair is an new technique which allows an easy intraperitoneally introduction, distension and circumferential fixation of a prosthetic mesh without transabdominal fixation sutures even for meshes larger than 16 cm up to 30 cm for the "slim-mesh" repair of wide ventral hernias. We report the technique of laparoscopic repair of VH with "slim-mesh". This technique enables an easy intra-peritoneally introduction of the mesh through the trocar because it reduces consistently its size, it allows a rapid intra-abdominal handling of the mesh and a fast and easy fixation for VH repair. The average time of surgery with "slim-mesh" for treatment of all 28 VH was 97 min ranging from 57 to 160 min. The average time for the repair of the 24 VH smaller than 10 cm was 91 and 135 min for the four VH larger than 10-22 cm. This new surgical technique leads to a reduction of surgical risks avoiding the use of transfascial sutures with the associated complications. This new surgical procedure in our experience is fast, safe, simple and also easily reproducible by surgeons in laparoscopic training. This technique may be used in wide VH (larger than 10-22 cm) that generally require open surgery.

  1. Evaluation of ECHO PS Positioning System in a Porcine Model of Simulated Laparoscopic Ventral Hernia Repair.

    Science.gov (United States)

    Hanna, Erin M; Voeller, Guy R; Roth, J Scott; Scott, Jeffrey R; Gagne, Darcy H; Iannitti, David A

    2013-01-01

    Purpose. Operative efficiency improvements for laparoscopic ventral hernia repair (LVHR) have focused on reducing operative time while maintaining overall repair efficacy. Our objective was to evaluate procedure time and positioning accuracy of an inflatable mesh positioning device (Echo PS Positioning System), as compared to a standard transfascial suture technique, using a porcine model of simulated LVHR. Methods. The study population consisted of seventeen general surgeons (n = 17) that performed simulated LVHR on seventeen (n = 17) female Yorkshire pigs using two implantation techniques: (1) Ventralight ST Mesh + Echo PS Positioning System (Echo PS) and (2) Ventralight ST Mesh + transfascial sutures (TSs). Procedure time and mesh centering accuracy overtop of a simulated surgical defect were evaluated. Results. Echo PS demonstrated a 38.9% reduction in the overall procedure time, as compared to TS. During mesh preparation and positioning, Echo PS demonstrated a 60.5% reduction in procedure time (P Echo PS (16.2%), this was not significantly different than TS. Conclusions. Echo PS demonstrated a significant reduction in overall simulated LVHR procedure time, particularly during mesh preparation/positioning. These operative time savings may translate into reduced operating room costs and improved surgeon/operating room efficiency.

  2. Closure versus non-closure of fascial defects in laparoscopic ventral and incisional hernia repairs: a review of the literature.

    Science.gov (United States)

    Suwa, Katsuhito; Okamoto, Tomoyoshi; Yanaga, Katsuhiko

    2016-07-01

    The laparoscopic technique for repairing ventral and incisional hernias (VIH) is now well established. However, several issues related to laparoscopic VIH repair, such as the high recurrence rate for hernias with large fascial defects and in extremely obese patients, are yet to be resolved. Additional problems include seroma formation, mesh bulging/eventration, and non-restoration of the abdominal wall rigidity/function with only bridging of the hernial orifice using standard laparoscopic intraperitoneal onlay mesh repair (sIPOM). To solve these problems, laparoscopic fascial defect closure with IPOM reinforcement (IPOM-Plus) has been introduced in the past decade, and a few studies have reported satisfactory outcomes. Although detailed techniques for fascial defect closure and handling of the mesh have been published, standardized techniques are yet to be established. We reviewed the literature on IPOM-Plus in the PubMed database and identified 16 reports in which the recurrence rate, incidence of seroma formation, and incidence of mesh bulging were 0-7.7, 0-11.4, and 0 %, respectively. Several comparison studies between sIPOM and IPOM-Plus seem to suggest that IPOM-Plus is associated with more favorable surgical outcomes; however, larger-scale studies are essential.

  3. Long-term symptomatic outcome and radiologic assessment of laparoscopic hiatal hernia repair

    NARCIS (Netherlands)

    Furnee, Edgar J. B.; Draaisma, Werner A.; Simmermacher, Rogier K.; Stapper, Gerard; Broeders, Ivo A. M. J.

    2010-01-01

    BACKGROUND: The long-term durability of laparoscopic repair of paraesophageal hiatal herniation is uncertain. This study focuses on the long-term symptomatic and radiologic outcome of laparoscopic paraesophageal herniation repair. METHODS: Between 2000 and 2007, 70 patients (49 females, mean age +/-

  4. Laparoscopic management of inferior lumbar hernia (Petit triangle hernia).

    Science.gov (United States)

    Ipek, T; Eyuboglu, E; Aydingoz, O

    2005-05-01

    Lumbar hernias are rare defects in the posterolateral abdominal wall that may be congenital or acquired. We present a case of laparoscopic approach to repair an acquired inferior triangle (Petit) lumbar hernia in a woman by using polytetrafluoroethylene mesh. The size of the hernia was 8 x 10 cm. The length of her hospital stay was 2 days. The patient resumed normal activities in less than 2 weeks. The main advantage of this approach is excellent operative visualization, thus avoiding injury to structures near the hernia during repair. Patients benefit from a minimally invasive approach with less pain, shortened hospital course, less analgesic requirements, better cosmetic result, and minimal life-style interference.

  5. Laparoscopic Repair of Incisional Hernia Following Liver Transplantation-Early Experience of a Single Institution in Taiwan.

    Science.gov (United States)

    Kuo, S-C; Lin, C-C; Elsarawy, A; Lin, Y-H; Wang, S-H; Wu, Y-J; Chen, C-L

    2017-10-01

    Ventral incisional hernia (VIH) is not uncommon following liver transplantation. Open repair was traditionally adopted for its management. Laparoscopic repair of VIH has been performed successfully in nontransplant patients with evidence of reduced recurrence rates and hospital stay. However, the application of VIH in post-transplantation patients has not been well established. Herein, we provide our initial experience with laparoscopic repair of post-transplantation VIH. From March 2015 to March 2016, 18 cases of post-transplantation VIH were subjected to laparoscopic repair (laparoscopy group). A historical control group of 17 patients who underwent conventional open repair (open group) from January 2013 to January 2015 were identified for comparison. The demographics and clinical outcomes were retrospectively compared. There were no significant differences among basic demographics between the 2 groups. No conversion was recorded in the laparoscopy group. Recurrence of VIH up to the end of the study period was not noted. In the laparoscopy group, the minor complications were lower (16.7% vs 52.9%; P = .035), the length of hospital stay was shorter (3 d vs 7 d, P = .007), but the median operative time was longer (137.5 min vs 106 min; P = .003). Laparoscopic repair of post-transplantation VIH is a safe and feasible procedure with shorter length of hospital stay. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Laparoscopic Repair and Percutaneous Endoscopic Gastrostomy to Treat Giant Esophageal Hiatal Hernia with Gastric Obstruction: A Case Report.

    Science.gov (United States)

    Hamai, Yoichi; Hihara, Jun; Tanabe, Kazuaki; Furukawa, Takaoki; Yamakita, Ichiko; Ibuki, Yuta; Okada, Morihito

    2015-06-01

    We describe a 74-year-old man with repeated aspiration pneumonia who developed gastric obstruction due to giant esophageal hiatal hernia (EHH). We repaired the giant EHH by laparoscopic surgery and subsequently anchored the stomach to the abdominal wall by percutaneous endoscopic gastrostomy (PEG) using gastrofiberscopy. Thereafter, the patient resumed oral intake and was discharged on postoperative day 21. At two years after these procedures, the patient has adequate oral intake and lives at home. Because this condition occurs more frequently in the elderly with comorbidities, laparoscopic surgery contributes to minimally invasive treatment. Furthermore, the procedure combined with concurrent gastropexy via PEG is useful for treating patients who have difficulty swallowing and for preventing recurrent hernia.

  7. Femoral hernia repair

    Science.gov (United States)

    Femorocele repair; Herniorrhaphy; Hernioplasty - femoral ... During surgery to repair the hernia, the bulging tissue is pushed back in. The weakened area is sewn closed or strengthened. This repair ...

  8. A prospective, multicenter, observational study on quality of life after laparoscopic inguinal hernia repair with ProGrip laparoscopic, self-fixating mesh according to the European Registry for Abdominal Wall Hernias Quality of Life Instrument.

    Science.gov (United States)

    Muysoms, Filip E; Vanlander, Aude; Ceulemans, Robrecht; Kyle-Leinhase, Iris; Michiels, Maarten; Jacobs, Ivo; Pletinckx, Pieter; Berrevoet, Frederik

    2016-11-01

    There is an increasing interest in patient-reported outcome measurement to evaluate hernia operations. Several hernia-specific quality of life (QoL) scales have been proposed, but none are constructed for preoperative assessment. The European Registry for Abdominal Wall Hernias (EuraHS) proposed the short, 9-question EuraHS-QoL instrument for assessment pre- and postoperatively. The EuraHS-QoL was evaluated in a prospective, multicenter validation study alongside the Visual Analogue Scale, Verbal Rating Scale, and Carolina Comfort Scale (https://clinicaltrials.gov; NCT01936584). We included 101 patients undergoing unilateral laparoscopic inguinal hernia repair with ProGrip laparoscopic, self-fixating mesh. Clinical follow-up at 12 months was 87% complete. The EuraHS-QoL score shows good internal consistency (Cronbach's α ≥ .90), good test-retest reliability (Spearman correlation coefficient r ≥ 0.72), and high correlation for pain with the Visual Analogue Scale, the Verbal Rating Scale, the Carolina Comfort Scale pain scale (r between 0.64 and 0.86), and for restriction of activity with the Carolina Comfort Scale movement scale (r between 0.65 and 0.79). Our results show significant improvement in quality of life at 3 weeks compared with preoperative and further significant improvement at 12 months (P 75%) or with a 95%) in the majority of the patients. The EuraHS-QoL instrument is a short and valid patient-reported outcome measurement following groin hernia repair. Laparoscopic inguinal hernia repair with ProGrip laparoscopic, self-fixating mesh results in a favorable outcome and significant improvement of quality of life compared with the preoperative assessment. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Comparison of the Effects of Laparoscopic and Open Repair Techniques on Postoperative Pain and Analgesic Consumption in Pediatric Unilateral Inguinal Hernia

    Directory of Open Access Journals (Sweden)

    Ferda Yılmaz İnal

    2014-06-01

    Full Text Available Aim: Although laparoscopic inguinal hernia (IH repair in adults is widely accepted, its advantages in pediatric age group are questionable. We aimed to compare the effects of open inguinal hernia repair and laparoscopic inguinal hernia repair on length of anaesthesia, postoperative pain and analgesic consumption in boys who underwent unilateral inguinal hernia repair. Methods: Forty patients aged between 7 and 14 years who underwent open and laparoscopic inguinal hernia repair were included in this study. The patients were randomly divided into two groups: unilateral open inguinal hernia repair group (OR n=20 and unilateral laparoscopic inguinal hernia repair group (LR n=20. All patients underwent general anesthesia. The duration of anaesthesia and the duration of surgery were recorded. The Patient Controlled Analgesia (PCA device was set at a 0.01 mg/kg bolus dose, 10 minutes lockout interval and 4 hour limit of 4 mg morphine. The patients, who received morphine PCA for 24 hours postoperatively, were monitored with continuous oximetry. The Visual Analogue Scale (VAS was used to measure pain (0 cm: no pain, 10 cm: worst possible pain. We recorded the side effects of morphine, such as respiratory depression, nausea, vomiting, urinary retention, pruritus. SpO2 level and Ramsay Sedation Scale (RSS, Numerical Rating Scale (NRS, and Visual Analogue Scale (VAS scores at intervals 1, 2, 4, 12, 24 hours as well as amount of analgesics consumed and number of requests within 24 hours postoperatively were recorded. Time to first walking was recorded. Results: In group OR, the mean duration of anaesthesia and surgery were 39.85 minutes and 28.85 minutes, respectively. In group LR, the mean duration of anaesthesia and surgery were 26.11 and 20.53 minutes, respectively. VAS scores and time to first walking were similar in both groups. There was no significant difference in amount of analgesics consumed and number of request between the two groups. In group OR

  10. Orchiectomy as a result of ischemic orchitis after laparoscopic inguinal hernia repair: case report of a rare complication

    Directory of Open Access Journals (Sweden)

    Moore John B

    2007-11-01

    Full Text Available Abstract Background Ischemic orchitis is an established complication after open inguinal hernia repair, but ischemic orchitis resulting in orchiectomy after the laparoscopic approach has not been reported. Case presentation The patient was a thirty-three year-old man who presented with bilateral direct inguinal hernias, right larger than left. He was a thin, muscular male with a narrow pelvis who underwent bilateral extraperitoneal mesh laparoscopic inguinal hernia repair. The case was complicated by pneumoperitoneum which limited the visibility of the pelvic anatomy; however, the mesh was successfully deployed bilaterally. Cautery was used to resect the direct sac on the right. The patient was discharged the same day and doing well with minimal pain and swelling until the fourth day after surgery. That night he presented with sudden-onset pain and swelling of his right testicle and denied both trauma to the area and any sexual activity. Ultrasound of the testicle revealed no blood flow to the testicle which required exploration and subsequent orchiectomy. Conclusion Ischemic orchitis typically presents 2–3 days after inguinal hernia surgery and can progress to infarction. This ischemic injury is likely due to thrombosis of the venous plexus, rather than iatrogenic arterial injury or inappropriate closure of the inguinal canal. Ultrasound/duplex scanning of the postoperative acute scrotum can help differentiate ischemic orchitis from infarction. Unfortunately, testicular torsion cannot be ruled out and scrotal exploration may be necessary. Although ischemic orchitis, atrophy, and orhiectomy are uncommon complications, all patients should be warned of these potential complications and operative consent should include these risks irrespective of the type of hernia or the surgical approach.

  11. Laparoscopic Partial Cystectomy With Excision of Mesh Migration Into the Bladder Following Repair of Inguinal Hernia

    Directory of Open Access Journals (Sweden)

    Satoshi Funada

    2016-09-01

    Full Text Available Migration of hernia mesh into the bladder is a rare complication of inguinal hernioplasty. We present the case of an 85-year-old man who complained of hematuria and fever some 20 years after right hernioplasty. Cystoscopy and computed tomography revealed mesh migration into the right anterior wall of the bladder. Laparoscopic partial cystectomy with excision of the migrated mesh was performed successfully. To our knowledge, this is the first case of mesh migration into the bladder treated by laparoscopic partial cystectomy.

  12. Low risk of trocar site hernia repair 12 years after primary laparoscopic surgery

    DEFF Research Database (Denmark)

    Helgstrand, Frederik; Rosenberg, Jacob; Kehlet, Henrik;

    2011-01-01

    The risk of trocar site hernia (TSH) may be 0-22%, but no large scaled data with long-term follow-up are available. The purpose of this study was to estimate the long-term risk of TSH repair.......The risk of trocar site hernia (TSH) may be 0-22%, but no large scaled data with long-term follow-up are available. The purpose of this study was to estimate the long-term risk of TSH repair....

  13. Low risk of trocar site hernia repair 12 years after primary laparoscopic surgery

    DEFF Research Database (Denmark)

    Helgstrand, Frederik; Rosenberg, Jacob; Kehlet, Henrik

    2011-01-01

    The risk of trocar site hernia (TSH) may be 0-22%, but no large scaled data with long-term follow-up are available. The purpose of this study was to estimate the long-term risk of TSH repair.......The risk of trocar site hernia (TSH) may be 0-22%, but no large scaled data with long-term follow-up are available. The purpose of this study was to estimate the long-term risk of TSH repair....

  14. ONSTEP versus laparoscopy for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-01

    a learning curve of about 50-100 cases and decreases chronic pain, but slightly increases the risk of serious complications compared with open mesh repairs. Therefore, a simpler kind of operation is needed. The ONSTEP technique is a possible solution to this problem. The objective of the present randomised......INTRODUCTION: The optimal repair of inguinal hernias remains controversial. It is recommended that an inguinal hernia be repaired using a mesh, either with a laparoscopic or an open approach. In Denmark, the laparoscopic approach is used in an increasing number of cases. The laparoscopic repair has...... clinical trial described in this protocol is to evaluate chronic pain after inguinal hernia repair using the ONSTEP method versus the laparoscopic approach. METHODS: This study is designed as a non-inferiority, two-arm, multicentre, randomised clinical trial, with a 1:1 allocation to ONSTEP or laparoscopic...

  15. ONSTEP versus laparoscopy for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-01

    INTRODUCTION: The optimal repair of inguinal hernias remains controversial. It is recommended that an inguinal hernia be repaired using a mesh, either with a laparoscopic or an open approach. In Denmark, the laparoscopic approach is used in an increasing number of cases. The laparoscopic repair has...... a learning curve of about 50-100 cases and decreases chronic pain, but slightly increases the risk of serious complications compared with open mesh repairs. Therefore, a simpler kind of operation is needed. The ONSTEP technique is a possible solution to this problem. The objective of the present randomised...... clinical trial described in this protocol is to evaluate chronic pain after inguinal hernia repair using the ONSTEP method versus the laparoscopic approach. METHODS: This study is designed as a non-inferiority, two-arm, multicentre, randomised clinical trial, with a 1:1 allocation to ONSTEP or laparoscopic...

  16. Coagulation, inflammatory, and stress responses in a randomized comparison of open and laparoscopic repair of recurrent inguinal hernia

    DEFF Research Database (Denmark)

    Rahr, H B; Bendix, J; Ahlburg, P;

    2006-01-01

    with recurrent inguinal hernia were randomized to OR under local anesthesia (n = 30) or LR under general anesthesia (n = 31). The magnitude of the surgical trauma was assessed by measuring markers of coagulation (prothrombin fragment 1 + 2), endothelial activation (von Willebrand factor), inflammation......BACKGROUND: In previous comparisons of inflammatory and stress responses to open (OR) and laparoscopic (LR) hernia repair, all operations were performed under general anesthesia. Since local anesthesia is widely used for OR, a comparison of this approach with LR seemed relevant. METHODS: Patients...... in both groups, with the CRP increase being significantly greater in the OR group. The other markers did not increase significantly. CONCLUSION: The acute phase response was more pronounced after OR, even when this was done under local anesthesia. Both techniques seemed rather atraumatic....

  17. Strategies to minimize adhesions to intraperitoneally placed mesh in laparoscopic ventral hernia repair.

    Science.gov (United States)

    Tran, Hanh; Saliba, Lucia; Chandratnam, Edward; Turingan, Isidro; Hawthorne, Wayne

    2012-01-01

    Adhesions to mesh/tacks in laparoscopic ventral hernia repair are often cited as reasons not to adopt its evidence-based superiority over conventional open methods. This pilot study assessed the occurrence of adhesions to full-sized Polypropylene and Gore-tex DualMesh Plus meshes and the possibility for adhesion prevention using fibrin sealant. Two 10-cm to 15-cm pieces of mesh were placed and fixed laparoscopically in pigs (25kg to 55kg). Group I: 2 animals with Polypropylene mesh on one side and DualMesh on other side. Group II: 2 animals with DualMesh on each side with fibrin sealant applied to the periphery of mesh and staples to one side. Group III: 1 animal with 2 pieces of Polypropylene mesh with fibrin sealant applied to the entire mesh. All animals underwent laparoscopy 3 months later to assess the extent of adhesions, and full-thickness specimens were removed for histological evaluation. More Polypropylene mesh was involved in adhesions than DualMesh. However, with the DualMesh involved in adhesions, more of the surface area was involved in forming adhesions than with Polypropylene mesh. None of the implanted DualMesh had visceral adhesions, while 2 out of 3 Polypropylene meshes had adhesions to both the liver and spleen but none to the bowel. Implanted Polypropylene mesh with fibrin sealant had no adhesions. DualMesh had shrunk more significantly than Polypropylene mesh. Histological evaluation showed absence of acute inflammatory response, significantly more chronic inflammatory response to DualMesh compared to Polypropylene and complete mesothelialization with both meshes. There was extensive collagen deposition between Polypropylene mesh fibers, while fibrosis occurred on both sides of DualMesh with synovial metaplasia over its peritoneal surface akin to encapsulation. DualMesh caused fewer omental and visceral adhesions than Polypropylene mesh did. Fibrin sealant eliminated adhesions to DualMesh and prevented adhesions to Polypropylene mesh when

  18. Interparietal hernias after open retromuscular hernia repair.

    Science.gov (United States)

    Carbonell, A M

    2008-12-01

    The retromuscular or sublay repair of ventral hernias, popularized by Rives and Stoppa, requires that a layer of tissue be reapproximated dorsal to the mesh to separate the bowel from the prosthetic. This is the first report of two patients who developed bowel obstruction resulting from interparietal incarceration between the posterior rectus sheath and the prosthetic graft through a defect in this dorsal layer. Both patients underwent open retromuscular hernia repair, one with lightweight polypropylene mesh, the other with human acellular dermal matrix. Postoperatively (day 3 and day 42, respectively), the patients developed signs of bowel obstruction. Computed tomography demonstrated the herniation of the small bowel into the potential space between the prosthesis and the posterior rectus sheath. The first patient underwent successful laparoscopic repair, while the second patient had an open operation to reduce the incarcerated bowel and repair the defect. In the patient convalescing from an uneventful retromuscular hernia repair who develops signs and symptoms of a bowel obstruction, there should be a high index of suspicion that an interparietal hernia may have formed, with the small bowel herniated into the surgically created space between the prosthetic and the posterior rectus sheath.

  19. Treatment and Controversies in Paraesophageal Hernia Repair

    Directory of Open Access Journals (Sweden)

    P. Marco eFisichella

    2015-04-01

    Full Text Available Background: Historically all paraesophageal hernias were repaired surgically, today intervention is reserved for symptomatic paraesophageal hernias. In this review, we describe the indications for repair and explore the controversies in paraesophageal hernia repair, which include a comparison of open to laparoscopic paraesophageal hernia repair, the necessity of complete sac excision, the routine performance of fundoplication, and the use of mesh for hernia repair.Methods: We searched Pubmed for papers published between 1980 and 2015 using the following keywords: hiatal hernias, paraesophageal hernias, regurgitation, dysphagia, gastroesophageal reflux disease, aspiration, GERD, endoscopy, manometry, pH monitoring, proton pump inhibitors, anemia, iron deficiency anemia, Nissen fundoplication, sac excision, mesh, mesh repair. Results: Indications for paraesophageal hernia repair have changed, and currently symptomatic paraesophageal hernias are recommended for repair. In addition, it is important not to overlook iron-deficiency anemia and pulmonary complaints, which tend to improve with repair. Current practice favors a laparoscopic approach, complete sac excision, primary crural repair with or without use of mesh, and a routine fundoplication.

  20. Laparoscopic hernioplasty of hiatal hernia

    Science.gov (United States)

    Yang, Xuefei; Hua, Rong; He, Kai; Shen, Qiwei

    2016-01-01

    Laparoscopic surgery is a good choice for surgical treatment of hiatal hernia because of its mini-invasive nature and intraperitoneal view and operating angle. This article will talk about the surgical procedures, technical details, precautions and complications about laparoscopic hernioplasty of hiatal hernia. PMID:27761447

  1. Repair of diaphragmatic hernia following spinal surgery by laparoscopic mesh application: a case report and review of the literature.

    Science.gov (United States)

    Bini, Roberto; Fontana, Diego; Longo, Alessandro; Manconi, Paolo; Leli, Renzo

    2014-01-01

    We describe the laparoscopic management of diaphragmatic hernia (DH) caused by vertebral pedicle screw displacement. A 58-year-old woman underwent surgery for scoliosis and underwent posterior pedicle screw fixation. In the first postoperative (PO)day, she developed mild dyspnea. An anteroposterior chest radiograph revealed bilateral pleural effusion, which was more pronounced on the left side. A thoracoabdominal computed tomography (CT) scan, performed in the second PO day, revealed a solid mass in the pleural cavity that was associated with screw displacement, which had also entered into the peritoneal cavity without apparent other lesion of hollow and solid viscous. In the third PO day, after the screw was removed, explorative laparoscopy was carried out. We observed herniation of the omentum through a small diaphragmatic tear. Once the absence of visceral injury was confirmed, we reduced the omentum into the abdomen. Then, we repaired the hernia by applying a dual layer polypropylene mesh over the defect with a 3-cm overlap. The remainder of the postoperative period was uneventful. Iatrogenic DH due to a pedicle screw displacement has never been described before. In cases of pleural effusion following spinal surgery, rapid assessment and treatment are crucial. We conclude that a laparoscopic approach to iatrogenic DH could be feasible and effective in a hemodynamically stable patient with negative CT findings because it enables the completion of the diagnostic cascade and the repair of the tear, providing excellent visualization of the abdominal viscera and diaphragmatic tears.

  2. Inguinal hernia repair - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100027.htm Inguinal hernia repair - series—Normal anatomy To use the sharing ... to slide 4 out of 4 Overview A hernia occurs when part of an organ protrudes through ...

  3. Low recurrence rate and low chronic pain associated with inguinal hernia repair by laparoscopic placement of Parietex ProGrip™ mesh: clinical outcomes of 220 hernias with mean follow-up at 23 months.

    Science.gov (United States)

    Birk, D; Hess, S; Garcia-Pardo, C

    2013-06-01

    The aim of this study was to demonstrate the safety and the efficacy of the self-gripping Parietex ProGrip™ mesh (Sofradim Production, Trévoux, France) used with the laparoscopic approach for inguinal hernia repair. The incidence of chronic pain, post-operative complications, patient satisfaction and hernia recurrence at follow-up after 12 months was evaluated. Data were collected retrospectively from patient files and were analyzed for 169 male and female patients with 220 primary inguinal hernias. All patients included had undergone surgical repair for inguinal hernia by the laparoscopic transabdominal preperitoneal approach using Parietex ProGrip™ meshes performed in the same clinical center in Germany. Pre-, per- and post-operative data were collected, and a follow-up after 12 months was performed prospectively. Complications, pain scored on a 0-10 numeric rating scale (NRS), patient satisfaction and hernia recurrence were assessed. The only complications were minor and were post-operative: hematoma/seroma (3 cases), secondary hemorrhage through the trocar's site (2 cases), hematuria, emphysema in the inguinal regions (both sides) and swelling above the genital organs (1 case for each). At mean follow-up at 22.8 months, there were only 3 reports of hernia recurrence: 1.4 % of the hernias. Most patients (95.9 %) were satisfied or very satisfied with their hernia repair with only 1.2 % reporting severe pain (NRS score 7-10) and 3.6 % reported mild pain. This study demonstrates that in experienced hands, inguinal hernia repair surgery performed by laparoscopic transabdominal preperitoneal hernioplasty using Parietex ProGrip™ self-gripping meshes is rapid, efficient and safe with low pain and low hernia recurrence rate.

  4. The Operation Duration and Short-Term Complications of Laparoscopic Transabdominal Prepritoneal Hernia Repair: Trendelenburg Versus Reverse-Trendelenburg Positions

    Directory of Open Access Journals (Sweden)

    Shirali A

    2011-11-01

    Full Text Available Background: The aim of this study was to compare operating time and short-term complications of laparoscopic transabdominal preperitoneal hernia repair during reperitonealization in Trendelenburg versus reverse-Trendelenburg positions.Methods : Thirty-nine patients with inguinal hernia were enrolled in this clinical trial. Study was done in Milad and Rasoul Akram hospitals in Tehran, Iran, during 2008-2010. The patients neither were pregnant nor did they have any signs of peritonitis, strangulation, perforation or infection. Moreover, they had a Body Mass Index (BMI below 35 kg/m2 and were physically fit for general anesthesia. The participants were divided into two groups by block randomization. The first (20 and the second (19 groups of patients underwent laparoscopic herniorrhaphy in Trendelenburg and reverse-Trendelenburg positions. Respectively all the operations were performed by one surgeon. The patients were visited one day and one week after the surgery.Results : Most frequent complications were rupture in peritoneal repair in 9 patients (23%, skin site bleeding in one patient (2.6%, and peritoneal tension in 33 patients (84.6% patients. Duration of surgery and peritoneal repair took a significantly longer time in Trendelenburg versus the reverse-Trendelenburg position. There were no differences in duration for returning to work or resumption of daily activities between the two groups. Pain in the first day following surgery was statistically more severe in the Trendelenburg group.Conclusion: This study demonstrated that reverse-Trendelenburg position took less time for herniorrhaphy and peritoneal repair than Trendelenburg position, although the complications were the same.

  5. Operative procedures of single-incision laparoscopic repair of pediatric epigastric hernia have become simple and feasible with the use of a novel suture-assisting needle

    Directory of Open Access Journals (Sweden)

    Kyoichi Deie

    2016-01-01

    Full Text Available We describe a simple and feasible procedure for single-incision laparoscopic repair of a pediatric epigastric hernia using a novel suture-assisting needle. A multichannel port was inserted through the umbilical vertical incision. After the orifice of the hernia was identified, a suture-assisting needle, which can hold a suture at its tip, with a 2-0 thread was pierced through the skin into one side of the rectus muscle sheath into the abdominal cavity. Next, after releasing the thread, the needle was pulled out to the subcutis and pierced through another side of the rectus muscle sheath. The needle, grasping the thread again, was subsequently pulled out through the abdominal wall outside, and the thread was tied extracorporeally. This knot was buried subcutaneously. Operative procedures of single-incision laparoscopic repair of an epigastric hernia have become simple and feasible with the use of a novel suture-assisting needle with an excellent cosmetic result.

  6. Laparoscopic tension-free hernioplasty for lumbar hernia.

    Science.gov (United States)

    Maeda, K; Kanehira, E; Shinno, H; Yamamura, K

    2003-09-01

    Lumbar hernia, a defect of the posterior abdominal wall, is a very rare condition. The repair of a posterior abdominal wall hernia by simply closing the hernia port with sutures may not be adequate, especially when the herniation is due to a weakness in the abdominal wall. Recently, a simple, logical method of tension-free repair has become a popular means for the treatment of various abdominal wall hernias. Previous studies have advocated the use of tension-free repair for lumbar hernia; the technique uses a mesh replacement and requires an extensive incision. Herein we present a case of superior lumbar hernia. Our technique consisted of a laparoscopic tension-free hernioplasty with the application of a Prolene mesh. This technique, which provides an excellent operative view, is safe, feasible, and minimally invasive. We conclude that laparoscopic tension-free repair should be the preferred option for the treatment of lumbar hernia.

  7. 腹腔镜下腹膜外腹股沟疝修补术研究%STUDY OF LAPAROSCOPIC INGUINAL HERNIA REPAIR IN INGUINAL HERNIA

    Institute of Scientific and Technical Information of China (English)

    王修庆

    2015-01-01

    目的:探索腹腔镜下实施腹膜外腹股沟疝修补术的临床安全性和有效性。方法回顾性分析27例实施腹膜外腹腔镜腹股沟疝修补术(TEP)患者的临床资料。结果27例腹股沟疝都成功进行了腹腔镜下 T EP ,无一例中转开腹,单侧手术时间48~115min ,平均53.20min ,双侧手术时间76~130min ,平均94min ,出血量11~58ml ,平均17.6ml。术后住院时间2~7d ,平均4.1d。患者术后出现腹股沟区血肿或血清肿3例,阴囊气肿1例。术后出现神经感觉异常2例,经对症治疗后消失。随访6~18个月,未发现腹股沟区慢性疼痛及不适者,无腹股沟疝复发。结论腹腔镜下腹膜外腹股沟疝修补术临床效果好,并发症少,近期复发率低,不易损伤神经,可同时完成双侧疝修补,值得基层医院推广应用。%Objective To explore the clinical safety and effectiveness of laparoscopic inguinal hernia re‐pair .Methods The clinical data of 27 cases of laparoscopic inguinal hernia repair (TEP) were retrospective‐ly analyzed .Results 27 cases of inguinal hernia were successfully performed laparoscopic TEP ,without a case of conversion to open surgery ,unilateral operation time of 48 ~ 115min ,average 53 .20min ,bilateral operation time 76~130min ,average 94min ,blood loss of 11 ~ 58ml ,an average of 17 .6ml .T he hospital stay was 2 to 7d ,with an average of 4 .1d .Developed groin hematoma or seroma after surgery in 3 cases , 1 cases of scrotal emphysema .2 cases of postoperative nerve sensory abnormalities ,after symptomatic treatment disappeared .Follow up for 6 ~ 18 months ,without chronic pain in the groin area and the dis‐covery ,no recurrence of inguinal hernia .Conclusion The clinical effect of laparoscopic inguinal hernia re‐pair is good ,the complication is few ,the recent recurrence rate is low ,and it is not easy to damage nerve , and can simultaneously complete bilateral hernia

  8. Early assessment of bilateral inguinal hernia repair: A comparison between the laparoscopic total extraperitoneal and Stoppa approaches

    Directory of Open Access Journals (Sweden)

    Edivaldo Massazo Utiyama

    2016-01-01

    Full Text Available Background: The present clinical trial was designed to compare the results of bilateral inguinal hernia repair between patients who underwent the conventional Stoppa technique and laparoscopic total extraperitoneal repair (LTE with a single mesh and without staple fixation. Patients and Methods: This controlled, randomised clinical trial was conducted at General Surgery and Trauma of the Clinics Hospital, Medical School, the University of São Paulo between September 2010 and February 2011. Totally, 50 male patients, with a bilateral inguinal hernia, older than 25 years were considered eligible for the study. The following parameters were analysed during the early post-operative period: (1 The intensity of surgical trauma, operation time, C-reactive protein (CRP levels, white blood cell count, bleeding and pain intensity; (2 quality of life assessment; and (3 post-operative complications. Results: LTE procedure was longer than the Stoppa procedure (134.6 min ± 38.3 vs. 90.6 min ± 41.3; P 0.05. There was no difference in pain during the 1st and 7th post-operative, physical functioning, physical limitation, the impact of pain on daily activities, and the Carolinas Comfort Scale during the 7th and 15th post-operative (P > 0.05. Complications occurred in 88% of Stoppa group (22 patients and 64% in LTE group (16 patients (P < 0.05. Conclusion: The comparative study between the Stoppa and LTE approaches for the bilateral inguinal hernia repair demonstrated that: (1 The LTE approach showed less surgical trauma despite the longer operation time; (2 Quality of life during the early post-operative period were similar; and (3 Complication rates were higher in the Stoppa group.

  9. Prospective analysis of laparoscopic ventral hernia repair using the Ventralight™ ST hernia patch with or without the ECHO PS™ positioning system.

    Science.gov (United States)

    Tollens, Tim; Topal, Halit; Vermeiren, Koen; Aelvoet, Chris

    2014-03-01

    The purpose of the current prospective study was to confirm the results of our previous study on the use of the Ventralight™ ST mesh. In this study we also evaluated a pre-attached positioning system. Between July 2011 and October 2013 prospectively collected data of 61 consecutive patients who underwent a laparoscopic ventral hernia repair were analyzed. Short- and long-term outcomes were described. A total of 61 patients were treated in this period (men/women ratio 44/17). Overall median follow-up was 7 months (range 2-29). There were 30 patients with a follow-up of at least 12 months. Mean hernia diameter was 6 x 5 cm (craniocaudal x laterolateral) (range 1.5 x 1.5 to 20 x 15 cm). Overall mean length of hospital stay was 4.4 days. Postoperative visual analog scale (VAS) at last follow-up was significantly lower than the preoperative VAS (3.01 vs 0.68; P = 0.011) There were no intraoperative complications. In the whole group, only 6 patients (10%) showed minor complications. Four patients had mild discomfort, another 2 patients developed a clinically significant seroma. The complication rate in the subgroup with a follow-up of at least 1 year was 13%. No recurrences were observed. This study confirms our preliminary findings on the use of this mesh. The optional positioning system offers a significantly more quick and proper mesh positioning.

  10. Comparative study of laparoscopic repair of inguinal hernia and open tension-free hernia repair in the treatment of adult inguinal hernia%腹腔镜经腹膜前疝修补术与开放式无张力疝修补术治疗成人腹股沟疝的对比研究

    Institute of Scientific and Technical Information of China (English)

    张卫东

    2016-01-01

    目的:探讨腹腔镜经腹膜前疝修补术与开放式无张力疝修补术治疗成人腹股沟疝的效果。方法:收治腹股沟疝患者46例,随机分成观察组(腹腔镜经腹膜前疝修补术)和对照组(开放式无张力疝修补术)各23例。结果:观察组患者住院时间和并发症发生率与对照组相比,差异有统计学意义(P<0.05)。结论:采用腹腔镜经腹膜前疝修补术方式治疗腹股沟疝效果显著,对患者造成的创伤比较小。%Objective:To investigate the effect of laparoscopic repair of inguinal hernia and open tension-free hernia repair in the treatment of adult inguinal hernia.Methods:46 patients with inguinal hernia were selected.They were randomly divided into the observation group(laparoscopic repair of inguinal hernia) and the control group(open tension-free hernia repair) with 23 cases in each group.Results:The hospitalization time and the incidence of complications of the observation group were significantly different(P<0.05).Conclusion:The effect of laparoscopic repair of inguinal hernia in the treatment of inguinal hernia is significant, and the trauma is relatively small.

  11. 腹腔镜手术治疗食管裂孔疝八例体会%Experience of eight patients treated by laparoscopic esophageal hiatal hernia repair

    Institute of Scientific and Technical Information of China (English)

    赵鹏; 张国志; 陈建立; 李曙光; 崔明新

    2012-01-01

    Objective To explore the safety and therapeutic effect of 8 patients with esophageal Hiatal Hernia treated by laparoscopic hernia repair.Methods A retrospective analysis was performed on the clinical data of 8 patients with esophageal Hiatal Hernia form Jun.2009 to Jun. 2010.Among the participants,3 conducted 360-degree fundoplication,5 conducted partial(270-degree) fundoplication.Silk sutures were used for the repair of esophageal perforation in 4 patients,and patch repair was used for the other 4 cases.Results Eight patients were treated by laparoscopic hernia repair,and all of them were cured without postoperative complications.The mean duration of surgery was ( 120 ± 30) min,with average blood loss ( 50 ± 12 ) ml.Patients had a mean postoperative hospital stay of(4.5 ± 2.5 )days.All the patients were followed up for 1 to 2 years,and no case was found to be relapsed.Conclusion Total laparoscopic hernia repair is minimally invasive,with short recovery course,less pain after surgery,little complication and short hospitalized time.Laparoscopic Hernia repair should be the preferred effective operation method for patients with esophageal Hiatal Hernia.%目的 探讨使用腹腔镜行食管裂孔疝修补术的疗效和安全性.方法 对8例食管裂孔疝患者行腹腔镜食管裂孔疝修补术,其中3例行360°胃底折叠术,5例行270°胃底部分折叠术.4例采用丝线缝合修补食管裂孔,4例应用补片修补食管裂孔.结果 8例腹腔镜食管裂孔疝修补术全部成功.手术时间平均( 120±30) min,术中出血量平均(50±12)ml,无术后并发症,术后平均住院(4.5±2.5)d.术后症状完全消失7例,好转1例.随访1~2年,无复发.结论 腹腔镜食管裂孔疝修补术具有疗效确定、安全和创伤小的优点,值得进一步推广应用.

  12. Laparoscopic surgery for inguinal hernia: Current status and controversies

    Directory of Open Access Journals (Sweden)

    Bhandarkar Deepraj

    2006-01-01

    Full Text Available Repair of inguinal hernia is one of the commonest operations performed by surgeons around the world. The treatment of this common problem has seen an evolution from the pure tissue repairs to the prosthetic repairs and in the recent past to laparoscopic repair. The fact that so many hernia repairs are practiced is a testimony to the fact that probably none is distinctly superior to the other. This review assesses the current status of surgery for repair of inguinal hernia and examines the various controversial issues surrounding the subject.

  13. 腹腔镜疝修补术与填充式无张力疝修补术的对比研究%Comparing the Laparoscopic Hernia Repair and Filled with Tension-free Hernia Repair

    Institute of Scientific and Technical Information of China (English)

    牟云川; 黄世华; 翟勋

    2015-01-01

    Objective To compare the application value between the laparoscopic hernia repair and ifled with tension-free hernia repair for inguinal hernia treatment.Methods 96 cases with inguinal hernia, which admited in our hospital during June 2012-June 2015, were selected as the research object. 50 cases were given the laparoscopic hernia repair (A group) and the other 46 cases were given the ifled with tension-free repair hernia repair. Basic data was no signiifcant difference in both groups; general index and the incidence of postoperative complications of the two groups were compared.Results Incidence of postoperative complications, intraoperative blood loss, and 1 year recurrence rate of the two groups were no signiifcant difference, there was no statisticaly signiifcant difference (P>0.05). The hospital stay, postoperative pain degree of the A group was lower than that of the group B, while the operation time of the group B was lower than that of A group, the difference was signiifcant statisticaly signiifcant (P<0.05). Conclusion Laparoscopic hernia repair and ifled with tension-free hernia repair can be as effective treatment of inguinal hernia, two kinds of operative methods advantages and disadvantages of each different, in the actual application needs in combination with the practical situation of patients, select the most appropriate way.%目的:对比腹腔镜疝修补术与填充式无张力疝修补术在治疗腹股沟疝中的应用价值。方法选取2012年6月至2015年6月我院收治的腹股沟疝患者96例,作为研究对象。其中行腹腔镜疝修补术患者50例(A组),填充式无张力疝修补术46例(B组),两组患者基础资料比较无显著差异,比较两组患者一般指标及术后并发症发生率。结果两组患者术后并发症发生率、术中出血量、1年复发率比较无显著差异,P>0.05,不具有统计学意义;A组患者住院时间、术后疼痛程度明显低于B组,但B组患

  14. Experience of 38 patients under laparoscopic directly hiatal hernia repair%腹腔镜食管裂孔疝修补术38例体会

    Institute of Scientific and Technical Information of China (English)

    黄伟; 张明敏; 贾俊奇; 郭永忠

    2015-01-01

    目的:探讨腹腔镜食管裂孔疝修补术的可行性及安全性。方法回顾性分析2012年12月至2015年3月,伊犁州友谊医院开展腹腔镜食管裂孔疝修补术38例患者的临床资料。结果38例腹腔镜直接食管裂孔疝修补全部获得成功。其中5例行胃底270°部分折叠术(Toupet 术),33例行胃底360°折叠术(Nissen 术),手术时间50~150 min,平均手术时间100 min,失血15~60 ml,术后24 h拔出胃管并全流质饮食,无术后并发症。平均住院7 d。术后随访3个月至3年,35例患者反酸、烧灼、胸痛症状较术前明显改善,3例改善欠佳,给予服用口服药物。结论食管裂孔疝腹腔镜修补技术是一种安全、可靠、有效的治疗方法。%Objective To explore the feasibility and safety of laparoscopic directly hiatal hernia repair.Methods Retrospective analysis the clinical data of 38 patients under laparoscopic hiatal hernia repair from December 2012 to March 2015.Results 38 cases of laparoscopic hiatal hernia repair all success directly.5 routine stomach bottom part 270°fold surgery ( Toupet) 33 stomach bottom part 360°fold after operation( Nissen) operation time on average 50 to 150 minutes, the average operation time, 100 in laparoscopic hiatal hernia repair,15 to 60 ml blood loss,postoperative 24 hours to pull out the tube and liquid diet,no postoperative complications.Average hospital 7 days.Conclusion After the three months follow-up, 38 cases of patients with no recurrence of 35 cases with acid reflux,chest pain obviously improved compared with preoperative, for hiatal hernia, laparoscopic hiatal hernia repair surgery is a safe, reliable, effective treatment.

  15. Combined laparoscopic and open extraperitoneal approach to scrotal hernias.

    Science.gov (United States)

    Ferzli, G S; Rim, S; Edwards, E D

    2013-04-01

    Laparoscopic repair of scrotal hernias is often a difficult endeavor to successfully complete. The longstanding nature of these hernias often results in significant adhesions and anatomic distortion of the inguinal floor. These two issues make reduction of the hernia arduous and subsequent reinforcement of the parietal sac difficult. We have previously described techniques to increase the chances of success when attempting laparoscopic repair of scrotal hernias. Here, we describe some of those techniques as well as a combined laparoscopic and open approach to achieve a robust preperitoneal repair of incarcerated scrotal hernias when the usual totally extraperitoneal approach does not work. We performed a retrospective review of 1890 TEP hernia repairs we performed from 1990 to 2010. Rate of conversion to an open approach or a combined laparoscopic and open approach was examined. Incidence of complications or recurrences was assessed over a 12-month follow-up period. Among the 1890 TEP repairs, 94 large scrotal hernias were identified. Of these, nine cases (9.5 %) required conversion to an open procedure due to an incarcerated and indurated omentum. Three were completed with a conventional open preperitoneal whereas six patients (6.4 %) underwent repair with the combined approach. In this group, no recurrences or complications were found over a 12-month period. In cases where a large scrotal hernia may be difficult or dangerous to reduce laparoscopically, immediate conversion to an open repair may not be necessary. A combined laparoscopic and open approach can greatly assist in the visualization and dissection of the preperitoneal space, thereby facilitating reduction of the hernia and placement of the mesh.

  16. Health Technology Assessment of laparoscopic compared to conventional surgery with and without mesh for incisional hernia repair regarding safety, efficacy and cost-effectiveness

    Science.gov (United States)

    Friedrich, Meik; Müller-Riemenschneider, Falk; Roll, Stephanie; Kulp, Werner; Vauth, Christoph; Greiner, Wolfgang; Willich, Stefan; von der Schulenburg, Johann-Matthias

    2008-01-01

    Introduction Incisional hernias are a common complication following abdominal surgery and they represent about 80% of all ventral hernia. In uncomplicated postoperative follow-up they can develop in about eleven percent of cases and up to 23% of cases with wound infections or other forms of wound complications. Localisation and size of the incisional hernia can vary according to the causal abdominal scar. Conservative treatment (e. g. weight reduction) is only available to relieve symptoms while operative treatments are the only therapeutic treatment option for incisional hernia. Traditionally, open suture repair was used for incisional hernia repair but was associated with recurrence rates as high as 46%. To strengthen the abdominal wall and prevent the development of recurrences the additional implantation of an alloplastic mesh is nowadays commonly used. Conventional hernia surgery as well as minimally invasive surgery, introduced in the early 90s, make use of this mesh-technique and thereby showed marked reductions in recurrence rates. However, there are possible side effects associated with mesh-implantation. Therefore recommendations remain uncertain on which technique to apply for incisional hernia repair and which technique might, under specific circumstances, be associated with advantages over others. Objectives The goal of this HTA-Report is to compare laparoscopic incisional hernia repair (LIHR) and conventional incisional hernia repair with and without mesh-implantation in terms of their medical efficacy and safety, their cost-effectiveness as well as their ethical, social und legal implications. In addition, this report aims to compare different techniques of mesh-implantation and mesh-fixation as well as to identify factors, in which certain techniques might be associated with advantages over others. Methods Relevant publications were identified by means of a structured search of databases accessed through the German Institute of Medical Documentation

  17. Health Technology Assessment of laparoscopic compared to conventional surgery with and without mesh for incisional hernia repair regarding safety, efficacy and cost-effectiveness

    Directory of Open Access Journals (Sweden)

    Willich, Stefan

    2008-03-01

    Full Text Available Introduction: Incisional hernias are a common complication following abdominal surgery and they represent about 80% of all ventral hernia. In uncomplicated postoperative follow-up they can develop in about eleven percent of cases and up to 23% of cases with wound infections or other forms of wound complications. Localisation and size of the incisional hernia can vary according to the causal abdominal scar. Conservative treatment (e. g. weight reduction is only available to relieve symptoms while operative treatments are the only therapeutic treatment option for incisional hernia. Traditionally, open suture repair was used for incisional hernia repair but was associated with recurrence rates as high as 46%. To strengthen the abdominal wall and prevent the development of recurrences the additional implantation of an alloplastic mesh is nowadays commonly used. Conventional hernia surgery as well as minimally invasive surgery, introduced in the early 90s, make use of this mesh-technique and thereby showed marked reductions in recurrence rates. However, there are possible side effects associated with mesh-implantation. Therefore recommendations remain uncertain on which technique to apply for incisional hernia repair and which technique might, under specific circumstances, be associated with advantages over others. Objectives: The goal of this HTA-Report is to compare laparoscopic incisional hernia repair (LIHR and conventional incisional hernia repair with and without mesh-implantation in terms of their medical efficacy and safety, their cost-effectiveness as well as their ethical, social und legal implications. In addition, this report aims to compare different techniques of mesh-implantation and mesh-fixation as well as to identify factors, in which certain techniques might be associated with advantages overothers. Methods: Relevant publications were identified by means of a structured search of databases accessed through the German Institute of

  18. Diaphragmatic hernia repair - slideshow

    Science.gov (United States)

    ... presentations/100014.htm Diaphragmatic hernia repair - series—Normal anatomy To use the sharing ... Overview The chest cavity includes the heart and lungs. The abdominal cavity includes the liver, the stomach, ...

  19. Hiatal hernia repair - slideshow

    Science.gov (United States)

    ... presentations/100028.htm Hiatal hernia repair - series—Normal anatomy To use the sharing features on ... Overview The esophagus runs through the diaphragm to the stomach. It functions to carry food from the mouth ...

  20. Use of Mesh in Laparoscopic Paraesophageal Hernia Repair: A Meta-Analysis and Risk-Benefit Analysis.

    Directory of Open Access Journals (Sweden)

    Beat P Müller-Stich

    Full Text Available Mesh augmentation seems to reduce recurrences following laparoscopic paraesophageal hernia repair (LPHR. However, there is an uncertain risk of mesh-associated complications. Risk-benefit analysis might solve the dilemma.A systematic literature search was performed to identify randomized controlled trials (RCTs and observational clinical studies (OCSs comparing laparoscopic mesh-augmented hiatoplasty (LMAH with laparoscopic mesh-free hiatoplasty (LH with regard to recurrences and complications. Random effects meta-analyses were performed to determine potential benefits of LMAH. All data regarding LMAH were used to estimate risk of mesh-associated complications. Risk-benefit analysis was performed using a Markov Monte Carlo decision-analytic model.Meta-analysis of 3 RCTs and 9 OCSs including 915 patients revealed a significantly lower recurrence rate for LMAH compared to LH (pooled proportions, 12.1% vs. 20.5%; odds ratio (OR, 0.55; 95% confidence interval (CI, 0.34 to 0.89; p = 0.04. Complication rates were comparable in both groups (pooled proportions, 15.3% vs. 14.2%; OR, 1.02; 95% CI, 0.63 to 1.65; p = 0.94. The systematic review of LMAH data yielded a mesh-associated complication rate of 1.9% (41/2121; 95% CI, 1.3% to 2.5% for those series reporting at least one mesh-associated complication. The Markov Monte Carlo decision-analytic model revealed a procedure-related mortality rate of 1.6% for LMAH and 1.8% for LH.Mesh application should be considered for LPHR because it reduces recurrences at least in the mid-term. Overall procedure-related complications and mortality seem to not be increased despite of potential mesh-associated complications.

  1. Laparoscopic repair for a previously unreported form of ventral hernia on the right iliac fossa in an elderly emaciated woman.

    Science.gov (United States)

    Yokoyama, T; Kobayashi, A; Shimizu, A; Motoyama, H; Miyagawa, S

    2015-10-01

    An 81-year-old emaciated woman was admitted to our hospital with a one-year history of recurrent bilateral inguinal swellings. Palpable lumps were observed not only in bilateral groin areas, but also on the right iliac fossa (RIF) of her abdomen. During a planned transabdominal preperitoneal laparoscopic herniorrhaphy, a previously unreported form of ventral hernia was observed at a position lateral and cranial to the right internal inguinal ring, which probably corresponded to the palpable lump on the RIF. The hernia orifice was 2 cm in diameter, and a vascular structure ran through the orifice. The contents of the hernia consisted of fatty tissue arising from the retroperitoneal tissue. Routine exploration revealed orifices of the following hernias: left indirect, right direct, bilateral femoral, bilateral obturator, and right Spigelian hernia. Her postoperative course was uneventful and a mass on the right lower quadrant disappeared after operation.

  2. 免补片法腹腔镜腹股沟疝修补术%Mesh free laparoscopic inguinal hernia repair

    Institute of Scientific and Technical Information of China (English)

    陈开运; 向国安; 王汉宁; 肖方联

    2009-01-01

    Objective To study the efficiency of iaparoscopic inguinal hernia repair without the use of a mesh. Methods We used laparoscopic hernia repair without the use of a mesh in 92 cases of inguinal hernia. Results were compared with that of total extraperitoneal laparoscopic inguinal hernioplasty(TEP) in 91 cases from January 2001 to March 2004. Results The laparoscopic procedures were successfully performed in all the patients. In mesh-free and TEP group respectively the operating time was (21±4) min vs. (70±16) min (t=28. 01, P0.05) respectively. Conclusions Mesh-free laparoseopie inguinal hernia repair is safe, cost-effective, as well as of much lower hernia recurrence.%目的 探讨免补片法腹腔镜下腹股沟疝修补的有效性.方法 回顾分析广东省第二人民医院2001年1月至2004年3月,应用腹腔镜免补片法治疗92例腹股沟疝的手术后恢复情况及随访结果,并与同期91例腹腔镜完全腹膜外疝修补手术(totally extraperitoneal laparoscopichemioplasty,TEP)的结果相比较.结果 免补片组与TEP组手术时间分别为(21±4)min与(70±16)min(t=28.01,P0.05).结论 腹腔镜免补片治疗腹股沟疝安全、可行,恢复快、住院时间短、费用少.

  3. Tailored or routine addition of an antireflux fundoplication in laparoscopic large hiatal hernia repair: a comparative cohort study

    NARCIS (Netherlands)

    Furnee, E.J.B.; Draaisma, W.A.; Gooszen, H.G.; Hazebroek, E.J.; Smout, A.J.P.M.; Broeders, I.A.M.J.

    2011-01-01

    BACKGROUND: There is controversy about the tailored or routine addition of an antireflux fundoplication in large hiatal hernia (type II-IV) repair. We investigated the strategy of selective addition of a fundoplication in patients with a large hiatal hernia and concomitant gastroesophageal reflux di

  4. 腹腔镜食管裂孔疝修补术12例报告%Laparoscopic hiatal hernia repair:a clinical analysis of 12 cases

    Institute of Scientific and Technical Information of China (English)

    李青; 渠时学; 谢光伟

    2012-01-01

    Objective:To explore the feasibility and clinical value of laparoscopic surgery in treating patients with hiatal herni-a. Methods:Twelve patients with hiatal hernia underwent laparoscopic hiatal hernia repair,including 9 cases of Nissen operation,3 cases of Toupet operation. 8 cases of hernia repaired with suture,4 cases repaired with Bard CruraSoftMesh. Results; 12 cases of laparoscopic hiatal hernia repair was successful in all. No conversions were needed. Mean operation time was (116 ±23) min (range :62-215 min). Mean intraoperative blood lose was ( 12 ± 2. 4) ml(range: 10-20 ml). Mean postoperative hospital stay was (5. 1 ±1.3) d ( range :3-19 d). Clinical symptoms were relieved in all cases. No mortality and severe complications were occurred. Symptoms completely disappeared in 9 cases (75% ) , improved in 3 cases (25% ). Conclusions: Laparoscopic repair of esophageal hiatal hernia with efficacy, safety and the advantages of minimally invasive, should be further applied clinically.%目的:探讨腹腔镜手术治疗食管裂孔疝的可行性及临床价值.方法:为12例食管裂孔疝患者行腹腔镜食管裂孔疝修补术,其中9例行胃底360度折叠术(Nissen术),3例行胃底270度部分折叠术(Toupet术).8例使用7号丝线缝合修补疝缺口,4例应用补片修补.结果:12例手术均获成功,无一例中转开腹.手术时间62 ~ 215 min,平均(116±23) min;术中出血量10 ~20 ml,平均(12±2.4)ml;术后住院3~19 d,平均(5.1±1.3)d;无严重并发症发生及死亡病例.术后症状完全消失9例(75%),好转3例(25%).结论:腹腔镜食管裂孔疝修补术安全,疗效确定,患者创伤小,值得临床应用.

  5. 80 cases of laparoscopic inguinal hernia repair%腹腔镜腹股沟疝修补术80例

    Institute of Scientific and Technical Information of China (English)

    夏云; 王震

    2015-01-01

    Objective To summarize the clinical effect and value of laparoscopic inguinal hernia repair. Methods From January 2011 to October 2011, 80 cases of inguinal hernia patients who were admitted to People's Hospital of Xishuangbanna were performed with laparoscopic inguinal hernia repair, including 40 cases of transabdominal preperitoneal (TAPP) and 40 cases of totally extraperitoneal (TEP). The clinical data, such as operation time, length of hospital stay and complications, were retrospectively analyzed. Results All operations were successful without any conversion. Operation time was (45. 0 ± 5. 0) minutes for TAPP group and 45. 0±3. 0 min for TEP group. The difference was not statistically (t =11. 14, P=0. 153). There were also no differences in length of hospital stay (t = 15. 25, P = 0. 128) and scrotal hematoma (χ2 = 6. 85, P=0. 087). While, two and five cases of urinary retention occurred in TAPP and TEP group with significant difference (χ2 = 13. 10, P=0. 000), respectively. TAPP group had 2 cases of groin pain (none in TEP group, χ2 = 8. 15, P=0. 000), which were reliefed in 2 weeks. With following up for 3 to 18 months, there was no recurrence. Conclusion Laparoscopic inguinal hernia repair surgery has short operation time, less hospital stay, fewer complications and lower recurrence and pain, and can also find occult hernias in the procedure at the same time, to avoid the secondary surgery. It is suitable for the treatment of inguinal hernia.%目的:总结腹腔镜腹股沟疝修补术的临床效果与价值。方法采集2011年1月至2014年10月,云南省西双版纳州医院收治的腹股沟疝患者80例,随机分为经腹腹膜前疝修补术(TAPP)组和完全腹膜外疝修补术(TEP)组,每组患者40例。对二组患者的手术时间、住院时间、并发症等临床资料进行回顾性分析。结果本组80例患者手术顺利,无中转开放手术。 TAPP 组平均手术时间(45.0±5.0)min,TEP 组平均手术时间(45.0±3.0) min

  6. Laparoscopic umbilical hernia repair in the presence of extensive paraumbilical collateral veins: A case report

    NARCIS (Netherlands)

    S.S. Lases (Seilenna); H.H. Eker (Hasan); E.G.J.M. Pierik; P. Klitsie (Pieter); B. de Goede (Barry); M.P.F.V. Peeters; G. Kazemier (Geert); J.F. Lange (Johan)

    2011-01-01

    textabstractA patient with an umbilical hernia presenting with collateral veins in the abdominal wall and umbilicus is a case that every hernia surgeon has to deal with occasionally. Several underlying diseases have been described to provoke collateral veins in the abdominal wall. However, the treat

  7. 腹腔镜腹股沟疝修补与开放性腹股沟疝修补的疗效对比研究%Comparative study on the laparoscopic inguinal hernia repair and open inguinal hernia repair

    Institute of Scientific and Technical Information of China (English)

    施景龙; 陈海生; 褚中华

    2014-01-01

    目的:比较腹腔镜腹股沟疝修补与开放性腹股沟疝修补的优缺点。方法对2012年5月~2013年5月中山市中医院240例成人腹股沟疝修补术进行回顾性分析,其中开放性疝修补术(开腹疝修补组)148例,腹腔镜疝修补术(腔镜疝修补组)92例。收集两组患者的手术时间、住院时间、住院费用、术后复发、术后慢性疼痛、术后阴囊积液及术后感染的临床资料并进行比较。结果开腹疝修补组患者在平均手术时间、平均住院费用少于腔镜疝修补(P 均<0.01);开腹疝修补组术后复发(3例)、术后慢性疼痛(11例)、术后阴囊积液(2例)及术后感染(1例)等总并发症高于腔镜疝修补组(P<0.05);两组的平均住院时间差异无统计学意义。结论腔镜组腹股沟疝修补术具有较少的术后并发症,但在住院时间、住院费用方面没有优势。%Objective To compare the efficacy between laparoscopic inguinal hernia repair and open inguinal hernia repair. Methods From May 2012 to May 2013, 240 cases of adult inguinal hernia repair were retrospectively analyzed. Of 240 cases ,148 cases underwent open herniorrhaphy (open group), 92 underwent laparoscopic herniorrhaphy (laparoscope group). The clinical parameters of two groups were recorded and analyzed,including operation time,.length of hospital stay, hospital expenses,. postoperative recurrence,.postoperative chronic pain,.postoperative scrotal hydrops and postoperative infection. Results The average operation time and hospitalization expenses for open group was 62.9± 9.8 min and 8420±2481 yuan,.lower than that laparoscopic group (76.2±9.4 min and 12468±33858 yuan,P<0.01). However, postoperative complications in open group were including recurrence (3 cases), chronic postoperative pain(11 cases), postoperative scrotal hydrops (2 cases), postoperative infection (1 case) were higher than that in laparoscopic group (P

  8. A comparative study on trans-umbilical single-port laparoscopic approach versus conventional repair for incarcerated inguinal hernia in children

    Directory of Open Access Journals (Sweden)

    Zhang Jun

    2016-01-01

    Full Text Available Purpose: The purpose of this study is to determine whether singleport laparoscopic repair (SLR for incarcerated inguinal hernia in children is superior toconventional repair (CR approaches. Method: Between March 2013 and September 2013, 126 infants and children treatedwere retrospectively reviewed. All the patients were divided into three groups. Group A (48 patients underwent trans-umbilical SLR, group B (36 patients was subjected to trans-umbilical conventional two-port laparoscopic repair (TLR while the conventional open surgery repair (COR was performed in group C (42 patients. Data regarding the operating time, bleeding volume, post-operative hydrocele formation, testicular atrophy, cosmetic results, recurrence rate, and duration of hospital stay of the patients were collected. Result: All the cases were completed successfully without conversion. The mean operative time for group A was 15 ± 3.9 min and 24 ± 7.2 min for unilateral hernia and bilateral hernia respectively, whereas for group B, it was 13 ± 6.7 min and 23 ± 9.2 min. The mean duration of surgery in group C was 35 ± 5.2 min for unilateral hernia. The recurrence rate was 0% in all the three groups. There were statistically significant differences in theoperating time, bleeding volume, post-operative hydrocele formation, cosmetic results and duration hospital stay between the three groups (P < 0.001. No statistically significant differences between SLR and TLR were observed except the more cosmetic result in SLR. Conclusion: SLR is safe and effective, minimally invasive, and is a new technology worth promoting.

  9. A prospective randomised controlled trial comparing chronic groin pain and quality of life in lightweight versus heavyweight polypropylene mesh in laparoscopic inguinal hernia repair

    Directory of Open Access Journals (Sweden)

    Pradeep Prakash

    2016-01-01

    Full Text Available Background: The aim of our study was to compare chronic groin pain and quality of life (QOL after laparoscopic lightweight (LW and heavyweight (HW mesh repair for groin hernia. Materials and Methods: One hundred and forty adult patients with uncomplicated inguinal hernia were randomised into HW mesh group or LW mesh group. Return to activity, chronic groin pain and recurrence rates were assessed. Short form-36 v2 health survey was used for QOL analysis. Results: One hundred and thirty-one completed follow-up of 3 months, 66 in HW mesh group and 65 in LW mesh group. Early post-operative convalescence was better in LW mesh group in terms of early return to walking (P = 0.01 and driving (P = 0.05. The incidence of early post-operative pain, chronic groin pain and QOL and recurrences were comparable. Conclusion: Outcomes following laparoscopic inguinal hernia repair using HW and LW mesh are comparable in the short-term as well as long-term.

  10. Laparoscopic treatment for inguinal hernia combined with cryptorchidism: Totally extraperitoneal repair with orchiectomy under the same operative view

    Science.gov (United States)

    Fujishima, Hajime; Sasaki, Atsushi; Takeuchi, Yu; Morimoto, Akio; Inomata, Masafumi

    2015-01-01

    Introduction Approximately 7% of child patients with inguinal hernias also present with cryptorchidism. On the other hand, combined adult cases are uncommon. Here we report two adult cases of inguinal hernia combined with intra-canalicular cryptorchidism who underwent totally extraperitoneal (TEP) repair with orchiectomy under the same operative view. Presentation of cases We treated two patients (49- and 38-year-old men) with right indirect inguinal hernias and cryptorchidism. Both patients underwent TEP repair with orchiectomy. In operative findings, an atrophic testis was drawn out with a hernia sac from the internal inguinal ring. After the testis was separated from the sac and cord structure was sheared, it was removed. The procedure did not require special techniques and devices. In both patients, the postoperative courses were satisfactory. Discussion To our knowledge, there has been only one such reported case till date which demonstrated the feasibility of TEP repair accompanied by orchiectomy. Conclusions TEP repair with orchiectomy under the same operative view could be safely performed in adults with an inguinal hernia combined with extra-abdominal cryptorchidism. This procedure could be an option for the treatment of such adult patients. PMID:26581081

  11. Therapy of umbilical hernia during laparoscopic cholecystectomy.

    Science.gov (United States)

    Zoricić, Ivan; Vukusić, Darko; Rasić, Zarko; Schwarz, Dragan; Sever, Marko

    2013-09-01

    The aim of this study is to show our experience with umbilical hernia herniorrhaphy and laparoscopic cholecystectomy, both in the same act. During last 10 years we operated 89 patients with cholecystitis and pre-existing umbilical hernia. In 61 of them we performed standard laparoscopic cholecystectomy and additional sutures of abdominal wall, and in 28 patients we performed in the same act laparoscopic cholecystectomy and herniorrhaphy of umbilical hernia. We observed incidence of postoperative herniation, and compared patients recovery after herniorrhaphy combined with laparoscopic cholecystectomy in the same act, and patients after standard laparoscopic cholecystectomy and additional sutures of abdominal wall. Patients, who had in the same time umbilical hernia herniorrhaphy and laparoscopic cholecystectomy, shown better postoperative recovery and lower incidence of postoperative umbilical hernias then patients with standard laparoscopic cholecystectomy and additional abdominal wall sutures.

  12. 老年食管裂孔疝的腹腔镜治疗%Laparoscopic repair of the esophageal hiatal hernia in elderly patients

    Institute of Scientific and Technical Information of China (English)

    郑亚杰; 田文; 马冰; 丁国飞

    2012-01-01

    Objective To investigate the methods,safety and efficacy of laparoscopic repair of the esophageal hiatal hernia in elderly patients. Methods There were twenty one elderly patients with esophageal hiatal hernia received the laparoscopic repair in our hospital from March 2007 to November 2010. The clinical data were analyzed and patients were followed up after surgery. Results All of the twenty one patients were completed laparoscopic repair of the esophageal hiatal hernia successfully. The operation time was 78 min in average (61-128 min)and the blood loss was between 10-110 ml,25ml in average. Six patients developed transient dysphagia after surgery,the symptoms subsided after conservative treatment. The mean postoperative hospital stay was 5 days (3-21 days). The patients were followed up for 12-31 months (mean 20 months),no recurrence or complication with mesh were found. Conclusions Laparoscopic repair of the esophageal hiatal hernia in elderly patients is a safe and can achieve good clinical results.%目的 探讨腹腔镜下应用补片行老年食管裂孔疝修补术的方法、安全性及临床效果.方法 2007年3月~2010年11月在腹腔镜下应用补片修补食管裂孔疝的21例老年患者,回顾分析临床资料并进行术后随访.结果 21例腹腔镜下应用补片行食管裂孔疝修补术的患者均顺利完成手术.手术时间61~128 min,平均78 min;手术出血10~1 10ml,平均25 ml;术后住院3~21 d,平均5d.术后6例出现短期的吞咽困难,均经保守治疗后好转,无手术死亡发生.随访12~31个月,平均20个月,未见食管裂孔疝复发病例及有关补片并发症的发生.结论 腹腔镜技术对老年人实施食管裂孔疝修补术是一项安全有效的手术方式,能够取得良好的临床效果.

  13. Analysis of complications of laparoscopic inguinal hernia repair%腹腔镜腹股沟疝修补术的并发症分析

    Institute of Scientific and Technical Information of China (English)

    李健文

    2009-01-01

    @@ 腹腔镜腹股沟疝修补术(laparoscopic inguinal hernia repair,LIHR)自1991年开展以来,在临床上应用愈来愈广泛,但随之也产生了一些并发症.本文结合文献报道和自身经验,对LIHR的各种并发症发生的原因、预防和处理作一探讨.

  14. Computed tomographic measurements of mesh shrinkage after laparoscopic ventral incisional hernia repair with an expanded polytetrafluoroethylene mesh.

    Science.gov (United States)

    Schoenmaeckers, Ernst J P; van der Valk, Steef B A; van den Hout, Huib W; Raymakers, Johan F T J; Rakic, Srdjan

    2009-07-01

    The potential for shrinkage of intraperitoneally implanted meshes for laparoscopic repair of ventral and incisional hernia (LRVIH) remains a concern. Numerous experimental studies on this issue reported very inconsistent results. Expanded polytetrafluoroethylene (ePTFE) mesh has the unique property of being revealed by computed tomography (CT). We therefore conducted an analysis of CT findings in patients who had previously undergone LRVIH with an ePTFE mesh (DualMesh, WL Gore, Flagstaff, AZ, USA) in order to evaluate the shrinkage of implanted meshes. Of 656 LRVIH patients with DualMesh, all patients who subsequently underwent CT scanning were identified and only those with precisely known transverse diameter of implanted mesh and with CT scans made more than 3 months postoperatively were selected (n = 40). Two radiologists who were blinded to the size of the implanted mesh measured in consensus the maximal transverse diameter of the meshes by using the AquariusNET program (TeraRecon Inc., San Mateo, CA, USA). Mesh shrinkage was defined as the relative loss of transverse diameter as compared with the original transverse diameter of the mesh. The mean time from LRVIH to CT scan was 17.9 months (range 3-59 months). The mean shrinkage of the mesh was 7.5% (range 0-23.7%). For 11 patients (28%) there was no shrinkage at all. Shrinkage of 1-10% was found in 16 patients (40%), of 10-20% in 10 patients (25%), and of 20-24% in 3 patients (7.5%). No correlation was found regarding the elapsed time between LRVIH and CT, and shrinkage. There were two recurrences, one possibly related to shrinkage. Our observations indicate that shrinkage of DualMesh is remarkably lower than has been reported in experimental studies (8-51%). This study is the first to address the problem of shrinkage after intraperitoneal implantation of synthetic mesh in a clinical material.

  15. TOTALLY EXTRAPERITONEAL LAPAROSCOPIC HERNIA REPAIR AND TENSION-FREE HERNIA REPAIR SURGERY EFFICACY COMPARISON%腹腔镜下完全腹膜外疝修补术与无张力疝修补术疗效对比

    Institute of Scientific and Technical Information of China (English)

    陈旭生; 莫伟锋; 钟志辉

    2014-01-01

    Objective:Under evaluation of laparoscopic totally extraperitoneal hernia repair clinical efficacy .Methods:Inguinal her-nia patients in March 2011-September 2013 in our hospital 71 cases were randomly divided into two groups , one group of 36 patients was observed under the use of laparoscopic totally extraperitoneal hernia repair treatment and the control group 35 cases treated with tension-free hernia repair .Two groups were compared operative time , postoperative ambulation time , postoperative pain duration , total hospital stay, incidence of complications and recurrence of the number of cases .Results:The postoperative indicators are significantly better than the control group , the difference between the two groups was statistically significant (P 0.05).Conclusions:Laparoscopic totally extraper-itoneal hernia repair surgery good clinical efficacy , time and total postoperative pain , shorter hospital stay , and can get out of bed earli-er, reducing pain and no recurrence ,which deserves to be orrlied in clinical practice .%目的:评价腹腔镜下完全腹膜外疝修补术的临床疗效。方法:选取2011-03~2013-09间我院收治的腹股沟疝患者71例,随机分为两组,其中观察组36例,使用腹腔镜下完全腹膜外疝修补术进行治疗,对照组35例,使用无张力疝修补术进行治疗,比较两组患者手术时间、术后下床活动时间、术后疼痛持续时间、总住院时间、并发症发生率与复发例数。结果:观察组术后各项指标均明显优于对照组,两组患者比较差异有统计学意义(P<0.05);两组患者在随访期间均无复发情况,比较差异无统计学意义(P>0.05)。结论:腹腔镜下完全腹膜外疝修补术临床疗效好,术后疼痛时间与总住院时间短,且能较早下床活动,减轻了患者痛苦,无复发情况,值得在临床上推广。

  16. [A Case of General Anesthesia for a Cardiac Transplanted Patient Undergoing Inguinal Hernia Repair under Laparoscopic Surgery].

    Science.gov (United States)

    Inoue, Mitsuko; Hayashi, Yasue; Fujita, Yuki; Shimizu, Motoko; Hotta, Arisa; Nakamoto, Ai; Yoshikawa, Noriko; Ohira, Naoko; Tatekawa, Shigeki

    2016-04-01

    A 52-year-old man was scheduled for the repair of inguinal hernia recurrence. When he was 48 years of age, he received a heart transplantation due to severe heart failure resulting from ischemic heart disease. When he was 50 years old, he suffered from inguinal hernia, and it was repaired under spinal anesthesia. During this surgery, he experienced pain because of the inadequate effect of anesthesia, but his blood pressure and heart rate were stable. We suspected that this was because of denervation of the heart. On hernia repair for inguinal hernia recurrence, general anesthesia was chosen, induced with midazolam, rocuronium, and fentanyl and maintained with sevoflurane, rocuronium, fentanyl, and remifentanil. The blood pressure was mostly stable during anesthesia, but we noted an increase in the heart rate when the trachea was intubated and extubated and when surgical incision started. This phenomenon may indicate reinnervation of the transplanted heart. We could safely manage anesthesia without invasive monitoring because the transplanted heart functioned favorably and surgery was minimally invasive.

  17. 腹腔镜下巨大食管裂孔疝修补术25例%Laparoscopic repair of giant hiatal hernia: analysis of 25 cases

    Institute of Scientific and Technical Information of China (English)

    赵宏志; 秦鸣放

    2011-01-01

    目的 探讨腹腔镜巨大食管裂孔疝修补术的临床特点和可行性.方法 2008年1月至2010年8月,应用腹腔镜治疗25例巨大食管裂孔疝,术中均使用专用补片修补食管裂孔,16例同时行胃底折叠术,记录围手术期相关指标,并随访观察治疗效果和术后复发情况.结果 25例均完成腹腔镜手术,手术85~210 min,平均106 min;术中出血量55~150 ml,平均94 ml.术后住院4~21天,平均6.8天.术后症状均得到缓解,无严重并发症,随访3~35个月,平均13.6个月,病人满意率为88%,4例出现轻度反酸症状,1例裂孔疝复发.结论 腹腔镜巨大食管裂孔疝修补术安全、可行,具有创伤小、恢复快、疗效可靠的特点,术中应用Bard CruraSoft补片可缩短手术时间,降低修补食管裂孔的难度,减少复发.%Objective To investigate the clinical characteristics and feasibility of laparoscopic repair of giant hiatal hernia. Methods From January 2008 to August 2010, 25 consecutive patients with giant hiatal hernia underwent laparoscopic repair. Crural closure was performed by means of two or three interrupted nonabsorbable sutures plus a tailored PTFE/ePTFE composite mesh. It was patched across the defect and secured to each crura with staples. Laparoscopic fundoplication was performed concomitantly in 16 cases according to the specific conditions of patients. Para-operative clinical parameters were recorded. All patients were routinely followed up. Clinical outcomes were collected and analyzed. Results All laparoscopic surgeries were accomplished successfully. The operating time was 85 -210 minutes (mean, 106 minutes) ,the operative blood loss was 55 - 150 ml( mean, 94 ml) ,the postoperative hospital stay was 4 -21 days( mean, 6.8 days). The symptoms in most cases were adequately relieved after operation. There was no severe postoperative morbidity. After the follow-up period of 3 - 35months ( mean, 13.6 months), the satisfaction rate of surgery was 88

  18. 腹腔镜全腹膜外疝修补术(TEP)与无张力疝修补术疗效比较%Comparison of the Efficacy of Laparoscopic Total Peritoneal Hernia Repair (TEP) and Tension Free Hernia Repair

    Institute of Scientific and Technical Information of China (English)

    施原; 肖金谭; 危少华

    2015-01-01

    Objective To explore discuss laparoscopic treatment of inguinal hernia cavity mir or that shows the total extraperitoneal hernia repair surgery skil s,and evaluate its merits and demerits about open without tension hernia repair.Methods Review analysis 80 cases of inguinal hernia patients,including in laparoscopic total extraperitoneal hernia repair (teb) 40 cases,40 cases to open without tension hernia repair.Results The cavity mir or ful of extraperitoneal hernia repair each index is bet er than the open group,the dif erence was statistical y significant ( <0.05).Conclusion Laparoscopic total extraperitoneal hernia repair (teb) is a safe and ef ective,is extremely low risk of complications,recurrence of probability is very low,and the chance of long-term chronic pain is also very low,for huge hernia,hernia recur ence,double side hernia and herniation in the elderly are more advantages.%目的探索讨论腹腔镜治疗腹股沟疝所用到的腔镜全腹膜外疝修补术的手术技巧,同时评价其优缺点是关于开放性无张力疝修补术的。方法分析回顾腹股沟疝患者80例,其中进行腹腔镜全腹膜外疝修补术(TEP)40例,进行开放性无张力疝修补术40例。结果腔镜全腹膜外疝修补术组各项指标优于开放组,差异有统计学意义(<0.05)。结论腹腔镜全腹膜外疝修补术(TEP)是安全有效的,发生并发症的几率是极低的,复发的几率也是十分低的,而且发生远期慢性疼痛的几率也是极低的,对于巨大疝、复发疝、双侧疝以及老年人疝则是更加具有优势的。

  19. Direct and recurrent inguinal hernias are associated with ventral hernia repair: a database study.

    Science.gov (United States)

    Henriksen, Nadia A; Sorensen, Lars T; Bay-Nielsen, Morten; Jorgensen, Lars N

    2013-02-01

    A systemically altered connective tissue metabolism has been demonstrated in patients with abdominal wall hernias. The most pronounced connective tissue changes are found in patients with direct or recurrent inguinal hernias as opposed to patients with indirect inguinal hernias. The aim of the present study was to assess whether direct or recurrent inguinal hernias are associated with an elevated rate of ventral hernia surgery. In the nationwide Danish Hernia Database, a cohort of 92,457 patients operated on for inguinal hernias was recorded from January 1998 until June 2010. Eight-hundred forty-three (0.91 %) of these patients underwent a ventral hernia operation between January 2007 and June 2010. A multivariate logistic regression analysis was applied to assess an association between inguinal and ventral hernia repair. Direct (Odds Ratio [OR] = 1.28 [95 % CI, 1.08-1.51]) and recurrent (OR = 1.76, [95 % CI, 1.39-2.23]) inguinal hernias were significantly associated with ventral hernia repair after adjustment for age, gender, and surgical approach (open or laparoscopic). Patients with direct and recurrent inguinal herniation are more prone to ventral hernia repair than patients with indirect inguinal herniation. This is the first study to show that herniogenesis is associated with type of inguinal hernia.

  20. A clinical control study of laparoscopic inguinal hernia repair vs inguinal hernia repair with UHS mesh%腹腔镜腹股沟疝修补术与应用UHS无张力疝修补术的对比研究

    Institute of Scientific and Technical Information of China (English)

    徐海; 杨康; 贺长林; 罗德富

    2011-01-01

    Objective To compare the therapeutic efiects between laparoscopic inguinal hernia repair and inguinal hernia repair with UHS mesh. Methods Eighty seven patients with inguinal hernia were performed with laparoscopic inguinal hernia repair including 50 cases received transabdominal extraperitoneal laparoscopic repair and 37 cases received totally extraperitoneal technique for repair during the period from March 2009 to January 2011, and 53 patients underwent open inguinal hernia repair with UHS mesh. The clinical data of these patients were retrospectively analyzed. The average operating time, duration of hospitalization, rate of complications, duration for recovery and short - term recurrence rate in both groups were compared. Results There was no significant difference found in average operating time, duration of hospitalization, duration for recovery and short - term recurrence rate between these two groups. The operating time with laparoscopy was longer than that with UHS mesh. Conclusion The laparoscopic inguinal hernia repair and inguinal hernia repair with UHS mesh had the similar curative effect if the technical standard was strictly mastered.%目的 研究比较腹腔镜腹股沟疝修补术与应用轻量型超普疝装置(UHS)补片无张力疝修补术的临床效果.方法 回顾性分析2009年3月至2011年1月年腹腔镜腹股沟疝修补术87例,应用轻量型UHS补片无张力疝修补术53例的临床资料,分析比较手术时间、住院天数、并发症发生率、恢复正常生活和工作时间、术后短期复发率等指标.结果 手术时间、术后住院天数、并发症发生率、恢复正常生活和工作时间、术后短期复发率等指标两组相比差异无统计学意义.结论 腹腔镜腹股沟疝修补术与应用UHS补片无张力疝修补术两种无张力修补方法治疗腹股沟疝均可取得满意疗效.

  1. Umbilical hernia repair

    Science.gov (United States)

    Umbilical hernia surgery ... and pain-free) for this surgery. If your hernia is small, you may receive spinal, epidural block , ... your belly button. Your surgeon will find your hernia and separate it from the tissues around it. ...

  2. Laparoscopic repair of Morgagni hernia and cholecystectomy in a 40-year-old male with Down's sindrome. Report of a case.

    Science.gov (United States)

    De Paolis, P; Mazza, L; Maglione, V; Fronda, G R

    2007-06-01

    Morgagni-Larrey hernia (MH) is an unusual diaphragmatic hernia of the retrosternal region. Few cases of MH, treated laparoscopically, associated with Down's syndrome (DS) have been reported in literature. On October 2004, a DS 40-year-old male was admitted to our Department with mild abdominal pain and nausea. Hematochemical tests were within the normal range. Ultrasonography showed biliary sludge and multiple gallstones. Chest X-ray revealed a right-sided paracardiac mass that appeared as MH after a thoraco-abdominal computed tomography (CT). Four trocars were placed as a routinary cholecystectomy. Abdominal exploration confirmed the presence of a voluminous hernia through a wide diaphragmatic defect (12 cm) on the left side of the falciform ligament, containing the last 20 cm ileal loops and right colon with the third lateral of transverse. After retrograde cholecystectomy and reduction of the herniated ileo-colonic tract from multiple adherences, the defect was repaired with an interrupted 2/0 silk suture and then a running 2/0 polypropylene suture. Postoperative course was complicated by pulmonary edema but subsequently the patient was discharged without further complications and has no recurrence after 2 years. In conclusion, surgery is necessary for symptomatic MH and to prevent possible severe complications. We preferred laparoscopy for the reduced morbidity compared to laparotomy, even if in our case the postoperative course was not uneventful. There are still few comparative data about the modality of closure of the defect between primary repair with nonabsorbable suture material, in case of small defects, or continuous monofilament suture or prosthesis in case of large defects.

  3. Pain after groin hernia repair

    DEFF Research Database (Denmark)

    Callesen, T; Bech, K; Nielsen, R

    1998-01-01

    BACKGROUND: The purpose of the study was to provide a detailed description of postoperative pain after elective day-case open inguinal hernia repair under local anaesthesia. METHODS: This was a prospective consecutive case series study. After 500 hernia operations in 466 unselected patients aged 18...... between types of surgery or hernia. CONCLUSION: Pain remained a problem despite the pre-emptive use of opioids, non-steroidal anti-inflammatory drugs and local anaesthesia, irrespective of surgical technique....

  4. Endoscopic inguinal hernia repair

    NARCIS (Netherlands)

    M.T.T. Knook

    2002-01-01

    textabstractInguinal hernias are among the oldest surgical challenges, having been recognized by the Egyptians in 1500 BC and Hippocrates in 400 BC. Celsus in 40 AD described Roman surgical practice, including manual hernia reduction for strangulated hernia, truss for reducible hernia and surgery

  5. Endoscopic inguinal hernia repair

    NARCIS (Netherlands)

    M.T.T. Knook

    2002-01-01

    textabstractInguinal hernias are among the oldest surgical challenges, having been recognized by the Egyptians in 1500 BC and Hippocrates in 400 BC. Celsus in 40 AD described Roman surgical practice, including manual hernia reduction for strangulated hernia, truss for reducible hernia and surgery on

  6. Endoscopic inguinal hernia repair

    NARCIS (Netherlands)

    M.T.T. Knook

    2002-01-01

    textabstractInguinal hernias are among the oldest surgical challenges, having been recognized by the Egyptians in 1500 BC and Hippocrates in 400 BC. Celsus in 40 AD described Roman surgical practice, including manual hernia reduction for strangulated hernia, truss for reducible hernia and surgery on

  7. Laparoscopic Ventral Hernia Repair

    Science.gov (United States)

    ... surgical incision was made. In this area the abdominal muscles have weakened; this results in a bulge or ... alternatives, billing or insurance coverage, or your surgeons training and experience, do not hesitate to ask your ...

  8. Single incision laparoscopic primary and incisional ventral hernia repair as the standard of care in the ambulatory setting; Does less equal better outcomes; Case series and literature review

    Directory of Open Access Journals (Sweden)

    Ross O. Downes

    2016-01-01

    Conclusion: SILS prosthetic repair of primary and incisional ventral hernia is easily feasible. In our series, SILS ventral hernia repair appears to be safe and effective. It may decrease parietal trauma augmenting its use in the ambulatory setting. Technology will continue to improve the wide applicability of this technique. Larger randomized trial studies are required to determine the rates of port-site incisional hernia compared with multiport laparoscopy.

  9. Synchronous femoral hernias diagnosed during endoscopic inguinal hernia repair.

    Science.gov (United States)

    Putnis, Soni; Wong, April; Berney, Christophe

    2011-12-01

    During totally extraperitoneal (TEP) endoscopic repair of inguinal hernias, it is possible to see the internal opening of the femoral canal. The aim of our study was to determine the incidence of synchronous femoral hernias found in patients undergoing TEP endoscopic inguinal hernia repair. This was a retrospective review of prospectively collected data on 362 consecutive patients who underwent 484 TEP endoscopic inguinal hernia repairs during a 5-year period, May 2005 to May 2010. During surgery, both inguinal and femoral canal orifices were routinely inspected. The presence of unilateral or bilateral inguinal and femoral hernias was recorded and repaired accordingly. There were a total of 362 patients. More males (343, 95%) underwent a TEP hernia repair than females (19, 5%). There were more cases of unilateral (240/362, 66%) than bilateral (122/362, 34%) inguinal hernias. A total of 18 cases of synchronous femoral hernias were found during operation. There was a higher incidence of femoral hernia in females (7/19, 37%) compared to males (11/343, 3%) (P hernias were clinically detectable preoperatively. Females undergoing elective inguinal hernia repair are more likely to have a synchronous femoral hernia than males. We suggest that all women presenting with an inguinal hernia also have a formal assessment of the femoral canal. TEP endoscopic inguinal hernia repair is an ideal approach as both inguinal and femoral orifices can be assessed and hernias repaired simultaneously during surgery.

  10. Application of Laparoscopic Repair of Inguinal Hernia by Laparoscopic Repair of Inguinal Hernia%免钉合补片腹腔镜经腹腔腹膜前疝修补术治疗腹股沟疝应用观察

    Institute of Scientific and Technical Information of China (English)

    曹景新

    2015-01-01

    Objective To observe the application ef ect of the laparoscopic treatment of inguinal hernia by using the laparoscopic repair of inguinal hernia. Methods From June 2014 to June 2012, 80 cases of inguinal hernia patients as research object, and randomly divided into experimental group and control group, 40 cases in each group. The experimental group was treated by using free combined with laparoscopic hernia repair, the control group was treated by combined laparoscopic repair, and the operation conditions and complications of the two groups were compared.Results The operation time, bleeding volume and length of hospital stay in the experimental group were significantly bet er than those in the control group, the incidence of complications in the experimental group was significantly lower than that in the control group (22.5%), the dif erence was statistical y significant ( <0.05). Conclusion Inguinal hernia patients by using the free pin and patch laparoscopic hernia repair of abdominal cavity, the ef ect is obvious, less complications, safe, is worthy of clinical promotion and application.%目的观察免钉合补片腹腔镜经腹腔腹膜前疝修补术治疗腹股沟疝的应用效果。方法选取我院2012年6月~2014年6月收治的80例腹股沟疝患者作为研究对象,并随机分为实验组和对照组各40例;实验组采用免钉合补片腹腔镜经腹腔腹膜前疝修补术进行治疗,对照组采用钉合腹腔镜修补术进行治疗;比较两组患者的手术情况及并发症情况。结果实验组手术时间、术中出血量及住院时间均明显优于对照组;实验组并发症发生率的5.0%明显低于对照组的22.5%;组间差异比较具有统计学意义(<0.05)。结论腹股沟疝患者采用免钉合补片腹腔镜经腹腔腹膜前疝修补术进行治疗,效果明显,并发症少,安全性良好,值得临床推广及应用。

  11. Nationwide prevalence of groin hernia repair

    DEFF Research Database (Denmark)

    Burcharth, Jakob; Pedersen, Michael; Bisgaard, Thue;

    2013-01-01

    Groin hernia repair is a commonly performed surgical procedure in the western world but large-scaled epidemiologic data are sparse. Large-scale data on the occurrence of groin hernia repair may provide further understanding to the pathophysiology of groin hernia development. This study was undert...... was undertaken to investigate the age and gender dependent prevalence of groin hernia repair....

  12. Groin hernia repair

    DEFF Research Database (Denmark)

    Kehlet, Henrik; Aasvang, Eske

    2005-01-01

    The choice of anesthesia for groin hernia repair is between general, regional (epidural or spinal), and local anesthesia. Existing data from large consecutive patient series and randomized studies have shown local anesthesia to be the method of choice because it can be performed by the surgeon......, does not necessarily require an attending anesthesiologist, translates into the shortest recovery (bypassing the postanesthesia care unit), has the lowest cost, and has the lowest postoperative morbidity regarding risk of urinary retention. Spinal anesthesia has no documented benefits for this small...... scientific data to support the choice of anesthesia, large epidemiologic and nationwide information from databases show an undesirable high (about 10-20%) use of spinal anesthesia and low (about 10%) use of local infiltration anesthesia. Surgeons and anesthesiologists should therefore adjust their anesthesia...

  13. Laparoscopic tension-free repair of umbilical hernia%腹腔镜下脐疝无张力修补术

    Institute of Scientific and Technical Information of China (English)

    马冰; 田文; 陈凛; 刘培发

    2010-01-01

    Objective To investigate the clinical effects of laparoscopic tension-free repair of umbilical hernia using mesh. Methods Form August 2006 to April 2009, 26 patients with umbilical hernia were repaired with mesh under laparoscopy. After the tissues surrounding umbilical perforation were separated by using ultrasonic scalpel, the mesh was stapled to the hernia edge with under laparoscopy. The efficacy of this procedures was analyzed in this study. Results The tension-free repairing operations were completed successfully in the 26 patients under laparoscopy. The patients felt slight pain and began eating normally on the second day after the operation. The mean operation time was 35 min (30-45 min) and the mean blood loss was 8 ml(5-15 ml). No operative death and infection occurred postoperatively. The mean postoperative hospital stay was 5 days (3-7 days). The patients were followed up for 3-25 months ( mean 14 months), no recurrence of the hernia occurred in this group. Patients were satisfied with the operation. Conclusions Tensionfree repairing of umbilical hernia with mesh under laparoscopy is a minimally invasive operation with fast recovery, few complications, it's in line with the principle of tension-free repair for hernia.%目的 探讨腹腔镜下应用补片行脐疝修补的临床效果.方法 2006年8月至2009年4月在腹腔镜下对26例脐疝患者进行修补治疗.手术方法为用超声刀进行脐孔周围组织分离后,应用腔内缝合器将补片钉合疝孔边缘完成脐疝修补术.分析总结腹腔镜下应用补片行脐疝修补的临床效果.结果 26例患者均成功地在腹腔镜下行脐疝无张力修补术.手术时间30~45 min,平均35min.术中出血5~15 ml,平均8 ml.所有患者术后疼痛轻微,排气、排便时间20~32 h,平均26 h.术后住院3~7 d,平均住院5 d.住院期间未发生脂肪液化及感染,无手术死亡病例.所有患者均获得随访,时间3~25个月,平均14个月,未发现脐疝复

  14. Is Pooled Data Analysis of Ventral and Incisional Hernia Repair Acceptable?

    OpenAIRE

    2015-01-01

    Purpose In meta-analyses and systematic reviews comparing laparoscopic with open repair of ventral hernias, data on umbilical, epigastric, and incisional hernias are pooled. Based on data from the Herniamed Hernia Registry, we aimed to investigate whether the differences in the therapy and treatment results justified such an approach. Methods Between 1st September 2009 and 31st August 2013, 31,664 patients with a ventral hernia were enrolled in the Herniamed Hernia Registry. The im...

  15. The clinical experience of laparoscopic repair of esophageal hiatal hernia%腹腔镜治疗食管裂孔疝56例临床分析

    Institute of Scientific and Technical Information of China (English)

    王玉楼; 王骥; 马东伟; 马红钦; 赵文星; 刘斌

    2015-01-01

    Objective The aim of the present study was to evaluate the safety and efficacy of laparoscopic repair of esophageal hiatal hernia at our hospital. Methods Between August 2010 and August 2014,56 patients at our department underwent laparoscopic repair and Nissen fundoplication of esophageal hiatal hernia,the clinical data from these cases were retrospectively analyzed. Results The mean operation time was(117.4 ±39.9)minutes,intraoperative blood loss was(47.3 ±21.8)ml,the time to first flatus was (35. 7 ± 13. 9)hours and the time of postoperative hospital stay was(5. 4 ± 2. 2)days. There were statistically significant reductions(P<0. 005)in visual analog scores(VAS)for all post-operative time points(1month and 6 months postoperatively). All cases were followed up,no hernia recurrence was found. Conclusion Laparoscopic repair and Nissen fundoplication is a technically safe and feasible surgical procedure for the treatment of esophageal hiatal hernia.%目的:探讨腹腔镜食管裂孔疝修补联合胃底折叠手术治疗食管裂孔疝的安全性和实用性。方法回顾性分析2010年8月至2014年8月在徐州医学院附属医院接受腹腔镜食管裂孔疝修补联合Nissen胃底折叠手术56例患者的围手术期及术后随访的临床资料。结果56例手术均顺利完成。平均手术时间(117.4±39.9) min,术中出血量(47.3±21.8) ml,术后胃肠功能恢复时间(35.7±13.9)h,术后住院时间(5.4±2.2)d。围手术期无严重并发症及死亡。胃食管反流综合症状VAS评分术后1个月、6个月与术前比较,差异有统计学意义( P<0.05)。术后随访均未见复发。结论腹腔镜食管裂孔疝修补联合胃底折叠手术是治疗食管裂孔疝的有效方法。

  16. Current developments in hernia repair; meshes, adhesives, and tacking.

    Science.gov (United States)

    Powell, Benjamin S; Voeller, Guy R

    2010-10-01

    Open and laparoscopic hernia surgery continues to evolve with new products allowing surgeons multiple choices in treating their patients. The evolution towards tension-free techniques in dealing with hernias requires that today's surgeons know the options available in meshes as well as fixation methods in order to have the best outcomes. In recent years, there has been a rapid expansion in the number of meshes available. Currently, there are numerous uncoated, coated, and biologic meshes in production that can be used in hernia repair. This paper will focus on the latest developments in coated meshes that allow for intra-abdominal placement as well as the different types of biologic meshes and their typical uses. Tacking devices for laparoscopic hernia repair now come in titanium as well as absorbable devices. AbsorbaTack™ (Covidien, Norwalk, CT) and Sorbafix™ (Davol, Warwick, RI) are two of the newest absorbable tacking devices thought to possibly benefit patients with decreased pain and long-term complications as compared with their titanium counterparts. Adhesives continue to be used more and more for hernia repair, especially in inguinal and paraesophageal hernia repairs. Tissucol™/Tisseel™ (Baxter, Deerfield, IL) and Evicel™ (Ethicon, Somerville, NJ) are two types of fibrin glues that are available for use in hernia repair. Practitioners using these biologic adhesives think there is less pain compared with tacking.

  17. Inguinal hernia repair

    OpenAIRE

    1998-01-01

    A hernia usually presents as a painful lump in the groin, often associated with a large strain but it may also be asymptomatic and coincidentally discovered on routine examination. The incidence of hernia increases with age but a large number affected are working men and they can be severely disabled by the condition. Inguinal hernia is a common condition and 763 hernia operations were carried out in Government hospitals in Malta and Gozo during 1997.

  18. Endoscopic inguinal hernia repair

    OpenAIRE

    2002-01-01

    textabstractInguinal hernias are among the oldest surgical challenges, having been recognized by the Egyptians in 1500 BC and Hippocrates in 400 BC. Celsus in 40 AD described Roman surgical practice, including manual hernia reduction for strangulated hernia, truss for reducible hernia and surgery only for pain. The operation was performed via a scrotal incision and the wound was left open for secondary healing to increase scarring. Scar tissue was considered optimal reinforcement of the weak ...

  19. The feasibility of laparoscopic management of incarcerated obturator hernia.

    Science.gov (United States)

    Liu, Jing; Zhu, Yilin; Shen, Yingmo; Liu, Sujun; Wang, Minggang; Zhao, Xuefei; Nie, Yusheng; Chen, Jie

    2017-02-01

    Obturator hernia (OH), a rare cause of acute small bowel obstruction, requires immediate surgical intervention to prevent serious complications and mortality. We assessed the safety and efficacy of laparoscopic surgery in patients with incarcerated OH presenting with acute abdomen in an emergency setting. Data pertaining to patients diagnosed with incarcerated OH between 2011 and April 2015 at our hospital were reviewed. Patients' characteristics, operation details and postoperative outcomes were retrospectively analyzed. All ten patients diagnosed with incarcerated obturator hernia during the reference period were females (average age 72.1 ± 11.8 years; average weight 44.1 ± 6.9 kg; average body mass index 17.8 ± 2.1 kg/m(2); average operating time 63 ± 15 min; average hospital stay 6.2 ± 6.6 days). Twelve occult hernias, including six contralateral OHs, two ipsilateral femoral hernias and two bilateral femoral hernias were detected in six patients (60 %), which were simultaneously repaired after laparoscopic exploration. Nine patients (90 %) were successfully treated with synthetic mesh by laparoscopic technique. Only one case required intraoperative conversion to open surgery due to strangulated intestine with perforation. Wound infection was reported in one patient who had undergone bowel resection, but with an eventual complete recovery. Postoperative period was uneventful in the other nine patients. No recurrence or complications were reported on follow-up (mean duration of follow-up: 6-54 months). In this study, laparoscopic technique was associated with a reduced duration of hospital stay and fewer complications. In addition to being a safe and minimally invasive strategy, it allowed for simultaneous diagnosis and treatment of occult hernias during the same procedure. The approach may be a better option for the treatment of incarcerated OH and occult hernias in selected patients.

  20. Comparative study of laparoscopic transabdominal preperitoneal hernia repair and open preperitoneal hernia repair for inguinal hernia%腹腔镜经腹腹膜前疝修补术与开腹腹膜前疝修补术治疗腹股沟疝的对比研究

    Institute of Scientific and Technical Information of China (English)

    林洋; 穆林松; 隋武; 于文涛

    2015-01-01

    目的:探讨经腹腹膜前腹腔镜腹股沟疝修补术与开腹腹膜前疝修补术治疗腹股沟疝的优势。方法回顾性分析2012年1月至2013年1月,青岛大学医学院附属烟台毓璜顶医院收治的72例腹股沟疝手术患者的临床资料。其中试验组38例,行腹腔镜腹股沟疝修补术;对照组34例,行开腹腹膜前疝修补术。结果本组手术均顺利完成,二组间术中出血量、术后下床活动时间、术后住院时间差异无统计学意义;手术时间、肛门排气时间差别无统计学意义;二组尿潴留、伤口感染、血肿、血清肿、伤口疼痛、术后复发差别无统计学意义。结论经腹腹膜前腹腔镜腹股沟疝修补术及开腹腹膜前疝修补术都是安全有效的,各有其优点,术者应该根据患者病情合理地选择术式。%Objective To explore the difference between laparoscopic transabdominal preperitoneal hernia repair (TAPP) and open preperitoneal hernia repair for the treatment of inguinal hernia. Methods A total of 72 cases with inguinal hernia underwent hernia repair in Yantai Yu Huang Ding Hospital affiliated to Qingdao University School of Medicine from January 2012 to January 2013 were retrospectively analyzed. 38 cases in test group were applied with TAPP, and 34 cases in control group with open preperitoneal hernia repair. Results All operations were successfully completed. No significant difference was found in blood loss during operation, postoperative activity time, and postoperative hospitalization time. There was no statistically significant difference in operation time and pass flatus time between these two groups. There was no statistically significant difference in urinary retention, wound infection, hematoma, seroma, wound pain and recurrence. Conclusion Both TAPP hernia repair and open preperitoneal hernia repair are safe and effective methods for the treatment of inguinal hernia. Either of way has its advantages

  1. Simultaneous laparoscopic management of Morgagni hernia and cholelithiasis: two case reports.

    Science.gov (United States)

    Shakya, Vikal Chandra

    2015-07-01

    Morgagni hernia is a rare type of diaphragmatic hernia. Though in the past, it has been dealt with an open approach, nowadays laparoscopic management is a favored approach. However, there are few controversies in this scenario. We present here two females of Aryan ethnicity, one 55 and another 45 years old, who presented with pain at upper abdomen and retrosternal chest pain; on investigations were found to have cholelithiasis along with Morgagni hernia which were managed via the laparoscopic approach in the same sitting. Repair of Morgagni hernia also via the minimally invasive technique can be offered to the patients like that for cholelithiasis.

  2. Pediatric inguinal hernia repair-a critical appraisal

    DEFF Research Database (Denmark)

    Rosenberg, J.

    2008-01-01

    Inguinal hernia repair in infants and babies is a routine operation, but many issues have not been addressed scientifically. Thus, it is not known, e.g., if all children with a hernia should be operated on, what is the best timing of surgery, or if the operation should be performed with an open...... approach or laparoscopically. The review is a critical discussion of these and other issues in pediatric herniorrhaphy pointing out the need for further research Udgivelsesdato: 2008/4...

  3. Scar endometriosis developing after an umbilical hernia repair with mesh.

    Science.gov (United States)

    Majeski, James; Craggie, James

    2004-05-01

    A 44-year-old female was initially evaluated for a 3-cm umbilical hernia, which developed after a laparoscopic myomectomy performed seven years prior. The umbilical hernia was repaired using a synthetic mesh. Eight months after the umbilical hernia repair, the patient returned with chronic pain in a 3-cm raised mass originating from the umbilical hernia repair incision. The mass and mesh were surgically removed. The umbilical fascial defect was repaired with a primary fascia-to-fascia closure and the umbilicus was reconstructed from adjacent skin. The mass was found histologically to be endometriosis and fascial scarring with a foreign body reaction to synthetic mesh. Umbilical endometriosis developed either from peritoneal endometrial seeding from a laparoscopic myomectomy or from metaplasia of multipotential cells, which developed into endometriosis due to inflammatory stimulation by the synthetic mesh. Synthetic mesh probably should be avoided in the surgical repair of a laparoscopically caused umbilical hernia in a premenopausal female especially if there is a history of pelvic endometriosis.

  4. Preperitoneal Surgery Using a Self-Adhesive Mesh for Inguinal Hernia Repair

    OpenAIRE

    2014-01-01

    Background and Objectives: Laparoscopic preperitoneal hernia repair with mesh has been reported to result in improved patient outcomes. However, there are few published data on the use of a totally extraperitoneal (TEP) approach. The purpose of this study was to present our experience and evaluate early outcomes of TEP inguinal hernia repair with self-adhesive mesh. Methods: This cohort study was a retrospective review of patients who underwent laparoscopic TEP inguinal hernial repair from Ap...

  5. Nationwide study of early outcomes after incisional hernia repair

    DEFF Research Database (Denmark)

    Bisgaard, T; Kehlet, H; Bay-Nielsen, M B;

    2009-01-01

    BACKGROUND: There are no nationwide studies on early outcomes after incisional hernia repair. METHODS: This study included all patients aged 18 years or more who had surgery for incisional hernia in Denmark between 1 January 2005 and 31 December 2006, and analysed clinical outcomes within 30 days...... of surgery. Patients having acute operations and those whose hernia repair was secondary to other procedures were excluded. RESULTS: Of a total of 2896 incisional hernia repairs (1872 open, 1024 laparoscopic), 2754 (95.1 per cent) were for primary hernia and 142 (4.9 per cent) for recurrence. The median...... hospital stay was 1 (range 0-88) day (open, 1 day; laparoscopic, 2 days); 10.0 per cent stayed for more than 6 days. Some 11.2 per cent of patients were readmitted (open, 10.1 per cent; laparoscopic, 13.1 per cent). Major complications were observed in 3.5 per cent (open, 2.8 per cent; laparoscopic, 4...

  6. 腹腔镜下生物补片修补成人脐疝%Laparoscopic degradable patch repair of umbilical hernia in adults

    Institute of Scientific and Technical Information of China (English)

    刘飞德; 李基业; 姚胜

    2009-01-01

    Objective To evaluate the methods and outcome of laparoscopic degradable bio-patch repair of umbilical hernia in adults. Methods From January 2003 to October 2008, 21 adult patients underwent elective laparoscopic patch repair of umbilical hernia. There were 15 women and 6 men. The mean age was 56 years old (range of 36-73). The diameter of hernia ring was from 3 to 7.5 cm averaging at 5.2 cm. All patients received general anesthesia. Preoperative bowel preparation routinely started one day before the operation. The patients received prophylaxis systemic antibiotics 30 minutes before the operation. An appropriate size of prosthetic patch (Composix E/X, Bard, USA) was that extended the defect margin for about 3-5 cm. The mesh was then inserted into the peritoneal cavity and spreaded flattening, with the polyplypylene side facing outside and it's center coinciding with that of the defect. The mesh was fixed to the abdominal wall with staple tacks in two rings, which was 3-5 cm along the hernia ring and 1-2 cm along the edge of the mesh. Results There was no conversion to open repair. The operative time was 30 to 96 rain and the average was 52 min. Two patients suffered from a transient postoperative tympanites and which subsided 2 to 3 days after the operation. One patient had a severe pain in the repair area around the umbilical and underwent oral medicine treatment, which disappeared one week after operation. There was no seroma and incision or mesh infection occurred. The postoperative hospital stay was 3 to 8 days and the average was 4. 2 days. The follow-up time was 3 months to 5 years and the average was 32 months. No ileus or hernia recurrence during the follow-up. Conclusion Laparoscopic patch repair of umbilical hernia in adults is a safe and effective procedure.%目的 探讨腹腔镜下生物补片修补成人脐疝的方法及效果.方法 2003年1月至2008年10月在腹腔镜下用生物补片修补脐疝21例,其中男6例,女15例,年龄36~73

  7. 基层医院开展腹腔镜治疗食管裂孔疝效果的临床体会%Clinical experience of laparoscopic hiatal hernia repair in primary hospital

    Institute of Scientific and Technical Information of China (English)

    李勇; 艾海提·牙生; 陈雷

    2015-01-01

    目的:评价基层医院应用腹腔镜开展食管裂孔疝修补手术的临床效果及可行性。方法回顾性分析2009年3月至2012年12月焉耆县人民医院行腹腔镜食管裂孔疝修补术6例及传统开腹行食管裂孔疝修补术5例患者的临床资料。结果6例患者均采用腹腔镜应用补片食管裂孔疝修补后同时行胃底折叠术,其中3例行Nissen胃底折叠术,3例行Toupet胃底折叠术,术后反流性食管炎症状包括胸骨后灼烧样疼痛、反酸、嗳气完全缓解。无手术并发症,无中转开腹及死亡病例。术后随访24~60个月,腹腔镜组无症状复发。复查胃镜,食管炎症及溃疡完全治愈。结论有硬件条件及手术经验的县级医院可开展食管裂孔疝腹腔镜手术治疗,并能取得良好的临床效果。%Objective Evaluate the clinical effects and feasibility of laparoscopic hiatal hernia repair in primary hospital. Methods From March 2009 to December 2012, 6 cases of laparoscopic hiatal hernia repair and 5 cases of open hiatal hernia repair were conducted in Yanqi county hospital. Clinical information were retrospectively analyzed. Results 6 patients were received laparoscopic hiatal hernia repair with mesh and combined with fundoplication, 3 for Nissen and 3 for Toupet. All of them achieved completely symptomatic relief without retrosternal burning-sensitive pain, acid regurgitation and belching. No complications, no conversion to open surgery and no death cases. With the follow-up of 24 months, no recurrence in laparoscopic group and no inflammationand anabrosis of esophagusby gastroscopic. Conclusion Primary hospital with hard condition and surgical experience can develop laparoscopic hiatal hernia repair, the long-term clinical and social effects are remarkable.

  8. 腹腔镜下治疗食管裂孔疝55例报告%Clinical Experience of Laparoscopic Repair of Esophageal Hiatal Hernia

    Institute of Scientific and Technical Information of China (English)

    梁明强; 朱勇; 郑炜; 郭朝晖; 康明强; 陈椿

    2014-01-01

    Objective To explore the feasibility and effectiveness of laparoscopic repair of esophageal hiatal hernia . Methods We retrospectively analyzed clinical data of 55 patients with esophageal hiatal hernia who underwent laparoscopic surgery in our hospital between March 2008 and March 2013.After laparoscopic repair of esophageal hiatal hernia , different types of fundoplication were carried out including Nisse fundoplication in 17 cases, Toupet fundoplication in 19 cases, Dor fundoplication in 19 cases. Results All the operations were successfully completed under laparoscope .Different fundoplication included 17 cases of Nissen fundoplication, 19 cases of Toupet fundoplication, and 19 cases of Dor fundoplication.The operative time was (69.6 ±13.0) min for Nissen operation, (68.0 ±8.2) min for Toupet operation, and (63.8 ±10.1) min for Dor, respectively.The intraoperative blood loss was (20.0 ±5.8) ml for Nissen operation, (20.6 ±9.5) ml for Toupet, and (21.7 ±5.0) ml for Dor, respectively.No blood transfusion was needed .The postoperative extubation time was (3.1 ±1.1) d for Nissen operation, (2.7 ±0.7) d for Toupet, and (2.3 ±1.1) d for Dor, respectively.The postoperative hospital stay was (9.1 ±4.9) d for Nissen operation, (8.4 ±2.6) d for Toupet, and (7.6 ±1.5) d for Dor, respectively.Clinical symptoms had been alleviated effectively after operation , without deaths. However, 3 patients (5.5%) had developed postoperative complications , including 2 cases of delayed gastric emptying and 1 case of dysphagia, which were relieved after treatment.The median follow-up time was 45 months (range, 6-60 months).Oral barium meal and endoscopic examinations showed no recurrence of hiatal hernia , esophageal stenosis , or esophageal diverticula . Conclusion Laparoscopic repair of esophageal hiatal hernia is safe and effective , and different fundoplications can be chosen according to conditions of patients .%目的:探讨腹腔镜下治疗食管裂孔疝的

  9. Ipsilateral occult hernias during endoscopic groin hernia repair

    Directory of Open Access Journals (Sweden)

    Jain Mayank

    2008-01-01

    Full Text Available Endoscopic repair of groin hernias allows the surgeon to have a complete view of the groin and pelvis to diagnose occult hernias both ipsilaterally and contralaterally. These occult hernias can then be treated simultaneously and may reduce the incidence of recurrence and persistent symptoms. The authors present four unusual cases where occult hernias were found ipsilaterally during an endoscopic repair. All these occult hernias were treated along with the clinically diagnosed hernia at the same surgery with excellent results and no post-operative morbidity.

  10. Laparoscopic transabdominal preperitoneal hernia repair:A report of 45 cases%经腹腹膜前疝修补术45例临床观察

    Institute of Scientific and Technical Information of China (English)

    丁世美; 肖东霖; 朱瑞凌; 孙文有; 彭学艳; 李会祥

    2015-01-01

    Objective To evaluate the feasibility and safety of laparoscopic transabdominal preperitoneal hernia repair (TAPP).Methods A total of 45 patients with inguinal hernia in People′s Hospital of Qujing Qilin District who underwent TAPP under general anesthesia,from June 201 3 to April 201 4,were enrolled in this retrospective study.The operation time,complication,length of stay and recurrence rate were recorded.Results All of the operations were successful.The mean operation time was (83 ±1 8 ) minutes,the mean postoperative hospital stay was (2.0 ±1 .0 ) days,and the inguinal hematoma /seroma occurred in 9 cases.After a follow-up of 5 to 1 0 months,a case of short-term recurrence was found at 1 month after the operation.While no long-term recurrence and no chronic pain in inguinal area were observed.Conclusion TAPP is a safe,feasible and effective tension-free repair for inguinal hernia.%目的:探讨经腹腹膜前疝修补术(TAPP)的可行性和安全性。方法回顾性分析2013年6月至2014年4月,曲靖市麒麟区人民医院收治腹股沟疝患者45例的临床资料,均在全身麻醉下行 TAPP 手术,观察手术时间、术后住院时间、术后并发症及复发情况。结果45例患者手术均获成功,平均手术时间(83±18)min,术后平均住院时间(2.0±1.0)d,术后腹股沟区血肿或积液9例,术后随访5~10个月,术后1个月内复发1例,无远期复发,未见腹股沟区慢性疼痛等并发症。结论TAPP 治疗腹股沟疝是一种安全有效的无张力疝修补技术。

  11. Inguinal hernia repair: anaesthesia, pain and convalescence.

    Science.gov (United States)

    Callesen, Torben

    2003-08-01

    Elective surgical repair of an inguinal or femoral hernia is one of the most common surgical procedures. The treatment, however, presents several challenges regarding anaesthesia for the procedure, the postoperative analgesic therapy and convalescence, as well as planning of the procedure. Local, general, and regional anaesthesia are all used for hernia repair, but to different degrees, primarily depending on traditions and whether the institution has specific interest in hernia surgery. Thus, the use of local anaesthesia varies from a few percent in Sweden, 18% in Denmark and up to almost 100% in specialised institutions, dedicated to hernia surgery. The feasibility of local anaesthesia is high, as judged by the rate of conversion to general anaesthesia (thirds have moderate or severe pain during activity, while one third still have moderate or severe pain after one week, and approximately 10% after 4 weeks. Pain after laparoscopic surgery is less pronounced than after open surgery, while different open repair techniques do not exhibit significant differences. Postoperative pain is best treated with a combination of local analgesia and peripherally acting agents (paracetamol, NSAID or their combination), while opioids should be avoided due to side effects, primarily nausea and sedation. Moderate or severe pain one year postoperatively is seen in 5-12% of patients. There seem to be no difference between different surgical or anaesthetic techniques, but the following factors have been related to a higher rate of chronic pain: previous or subsequent hernia surgery on the same side, young age, pain before surgery, high pain scores in the immediate postoperative period, and postoperative complications and prolonged convalescence. Patients should be informed about the risk of chronic pain, particularly if the hernia is asymptomatic. The duration of convalescence after hernia repair varies considerably, primarily due to variation in recommendations. No documentation is

  12. 腹腔镜下腹股沟疝修补术治疗成人腹股沟疝的疗效及并发症%Clinical effect and complication of laparoscopic inguinal hernia repair in the treatment of adult inguinal hernia

    Institute of Scientific and Technical Information of China (English)

    卢冠坤; 余智涛; 高鹏

    2016-01-01

    Objective To probe into the clinical effects and complication of laparoscopic inguinal hernia repair in the treatment of adult inguinal hernia. Methods 128 cases of adult inguinal hernia patients who accepted treatments in our hospital during January 2014 and January 2015 were selected, and they were divided into the observation group and the control group by the digital table random grouping methods, with 64 cases in each group. In the control group patients were treated with traditional open tension-free hernia repair treatment, while in the observation group patients were given laparoscopic inguinal hernia repair for treatment. Then, the clinical efficacy and complications of the two groups of patients were compared. Results The operation time in the control group was significantly longer than that in the observation group, the amount of bleeding was significantly more than that in observation group, the operation cost was significantly lower than the observation group,P0.05;且切口疼痛、血肿发生率显著低于对照组,P<0.05。结论腹腔镜下腹股沟疝修补术较传统开放式无张力疝具有切口小、出血量小、恢复快、复发率低、安全性高的特点,值得临床推广。

  13. A prospective randomized comparison of testicular functions, sexual functions and quality of life following laparoscopic totally extra-peritoneal (TEP) and trans-abdominal pre-peritoneal (TAPP) inguinal hernia repairs.

    Science.gov (United States)

    Bansal, Virinder Kumar; Krishna, Asuri; Manek, Pratik; Kumar, Subodh; Prajapati, Omprakash; Subramaniam, Rajeshwari; Kumar, Anand; Kumar, Atin; Sagar, Rajesh; Misra, M C

    2017-03-01

    There is very scant literature on the impact of inguinal hernia mesh repair on testicular functions and sexual functions following open and laparoscopic repair. The present randomized study compares TAPP and TEP repairs in terms of testicular functions, sexual functions, quality of life and chronic groin pain. This study was conducted from April 2012 to October 2014. A total of 160 patients with uncomplicated groin hernia were randomized to either trans-abdominal pre-peritoneal (TAPP) repair or totally extra-peritoneal (TEP) repair. Testicular functions were assessed by measuring testicular volume, testicular hormone levels preoperatively and at 3 months postoperatively. Sexual functions were assessed using BMSFI, and quality of life was assessed using WHO-QOL BREF scale preoperatively and at 3 and 6 months postoperatively. Chronic groin pain was evaluated using the VAS scale at 3 months, 6 months and at 1 year. The median duration of follow-up was 13 months (range 6-18 months). The mean preoperative pain scores (p value 0.35) as well as the chronic groin pain were similar between TEP and TAPP repairs at 3 months (p value 0.06) and 6 months (p value 0.86). The testicular resistive index and testicular volume did not show any significant change at follow-up of 3 months (p value 0.9) in the study population. No significant difference was observed in testicular resistive index and testicular volume when comparing TEP and TAPP groups at at follow-up of 3 months (p value >0.05). There was a statistically significant improvement in the sexual drive score, erectile function and overall satisfaction over the follow-up period following laparoscopic inguinal hernia repair. However, sexual function improvement was similar in patients undergoing both TEP and TAPP repairs. All the domains of quality of life in the study population showed a significant improvement at a follow-up of 3 and 6 months. Subgroup analysis of all the domains of quality of life in both TAPP

  14. 腹腔镜下两种腹股沟疝修补术治疗腹股沟疝临床疗效分析%Clinical curative effect analysis of Two laparoscopic inguinal hernia repair treatment of inguinal hernia

    Institute of Scientific and Technical Information of China (English)

    屈陈江; 周亮; 季良

    2013-01-01

    Objective To investigate the efficacy and safety of Two laparoscopic inguinal hernia repair treatment of inguinal hernia. Methods 38 patients treated in our hospital from March 2010 to August 2012 were analysed retrospectively, and with the same period by laparoscopic peritoneal and former suture ( TAPP) comparative analysis. Results Two groups of patients in hospital costs, length of hospital stay, postoperative of bed time and the incidence of complications were no significant differences between the two groups was statistically significant ( P > 0. 05) ; But the operation time TAPP group is greater than the TEP group, two groups of comparisons difference has statistical significance ( P <0. 05) ; TAPP group of postoperative recurrence in 2 cases, no recurrence TEP group. Conclusion TAPP and TEP are adult inguinal hernia treatment effective method, but TEP short operative time, higher safety, it is worth clinical application.%目的 探讨腹腔镜下两种腹股沟疝修补术治疗腹股沟疝的有效性及安全性.方法 回顾性分析2010年3月至2012年8月施行腹腔镜下完全腹膜外腹股沟疝修补术(TEP)的38例成人腹股沟疝患者的临床资料,并与同期施行经腹腔镜腹膜前修补术(TA PP)进行比较分析.结果 两组患者住院时间、住院费用、术后下床时间及并发症的发病率均无显著差异(P>0.05);但是手术时间TAPP组长于TEP组,两组比较差异具有统计学意义(P<0.05);TAPP组术后复发2例,TEP组无复发.结论 TAPP和TEP均是治疗成人腹股沟疝的有效方法,但TEP手术时间短,安全性更高,值得临床推广应用.

  15. 微型腹腔镜下套线法治疗儿童腹股沟斜疝%Mini-laparoscopic indirect inguinal hernia repair by overlapping line in children

    Institute of Scientific and Technical Information of China (English)

    林洋; 穆林松; 隋武; 于文涛

    2014-01-01

    Objective To summarize the experiences of mini-laparoscopic indirect inguinal hernia repair by overlapping line in children.Methods A total of 1 760 cases with indirect inguinal hernia who underwent mini-laparoscopic hernia repair by overlapping line in Yantai Yu Huang Ding Hospital Affiliated to Qingdao University School of Medicine from August 2001 to March 201 3 were retrospectively analyzed. Results All operations were successfully completed.It took 5 to 8 minutes for operations in unilateral hernia cases,and 8 to 1 5 minutes in bilateral hernia cases.Patients were discharged in 1 to 2 days after operation. At postoperative follow-up ranging from 6 to 1 2 months,there were 8 cases of greater omentum herniation from umbilical incision,5 cases of incision knot reaction,9 cases of recurrence,and 1 case of communicating hydrocele testis.Conclusions Mini-laparoscopic indirect inguinal hernia repair by overlapping line is a safe and reliable treatment in children.It has the advantages of less trauma,lower rate of complications, shorter hospital stay,and it will contributed to find and deal with occult hernia at the same time,which is worthy to be popularized in clinic.%目的:总结微型腹腔镜下套线法治疗儿童腹股沟斜疝的经验。方法回顾性分析2001年8月至2013年3月,青岛大学医学院附属烟台毓璜顶医院应用微型腹腔镜下套线法治疗儿童腹股沟斜疝1760例的临床资料。结果本组手术均顺利完成,手术时间单侧5~8 min,双侧8~15 min,术后1~2 d出院。术后随访6~12个月,脐部切口大网膜突出8例,切口线结反应5例,复发9例,交通性鞘膜积液1例。结论微型腹腔镜下套线法治疗儿童腹股沟斜疝创伤小,疗效可靠,并发症少,住院时间短,可同时发现及处理对侧隐匿疝,值得临床推广。

  16. [Trocar site incisional hernia in laparoscopic surgery].

    Science.gov (United States)

    Comajuncosas, Jordi; Vallverdú, Helena; Orbeal, Rolando; Parés, David

    2011-02-01

    Trocar site incisional hernias (TSIH) are the most common complications in laparoscopic surgery. We have carried out a review of the literature with the aim of establishing their incidence, the reasons for them happening, and their prevention. After a search in the MEDLINE PubMed and PubMed CENTRAL data bases from 1991 to 2009, combining the words: "hernia", "laparoscopy" and "trocar", we obtained 545 articles, of which we analysed 60 of them. The incidence of TSIH varies between 0.18% and 2.8%. The diameter of the trocar, obesity and age play a fundamental role when proceeding to close the fascia, a closure which is the most important factor to prevent these incisional hernias appearing. The appearance of new laparoscopic material and the increasing more common closure of defects of the fascia means that new and more extensive prospective studies should be performed.

  17. Umbilical and epigastric hernia repair.

    Science.gov (United States)

    Muschaweck, Ulrike

    2003-10-01

    The repair of umbilical and epigastric hernias still represents a challenge to surgeons. Although a common and relatively simple procedure, there is no exact protocol today on how the repair should be done. The Mayo technique and its alterations could not stand the test of time: a recurrence rate of 20% and higher is not acceptable for any surgical procedure. Although there is no consensus opinion, one thing is clear: the importance of an anatomic repair without tension and without an artificial enlargement of the defect. In 1987 Lichtenstein reported on 6321 cases of herniorraphy with a tension free repair, and in 1994 Stuart reemphasized that special importance in his editorial in the Lancet. A newer study from Brancato and coworkers in Italy also states the advantage of a tension-free prosthetic repair in 16 patients with epigastric hernia. We have gone even further and recommend a tailored-to-the-patient repair using a customized polypropylene mesh and a one-layer running suture. The advantages should be obvious: no artificial creation of an even bigger than original defect, a completely tension-free repair, and little to no recurrence of the hernia. Our results clearly prove that assumption. Moreover, the procedure is extremely safe and complications are very rare and minor. We conclude that using a mesh plug in a customized tension-free repair of umbilical and epigastric hernia shows many advantages over the commonly used methods. And we finally conclude with the words of Albert Einstein: "The only source of knowledge is experience."

  18. [The trocar hernia after laparoscopic operative interventions. classification, treatment, prophylaxis].

    Science.gov (United States)

    Nychytaĭlo, M Iu; Bulyk, I I; Zahriĭchuk, M S; Korytko, I P; Homan, A V

    2014-11-01

    Own experience of treatment of patients, suffering trocar hernias, occurred after laparoscopic operative interventions, was analyzed. Classification of trocar hernias was proposed, the main factors of risk and prognostic criteria of a trocar hernias formation were analyzed. The main methods of the trocar hernias correction are adduced.

  19. Open reconstruction of sizeable ventral hernias in the laparoscopic era.

    Science.gov (United States)

    Pavlakis, Emmanouil; Avgerinos, Efthimios; Filippou, Dimitrios; Pikoulis, Emmanouil; Tsatsoulis, Panagiotis; Skandalakis, Panagiotis

    2006-02-01

    The purpose of this study was to review our 15 years of experience in the repair of sizeable ventral hernias with a standardized open surgery technique, to evaluate the clinical outcome, and to assess the decreasing role of traditional surgical techniques in the laparoscopic era. A retrospective study has been conducted, including 200 patients operated for ventral hernia defects with a standardized underlay mesh implantation technique between 1990 and 2004. Their mean age was 62.6 (range 21-88) years and their mean BMI (body mass index) was 33.4 (range 22-69). Out of them, 56 per cent presented one to four major risk factors and 31.5 per cent had previously undergone ventral hernia repair surgery. The mean size of hernial defect was 135.2 (range 24-684) cm2. The mean follow-up was 43 (range 3-174) months. The overall major complication rate was 3.8 per cent and overall recurrence rate was 9.6 per cent. Our retrospective study confirms the safety and efficacy of open reconstruction in complex hernias. Prospective randomized homogenous trials with long-term follow-up are needed to provide us a better evidence-based approach. Minimal invasive surgery is favored but open reconstruction should still be considered as an alternative for sizeable ventral hernias management. A careful selection among patients for selecting the optimal technique is necessary.

  20. Groin hernia repair in young males: mesh or sutured repair?

    DEFF Research Database (Denmark)

    Bisgaard, T; Bay-Nielsen, M; Kehlet, H

    2010-01-01

    Large-scale data for the optimal inguinal hernia repair in younger men with an indirect hernia is not available. We analysed nationwide data for risk of reoperation in younger men after a primary repair using a Lichtenstein operation or a conventional non-mesh hernia repair....

  1. Laparoscopic hernioplasty by Eyeglass-Shaped Mesh in 54 patients with bilateral inguinal hernia

    Directory of Open Access Journals (Sweden)

    Talebpour M

    2007-09-01

    Full Text Available   Background: Laparoscopic hernioplasty is a standard technique with increasing interest of patients and surgeons. Bilateral hernioplasty can be performed by laparoscopy as well. The aim of this study is to show laparoscopic bilateral hernioplasty is an acceptable method and use of eye-shaped mesh getting the best result.Methods: In 54 cases with bilateral inguinal hernia, under general anesthesia laparos-copic reconstruction with eye-shaped prolene mesh performed. All cases of recurrent, big, direct, indirect and femoral hernia were entered in the study.Results: Seven of 54 cases were female. Four cases (male had direct hernia, four female had femoral hernia and remaining of the study group had indirect form. Direct hernia 4 case (male, femoral hernia 4 (female and remaining were indirect hernia. Operation performed without any complications in all cases. In 12 cases sac of hernia was too much enlarged so technique of bridge at the base of sac used. In five cases diameter of defect was more than 2 centimeter. In three of them defect repaired by suture before mesh insertion. Postoperative complications were seroma at distal of mesh in 23 cases (absorbed during 3 weeks spontaneously, reaction to mesh in one case (mesh and protack removed after 3 months of operation. Conservative management was ineffective and anterior repair performed, recurrence in one case (after 2 months of operation due to displacement of mesh in big direct hernia. Post operative hospital stay was 1.3 day (mean time. Painless movement and mobilization was obvious after 48 hours.Conclusion: Laparoscopic bilateral hernioplasty using eye-shaped prolene mesh is an acceptable method with good results especially in indirect hernia. In direct hernia, repair of defect by suturing and fixation of mesh is preferred.

  2. INTRAOPERATIVE PNEUMOTHORAX COMPLICATING TOTALLY EXTRAPERITONEAL INGUINAL HERNIA REPAIR

    Directory of Open Access Journals (Sweden)

    Charulatha

    2015-07-01

    Full Text Available Laparoscopic inguinal hernia repair compared with open procedure is associated with reduced recurrence rate and earlier return to work. [1,2] Though insufflation of carbon dioxide is limited to preperitoneal space, higher insufflation pressures and longer operative times have been associated with pneumothorax and pneumomediastinum even during totally extra peritoneal patchplasty (TEP . [3] We present a patient who developed pneumothorax due to inadvertent peritoneal tear during hernial sac dissection that resolved with conservative management in the postoperative period. This case report highlights the importance of peritoneal tear closure before proceeding with the rest of the procedure during extra peritoneal inguinal hernia repair.

  3. Long-term outcomes of 1326 laparoscopic incisional and ventral hernia repair with the routine suturing concept: a single institution experience.

    Science.gov (United States)

    Chelala, E; Baraké, H; Estievenart, J; Dessily, M; Charara, F; Allé, J L

    2016-02-01

    This retrospective chart analysis reports and assesses the long-term (beyond 10 years) safety and efficiency of a single institution's experience in 1326 laparoscopic incisional and ventral hernia repairs (LIVHR), defending the principle of the suturing defect (augmentation repair concept) prior to laparoscopic reinforcement with a composite mesh (IPOM Plus). This study aims to prove the feasibility and validity of IPOM Plus repair, among other concepts, as a well-justified treatment of incisional or ventral hernias, rendering a good long-term outcome result. A single institution's systematic retrospective review of 1326 LIVHR was conducted between the years 2000 and 2014. A standardized technique of routine closure of the defect prior to the intraperitoneal onlay mesh (IPOM) reinforcement was performed in all patients. The standardized technique of "defect closure" by laparoscopy approximating the linea alba under physiological tension was assigned by either the transparietal U reverse interrupted stitches or the extracorporeal closure in larger defects. All patients benefited from the implant Parietex composite mesh through an Intraperitoneal Onlay Mesh placement with transfacial suturing. LIVHR was performed on 1326 patients, 52.57% female and 47.43% male. The majority of our patients were young (mean age 52.19 years) and obese (average BMI 32.57 kg/m2). The mean operating time was 70 min and hospital stay 2 days, with a mean follow-up of 78 months. On the overall early complications of 5.78%, we achieved over time the elimination of the dead space by routine closure of the defect, thus reducing seroma formation to 2.56%, with a low risk of infection technical improvement in the suturing concept and our growing experience, we managed to reduce the incidence of transient pain to a low acceptable rate of 3.24% (VAS 5-7) that decreased to 2.56% on a chronic pain stage, which is comparable to the literature. On the overall rate of late complications of 10.74%, we

  4. Laparoscopic Transabdominal Preperitoneal Approach for Bilateral Inguinal Hernia Repair in 17 Cases%腹腔镜下腹膜前修补术治疗双侧腹股沟疝17例

    Institute of Scientific and Technical Information of China (English)

    李奎; 孙亮; 舒若; 郭姝婧; 罗华友

    2015-01-01

    目的:探讨双侧腹股沟疝腹腔镜下腹膜前修补术的效果。方法2011年7月~2012年6月我院行腹腔镜经腹腹膜前双侧腹股沟疝修补术17例,全麻后建立气腹,回纳疝内容物,切开腹膜并分离腹膜前间隙,游离疝囊和腹膜返折,分离耻骨后间隙( Retzius间隙)和腹股沟后间隙( Bogrus间隙),将补片完整覆盖双侧的耻骨肌孔,补片的内缘在耻骨联合处重叠,并使用钉枪固定确切,随后关闭腹膜裂口,关闭气腹完成手术。结果17例均成功完成腹腔镜双侧腹股沟疝修补。手术时间73~115 min,平均95 min。术中出血量9~53 ml,平均24 ml。术后疝囊内血清肿1例,皮下穿刺抽吸后包块消失;术后下腹壁疼痛1例,未特殊处理,术后1个月疼痛消失。无补片排异反应,无肠梗阻,肠粘连等发生。16例随访19~26个月,平均22个月,无复发。结论腹腔镜下经腹腹膜前双侧腹股沟疝修补术安全有效,在修复复发疝和巨大疝有独到优势,值得临床推广。%Objective To discuss the efficacy of laparoscopic transabdominal preperitoneal ( TAPP) approach for bilateral inguinal hernia repair . Methods A retrospective analysis was made on clinical data of 17 cases of laparoscopic transabdominal preperitoneal bilateral inguinal hernia repair from July 2011 to June 2012.The pneumoperitoneum was established after general anesthesia .The hernia contents were returned .The peritoneum was opened and the preperitoneal space was separated .Then the hernia sac and peritoneal reflextion were dissociated , and the retropubic space ( Retzius space ) and retroinguinal space ( Bogrus space ) were separated .Patches were used to cover the bilateral myopectineal orifice completely , overlapping the inner edge of the patch in the pubic symphysis , and fixed by using a nail gun .The peritoneum gap was closed and the pneumoperitoneum was removed to finish the operation

  5. Nationwide prevalence of groin hernia repair.

    Directory of Open Access Journals (Sweden)

    Jakob Burcharth

    Full Text Available INTRODUCTION: Groin hernia repair is a commonly performed surgical procedure in the western world but large-scaled epidemiologic data are sparse. Large-scale data on the occurrence of groin hernia repair may provide further understanding to the pathophysiology of groin hernia development. This study was undertaken to investigate the age and gender dependent prevalence of groin hernia repair. METHODS: In a nationwide register-based study, using data from the Civil Registration System covering all Danish citizens, we established a population-based cohort of all people living in Denmark on December 31(st, 2010. Within this population all groin hernia repairs during the past 5 years were identified using data from the ICD 10(th edition in the Danish National Hospital Register. RESULTS: The study population covered n = 5,639,885 persons. During the five years study period 46,717 groin hernia repairs were performed (88.6% males, 11.4% females. Inguinal hernias comprised 97% of groin hernia repairs (90.2% males, 9.8% females and femoral hernias 3% of groin hernia repairs (29.8% males, 70.2% females. Patients between 0-5 years and 75-80 years constituted the two dominant groups for inguinal hernia repair. In contrast, the age-specific prevalence of femoral hernia repair increased steadily throughout life peaking at age 80-90 years in both men and women. CONCLUSION: The age distribution of inguinal hernia repair is bimodal peaking at early childhood and old age, whereas the prevalence of femoral hernia repair increased steadily throughout life. This information can be used to formulate new hypotheses regarding disease etiology with regard to age and gender specifications.

  6. 经济型完全腹膜外腹腔镜腹股沟疝修补术%Economical Laparoscopic Total Extraperitoneal Inguinal Hernia Repair.

    Institute of Scientific and Technical Information of China (English)

    魏亚元; 吴相柏; 马波

    2012-01-01

      目的探讨较经济的完全腹膜外腹腔镜腹股沟疝修补术(TEP)的可行性,总结经济型TEP的操作经验,为TEP的推广提供借鉴。方法回顾性分析我院2006年6月~2007年12月对23例腹股沟疝进行TEP的临床资料;采用连续硬膜外麻醉,免气囊扩张器建立腹膜外间隙,使用国产聚丙烯补片且不予钉合固定等系列降低手术成本的手术方法。结果腹膜撕裂3例,中转开放手术2例,中转全麻1例,均发生于斜疝;手术时间40~180分钟,平均住院5天,住院费用降低4500~5000元;术后无疼痛、血清肿、感染、疝复发等并发症发生。结论采用连续硬膜外麻醉,免气囊分离器,国产聚丙烯补片不予钉合固定的TEP是可行的,为其在基层医院的开展提供了借鉴作用。%  0bjective To explore the feasibility of economical laparoscopic total extraperitoneal repair (TEP) for inguinal hernia, to summarize and provide the experience of economical TEP . Methods The clinical data of 23 cases of inguinal hernia treated by laparoscopic TEP was retrospectively analyzed from June 2006 to December 2007 in this hospital. In order to reduce operation cost, various methods were adopted such as deploying epidural anesthesia, using the domestic polypropylene mesh, non-stapling the mesh and providing spatium extraperitoneale without using the baloon dissector. Results 3 cases abdominal membrane of indirect hernia were lacerated, among which 2 cases was conversed to open surgery and 1 case to general anesthesia. The operation time was 40~180 min, the average postoperative hospital stay was 5 days and reduce the hospitalization cost about RMB ¥4,500~5,000. There were no complications such as pain, seroma, wound infection and recurrence. Conclusion TEP with epidural anesthesia, exempting the baloon dissector and non-stapling of the domestic polypropylene mesh is feasible. It is possible to be applied in hospitals at local

  7. 经济型完全腹膜外腹腔镜腹股沟疝修补术%Economical laparoscopic total extraperitoneal inguinal hernia repair

    Institute of Scientific and Technical Information of China (English)

    吴相柏; 杜小宜; 魏亚元; 吴利达; 宋文军; 陶凯雄

    2008-01-01

    Objective To explore the feasibility of economical laparoscopic total extraperitoneal repair (TEP) for inguinal hernia, to summarize and provide the experience of economical TEP.Methods The clinical data of 23 cases of inguinal hernia treated by laparoscopic TEP was retrospectively analyzed from June 2006 to December 2007 in our hospital. In order to reduce operation cost, various methods were adopted such as deploying epidural anesthesia, using the domestic polypropylene mesh, non-stapling the mesh and providing spatium extraperitoneale without using the balloon dissector. Results 3 cases abdominal membrane of indirect hernia were lacerated, among which 2 cases was conversed to open surgery and 1 case to general anesthesia. The operation time was 40~180 min, the average postoperative hospital stay was 5 days and the hospitalization cost was RMB $4,500~5,000. There were no complications such as pain, seroma, wound infection and recurrence. Conclusions TEP with epidural anesthesia, exempting the balloon dissector and non-stapling of the domestic polypropylene mesh is feasible. It is possible to be applied in hospitals at local level.%目的 探讨较经济的完全腹膜外腹腔镜腹股沟疝修补术(TEP)的可行性,总结经济型TEP的操作经验,为TEP的推广提供借鉴.方法 回顾性分析我院2006年6月至2007年12月对23例腹股沟疝进行TEP的临床资料;采用连续硬膜外麻醉,免气囊扩张器建立腹膜外间隙,使用国产聚丙烯补片且不予钉合固定等系列降低手术成本的手术方法.结果 23例腹股沟疝患者腹膜撕裂3例,中转开放手术2例,中转全麻1例(均发生于斜疝);手术时间40~180 min,平均住院5 d,住院费用4500.00~5000.00元;术后无疼痛、血清肿、感染、疝复发等并发症发生.结论 采用连续硬膜外麻醉,免气囊分离器,国产聚丙烯补片不予钉合固定的TEP是可行的,为其在基层医院的开展提供了借鉴作用.

  8. Clinical application of tension-free repair in laparoscopic hiatal hernia repair%无张力疝修补技术在腹腔镜食管裂孔疝修补中的应用

    Institute of Scientific and Technical Information of China (English)

    臧宇; 李晨; 田文

    2015-01-01

    Objective To detect clinical outcome of laparoscopic hiatal hernia tension-free repair. Methods Clinical data and follow-up results of 74 patients who underwent laparoscopic hiatal hernia repair in our hospital from July 2010 to October 2014 were analyzed retrospectively. Results All operations were accomplished successfully with an average operation time of 85-185 (107.3±5.6) min, an average operative blood loss of 30-120 (67.2±7.5) ml and an average hospital stay of 3-9 d. Hiatus hernia special patches were placed to repair and reinforce the esophageal hiatus with none complications caused by patch occurred during postoperative follow-up in all operations. Follow up time of 74 patients were 3-53 (31.0±2.1) months. The main symptoms of 66 cases (89%) were alleviated postoperatively, 8 patients still had preoperative main symptoms, heartburn and acid reflux were found in 2 cases, chest pain in 4 cases, nausea and vomiting in 1 case and dysphagia in 2 cases. None HH recurrence occurred as a result of 3 months postoperative digestive barium meal examination. Conclusion Laparoscopic hiatal hernia tension-free repair has the advantages of safety, minimally invasion, effectiveness and feasibility, which is worthy of further development and promotion.%目的:探究腹腔镜食管裂孔无张力疝修补的临床效果。方法回顾性分析2010年7月-2014年10月在解放军总医院普通外科接受腹腔镜食管裂孔疝修补术的74例患者的临床资料及随访结果。结果74例手术均顺利完成。手术时间85~185(107.3±5.6) min,术中出血量30~120(67.2±7.5) ml。术后住院3~9 d。所有手术均放置食管裂孔疝专用补片予修补并加固食管裂孔,术后随访期间未发生补片引起的并发症。74例患者随访3~53(31.0±2.1)个月。66例(89%)术后主要症状得到缓解,8例患者术后仍有术前不适症状,烧心反酸2例、胸骨后疼痛4例、恶心呕吐1例、吞咽困难2例。术后3个月复查上

  9. 腹腔镜技术在食管裂孔疝修补手术中的初步体会(附3例报告)%The experience of the laparoscopic hiatal hernia repair

    Institute of Scientific and Technical Information of China (English)

    闵凯; 吴彪; 任俊; 曹峰瑜

    2014-01-01

    Objective Expore the application of the laparoscopic technique about hiatal hernia repair.Methods From March 2013 to March 2014,3 cases of laparoscopic hiatal hernia repair the First Hospital of Wuhan were retrospectively analyzed.Results Successful completion of the results of 3 cases and no case was transferred to open operation.Nissen for 2 cases,suture for 1 case.Surgery time for an average of 120 minutes,postoperative stayed at the hospital,on average 5 days,no case was severe postoperative complications.All cases were followed up an average of 6 months,none was recurrence. Conclusion Laparoscopic hiatal hernia repair is minimally invasive,safe and effective,it conforms to the requirements of rapid rehabilitation surgery.%目的:探讨腹腔镜技术在修补食管裂孔疝手术中的应用。方法回顾性分析武汉市第一医院2013年3月至2014年3月,3例行腹腔镜食管裂孔疝手术患者的临床资料。结果3例腹腔镜手术均顺利完成,无中转开腹手术。2例同时行 Nissen 胃底折叠术,1例仅行裂孔修补术,平均手术时间120 min,平均住院5 d,无术后并发症。术后平均随访时间6月,无复发病例。结论腹腔镜修补食管裂孔疝手术具有微创,安全,有效的特点,符合快速康复外科的要求。

  10. Lumbar hernia: surgical anatomy, embryology, and technique of repair.

    Science.gov (United States)

    Stamatiou, Dimitrios; Skandalakis, John E; Skandalakis, Lee J; Mirilas, Petros

    2009-03-01

    Lumbar hernia is the protrusion of intraperitoneal or extraperitoneal contents through a defect of the posterolateral abdominal wall. Barbette was the first, in 1672, to suggest the existence of lumbar hernias. The first case was reported by Garangeot in 1731. Petit and Grynfeltt delineated the boundaries of the inferior and superior lumbar triangles in 1783 and 1866, respectively. These two anatomical sites account for about 95 per cent of lumbar hernias. Approximately 20 per cent of lumbar hernias are congenital. The rest are either primarily or secondarily acquired. The most common cause of primarily acquired lumbar hernias is increased intra-abdominal pressure. Secondarily acquired lumbar hernias are associated with prior surgical incisions, trauma, and abscess formation. During embryologic development, weakening of the area of the aponeuroses of the layered abdominal muscles that derive from somitic mesoderm, which invades the somatopleure, may potentially lead to lumbar hernias. Repair of lumbar hernias should be performed as early as possible to avoid incarceration and strangulation. The classic repair technique uses the open approach, where closure of the defect is performed either directly or using prosthetic mesh. The laparoscopic approach, either transabdominal or extraperitoneal, is an alternative.

  11. Staged hernia repair preceded by gastric bypass for the treatment of morbidly obese patients with complex ventral hernias.

    Science.gov (United States)

    Newcomb, W L; Polhill, J L; Chen, A Y; Kuwada, T S; Gersin, K S; Getz, S B; Kercher, K W; Heniford, B T

    2008-10-01

    Obesity may be the most predominant risk factor for recurrence following ventral hernia repair. This is secondary to significantly increased intra-abdominal pressures, higher rates of wound complications, and the technical difficulties encountered due to obesity. Medically managed weight loss prior to surgery is difficult. One potential strategy is to provide a surgical means to correct patient weight prior to hernia repair. After institutional review board approval, we reviewed the medical records of all patients who underwent gastric bypass surgery prior to the definitive repair of a complex ventral hernia at our medical center. Twenty-seven morbidly obese patients with an average of 3.7 (range 1-10) failed ventral hernia repairs underwent gastric bypass prior to definitive ventral hernia repair. Twenty-two of the gastric bypasses were open operations and five were laparoscopic. The patients' average pre-bypass body mass index (BMI) was 51 kg/m2 (range 39-69 kg/m2), which decreased to an average of 33 kg/m2 (range 25-37 kg/m2) at the time of hernia repair at a mean of 1.3 years (range 0.9-3.1 years) after gastric bypass. Seven patients had hernia repair at the same time as their gastric bypass (four sutured, three biologic mesh), all of which recurred. Of the 27 patients, 19 had an open hernia repair and eight had a laparoscopic repair. Panniculectomy was performed concurrently in 15 patients who had an open repair. Prior to formal hernia repair, one patient required an urgent operation to repair a hernia incarceration and a small-bowel obstruction 11 months after gastric bypass. The average hernia and mesh size was 203 cm2 (range 24-1,350 cm2) and 1,040 cm2 (range 400-2,700 cm2), respectively. There have been no recurrences at an average follow-up of 20 months (range 2 months-5 years). Gastric bypass prior to staged ventral hernia repair in morbidly obese patients with complex ventral hernias is a safe and definitive method to effect weight loss and facilitate a

  12. Subsequent abdominal surgery after laparoscopic ventral and incisional hernia repair with an expanded polytetrafluoroethylene mesh: a single institution experience with 72 reoperations.

    Science.gov (United States)

    Wassenaar, E B; Schoenmaeckers, E J P; Raymakers, J T F J; Rakic, S

    2010-04-01

    Laparoscopic ventral and incisional hernia repair (LVIHR) carries a risk of adhesion formation and can influence subsequent abdominal operations (SAOs). We performed a retrospective study of findings during reoperations of patients who had previously had an LVIHR by using an expanded polytetrafluoroethylene mesh (DualMesh; WL Gore, Flagstaff, AZ, USA). The medical records of all 695 patients who had LVIHR at our hospital were reviewed. Patients who underwent SAO for various indications were identified (n = 72) and analyzed. Seven LVIHR patients (1%) had early SAO (within a few days). In six patients (86%), removal of the mesh was required. Intra-operatively, in all six of these patients with peritonitis, there were no adhesions against the implant identified. Late SAOs (after more than 1 month) were performed in 65 patients (9.4%). Only one patient required acute surgical intervention due to an LVIHR-related adhesion (0.15%). Laparoscopy was performed in 83% and laparotomy in 17% of patients. Adhesions against the implant were present in 83% of patients; in 65%, the adhesions involved omentum only, and in 18%, they involved the bowel. Adhesiolysis was always easy and caused no inadvertent enterotomies. SAOs were devoid of postoperative complications. In this largest series of reoperations after LVIHR, the majority of patients had mild or moderate adhesions against the implant. The specific observations that: (1) no relaparoscopies had to be converted, (2) no inadvertent enterotomies were made during adhesiolysis, and (3) SAOs have practically been devoid of peri- and postoperative complications indicate that SAOs can be safely performed after previous LVIHR with DualMesh.

  13. 腹腔镜腹股沟疝修补术300例%Laparoscopic Inguinal Hernia Repair: Report of 300 Cases

    Institute of Scientific and Technical Information of China (English)

    王卫军; 方钱; 李剑锋; 金鹏飞; 李智涛; 李嘉根

    2011-01-01

    Objective To evaluate the safety and efficacy of laparoscopic inguinal hernia repair.Methods The clinical data of 300 cases ( 357 sides) who received laparoscopic inguinal hernia repair, including 221 cases ( 273 sides) of transabdominal preperitoneal (TAPP) and 79 cases (84 sides) of totally extraperitoneal (TEP), from March 2005 to March 2010 were analyzed retrospectively.In TAPP group, the peritoneum was opened after pneumoperitoneum, the hernia was then pulled back so that to separate the preperitoneal space and place and nail the MESH.In the TEP group, the preperitoneal space was built by blunt dissection, and then Mesh was placed before gas release.Results The procedures were completed successfully in all the 300 cases without conversion to open surgery.The mean operation time for TAPP and TEP was 44.2 min ( 30 - 150 min) and 36.7 min ( 25 -110 min) respectively.No analgesic was used after the procedures.Complications included seroma ( 12.6% , 45/357), temporary nerve paresthesia (6.4% , 23/357), injury to the inferior epigastric artery (1.1% , 4/357), urinary retention (0.6% , 2/357) and injury to the spermatic duct (0.3% , 1/357).The mean postoperative hospital stay was 4.8 d (3 -10 d).The rate of patient taking normal activity in 2 and 4 weeks postoperation was 94.0% (282/300) and 100% respectively.267 patients were followed up for 2 - 60 months (mean,24.2months), during which no recurrence was found.Conclusions Both TAPP and TEP are safe and effective for hernia repair.Surgeons may choose any of them following their own experience.%目的 评价腹腔镜腹股沟疝修补术的安全性和有效性.方法 2005年3月~2010年3月行腹腔镜腹股沟疝修补术300例(357侧),其中TAPP 221例(273侧),TEP 79例(84侧).TAPP:建立气腹后打开腹膜,回纳疝囊,分离出腹膜前间隙,置入补片后钉合器固定,关闭腹膜.TEP:在腹膜前钝性建立足够间隙,回纳疝囊,置入补片覆盖缺损后放气.结果 300例手术全

  14. Perioperative nursing of totally extraperitoneal laparoscopic hernia repair under local anesthesia%局麻下腹腔镜完全腹膜外疝修补术的围手术期护理

    Institute of Scientific and Technical Information of China (English)

    宋赛花; 张小琴; 倪春华

    2011-01-01

    Objective To summarize perioperative nursing experience of totally extraperi-toneal laparoscopic hernia repair under local anesthesia. Methods The effect of perioperative nursing on 26 cases with inguinal hernia treated by totally extraperitoneal laparoscopic hernia repair under local anesthesia from January 2009 to January 2010 was observed. Results All cases were operated successfully. The average postoperative stay was 2.4(1 -4) days. Most complications included 2 cases of subcutancous emphysema. There were no complications of hematoma/seroma, persistent nervous pain, wound infection, mesh infection after operations, and urinary retentio. All patients were followed up for 8 (3~15) months, and there were no recurrence. Conclusion Totally extraperitoneal laparoscopic hernia repair under local anesthesia is safe and effective for inguinal hernia with advantages of less pain, quick recovery and, lower operation cost, which can be easily accepted by both patients and surgeons. It can obviously reduce the nursing workload, but mental nursing is also very important.%目的 总结局麻下腹腔镜完全腹膜外疝修补术(TEP)的围手术期护理经验.方法对2009年1月-2010年1月采用局麻完成的26例(28例次)TEP患者进行围手术期护理观察.结果所有患者均治愈,术后平均住院2.4d,主要并发症为皮下气肿2例,术后未出现血肿/血清肿、持续性神经性疼痛、切口感染、补片感染及尿潴留,术后平均随访8个月未见复发病例.结论局麻下腹腔镜完全腹膜外疝修补术安全可靠,术后疼痛轻,恢复更快,术后恢复体力活动早,可以明显降低手术费用,易被患者及外科医生接受,明显减少了护理工作量,但心理护理非常重要.

  15. Umbilical Hernia Repair with Proceed Ventral Patch

    Directory of Open Access Journals (Sweden)

    Salati Sajad Ahmad

    2014-07-01

    Full Text Available Umbilical hernia is one the commonest surgical lesions and there is a variety of methods available for its repair. Proceed Ventral Patch is a recent and novel innovation in hernia management and we present a successful management of umbilical hernia in a 45 years old obese patient with this technique

  16. Comparative Study of the Effect of Local Anesthesia,Epidural Tension-free Hernia Repair and Laparoscopic Total Extraperitoneal Hernia Repai r%局麻、硬膜外麻开放式无张力疝修补术与腹腔镜全腹膜外疝修补术的疗效对比研究

    Institute of Scientific and Technical Information of China (English)

    李群华; 金万亮; 邓孙林; 刘凯; 盘毅辉; 郭建业

    2014-01-01

    目的:研究局麻、硬膜外麻下开放式无张力疝修补术与腹腔镜全腹膜外疝修补术(TEP)治疗成人腹股沟疝的疗效对比。方法:回顾性分析本院2009年8月-2014年3月诊治的87例成人腹股沟疝患者的临床资料,根据患者的经济情况和病情等选择不同术式,其中23例行局麻下疝修补的患者作为局麻组,36例硬膜外麻下行无张力疝修补术的患者作为硬膜外麻组,28例行腹腔镜全腹膜外疝修补的患者作为腹腔镜组。观察比较三组患者的手术时间、术后下床时间、总住院时间、术后疼痛时间、住院费用、术后并发症和术后复发率等指标。结果:三组患者手术均成功。手术时间以硬膜外麻组时间最短,腹腔镜组时间最长(P0.05);三组均无近期复发病例。结论:三种术式各有最佳适应证和优缺点,应个体化选择疝修补术,腹腔镜腹股沟疝修补术有良好的发展前景。%To study the contrast effect of local anesthesia,epidural anesthesia for open tension-free hernia repair and laparoscopic total extraperitoneal hernia repair(TEP)in the treatment of adult inguinal hernia. Method:The clinical data of 87 patients with adult inguinal hernia in our hospital from August 2009 to March 2014 were retrospectively analyzed,selected different surgery according to the patient’s economic conditions and disease,23 patients with hernia repair under local anesthesia were selected as local anesthesia group,36 patients with tension-free hernia repair under epidural anesthesia were selected as epidural anesthesia group,28 patients with laparoscopic total extraperitoneal hernia repair were selected as the laparoscopic group.The operation time,postoperative ambulation time, hospitalization time,postoperative pain,hospitalization expenses,postoperative complications and recurrence rate of the three groups were observed and compared.Result:Three groups of patients with

  17. Laparoscopic management of urachal cyst associated with umbilical hernia.

    Science.gov (United States)

    Gregory, G C; Vijay, R; Ligaj, M; Shiwani, M H

    2011-02-01

    The urachal cyst is a rare clinical entity of a urachal remnant. It is usually asymptomatic but can present with haematuria, tumour, urachal stone and infection. We present a case of a 63-year-old lady with a body mass index (BMI) of 49 who presented with a painful swelling in the umbilical region associated with an umbilical hernia. An ultrasound and computed tomography (CT) scan showed a suspected herniation of an umbilical remnant cyst through a paraumbilical defect. Laparoscopy confirmed the urachal cyst of 3 cm in size with a band connected with the cyst down to the urinary bladder associated with a 3-cm paraumbilical hernia. We removed the cyst and repaired the hernia laparoscopically uneventfully, after which her recovery was perfect. Radiological and laparoscopic pictures have not been reported in the English literature before. Although this condition is very rare, we suggest that it should be considered in the differential diagnosis of painful paraumbilical swelling. CT scanning and laparoscopy seems to be valuable, especially in obese patients.

  18. [Complications of inguinal hernia repair].

    Science.gov (United States)

    Forte, A; D'Urso, A; Gallinaro, L S; Lo Storto, G; Bosco, M R; Vietri, F; Beltrami, V

    2002-03-01

    It's shown by literature and confirmed by Author's experience that, on account of the excellent results, prosthetic repair of inguinal hernia is more effective than "conventional" (Bassini, Mc Vay, Shouldice). Between January 1993 and December 2000 were observed 875 patients with inguinal hernia (814 monolateral, 61 bilateral); all patients underwent a Lichtenstein repair both in the primary version and in its variations (internal ring plastic, trasversalis plicate, plug repair). The patients were discharged from hospital within 24 hours after surgery in 90% of cases. No important intraoperative complications were observed; the patients restarting work varied from 3 to 15 days after the discharging in relation to patient anxiety, onset of complications and to the type of work. The complications observed were: urine retention (1.6%), superficial haematoma (1.3%), superficial infection (1%), wound suppuration (0.5%), serous effusion (0.7%), postsurgery pain (2.1%), scrotal edema (1.7%), persistent inguinal neuralgia (0.6), local hypoesthesia (4.3%), ischemical orchitis (0.1%), recurrence (0.2%). In conclusion Authors assert that "tension free" repair allows optimal results both for the surgery point (easiness of the technique, repeatability, less invasivity, scanty incident of recurrences, low frequency of postoperative complications) and in economic terms, allowing an early mobilization of the patients. A further improvement would be obtained with more care in surgical and patient management, with more excellent results.

  19. Laparoscopic repair for inguinal hernia in old-aged patients: 56 cases report%老年人腹腔镜腹股沟疝修补术(附56例报告)

    Institute of Scientific and Technical Information of China (English)

    潘玉琴; 吴卫东; 方芳

    2012-01-01

    目的:总结老年人腹腔镜腹股沟疝修补术的经验,分析术中和术后情况,了解该术式在老年病人中使用的安全性.方法:回顾分析2007年1月至2011年12月行腹腔镜腹股沟疝修补术56例64侧病人的临床资料,其中单侧腹股沟疝48例(斜疝34例,直疝10例,股疝4例),双侧腹股沟疝8例.术后平均随访时间(36±11)个月.结果:56例中完成经腹腹膜前(transabdominal preperitoneal,TAPP)补片植入术26例,完全腹膜外(totally extraperitoneal,TEP)补片植入术30例.平均手术时间TAPP(78±14)min,TEP(64±10)min;术后平均住院时间(5.8±1.8)d;术后并发症依次为暂时性神经感觉异常37.5%(21/56)、慢性疼痛28.6%(16/56)和血清肿21.4%(12/56).术后复发率1.8% (1/56).结论:腹腔镜腹股沟疝修补在老年病人的使用中,有创伤小、恢复快、复发率低、安全性好等优点.%Objective To analyze the clinical data of laparoscopic repairing for inguinal hernia in old-aged patients. Methods Clinical data of 56 cases with inguinal hernia in our department from Jan 2007 to Dec 2011 were retrospectively analyzed. There were 48 cases of single-sided hernia, including 34 indirect inguinal hernia, 10 direct inguinal hernia and 4 femoral hernia. The rest 8 cases were double-sided inguinal hernia. The follow-up was done on (36± 11) months after operation. Results All cases underwent laparoscopic repair successfully. There were 26 case with transabdominal preperitoneal (TAPP) and 30 cases with totally extraperitoneal (TEP). The average operative time was (78± 14) min for TAPP and(64±10) min for TEP. The average length of postoperative stay was(5,8±1.8) days. The most common postoperative complications were transient paresthesia (37.5%,21/56), chronic pain(28.6%, 16/56) and seroma (21.4%, 12/ 56). The recurrence rate was 1.8%(l/56). Conclusions Laparoscopic repair for inguinal hernia has the advantage of less trauma, faster recovery and lower recurrent rate for

  20. 完全腹膜外疝修补术与 Lichtenstein 修补术对比研究%Comparative study of laparoscopic totally extraperitoneal repair and Lichtenstein hernia repair

    Institute of Scientific and Technical Information of China (English)

    俞德梁; 张宪国

    2015-01-01

    目的:对比完全腹膜外疝修补术(TEP)与李金斯坦(Lichtenstein)疝修补术治疗腹股沟疝的临床疗效。方法回顾性分析2012年6月至2014年6月,厦门市第五医院181例成人原发单侧腹股沟疝患者行 TEP 与 Lichtenstein 疝修补术术式的临床资料,对比观察二组患者平均住院时间、住院费用、术后并发症及复发率。结果 TEP 组 Lichtenstein 组住院时间分别为(7.5±2.2)、(9.3±3.4) d,差异有统计学意义(t=4.084,P=0.000)。 TEP 组与 Lichtenstein 组住院费用分别为(8601±1726)、(6922±2014)元,差异有统计学意义(t =5.872,P =0.000)。 TEP 组与 Lichtenstein 组术后近、远期并发症发生率分别为(3.94% vs 3.81%,χ2=0.002,P=0.962)、(0% vs 0.95%,χ2=0.728, P=0.394),二组术后均无复发。结论 TEP 与 Lichtenstein 术式均可较安全有效的应用于原发腹股沟疝的治疗,但同样条件下优先选择 TEP 术式。%Objective To compare the clinical efficacy of laparoscopic totally extraperitoneal repair (TEP) and Lichtenstein repair for inguinal hernia. Methods The 181 inguinal hernia patient′s clinical data with TEP and Lichtenstein repair were retrospectively analyzed, from June 2012 to June 2014, in the Fifth Hospital of Xiamen City. Average length of hospital stay, cost of hospitalization, incidence of postoperative complications and recurrence were analyzed. Results The average length of hospital stay of patients with TEP group was less than Lichtenstein group (P 0. 05). Conclusion Both TEP and Lichtenstein repair can achieve good effect, and TEP should be preferred in the same condition.

  1. Long-term Recurrence and Complications Associated With Elective Incisional Hernia Repair

    DEFF Research Database (Denmark)

    Kokotovic, Dunja; Bisgaard, Thue; Helgstrand, Frederik

    2016-01-01

    Importance: Prosthetic mesh is frequently used to reinforce the repair of abdominal wall incisional hernias. The benefits of mesh for reducing the risk of hernia recurrence or the long-term risks of mesh-related complications are not known. Objective: To investigate the risks of long......-term recurrence and mesh-related complications following elective abdominal wall hernia repair in a population with complete follow-up. Design, Setting, and Participants: Registry-based nationwide cohort study including all elective incisional hernia repairs in Denmark from January 1, 2007, to December 31, 2010....... Exposures: Hernia repair using mesh performed by either open or laparoscopic techniques vs open repair without use of mesh. Main Outcomes and Measures: Five-year risk of reoperation for recurrence and 5-year risk of all mesh-related complications requiring subsequent surgery. Results: Among the 3242...

  2. Is laparoscopic treatment of incisional and recurrent hernias associated with an increased risk for complications?

    Science.gov (United States)

    Meyer, Rüdiger; Häge, Anna; Zimmermann, Markus; Bruch, Hans-Peter; Keck, Tobias; Hoffmann, Martin; Schlöricke, Erik

    2015-07-01

    Hernias of the ventral abdominal wall can be treated with an intraperitoneal onlay mesh (IPOM). The aim of this cohort study was to analyze the complications and recurrence rates after laparoscopic ventral hernia repair focusing especially on incisional and recurrent hernias. The study population comprised 149 patients with a hernia of the abdominal wall, which was treated with an IPOM between January 2006 and January 2011. Fifty-one patients had a primary hernia (group I) and 98 patients had preceding abdominal surgery (group II). In group II 64 patients had an incisional hernia and 34 patients had a recurrent hernia. The median body mass index was 30.3 kg/m(2) (14.8-69.1) without any significance in sub-group comparison. The mean duration of surgery and the length of stay were significantly longer in group II (p hernias as incisional hernias, recurrent hernias and hernias with interenteric and enteroperitoneal adhesions is associated with high rates of minor and major complications. A high level of expertise of the surgeon and the camera-guiding assistant is therefore needed. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  3. Clinical experience of laparoscopic inguinal hernia repair in children%腹腔镜下微创治疗儿童腹股沟疝的临床体会

    Institute of Scientific and Technical Information of China (English)

    陈康; 王光远; 郎庆华; 冉启琼; 毛宏铭; 孟祥宁; 刘应梅

    2014-01-01

    目的:探讨腹腔镜下微创治疗儿童腹股沟疝的可行性。方法回顾性分析2012年4月至2013年9月,六盘水市人民医院在全身麻醉腹腔镜下行儿童疝囊高位结扎治疗儿童腹股沟疝198例的临床资料。结果198例患者手术均顺利,手术时间10~20 min,平均15 min。术后均未用抗生素,术后6h内即可适量活动及进流质饮食。所有患者均达一期愈合,住院时间3~4d。术后随访6个月,均无复发、血肿、水肿等并发症;术后发生切口大网膜疝1例。结论儿童腹股沟疝行腹腔镜下疝囊高位结扎术,减少术后复发,并发症少,值得临床推广应用。%Objective To evaluate the feasibility of laparoscopic inguinal hernia repair as a minimally invasive treatment in children.Methods A total of 1 98 cases of inguinal hernia in children receiving laparoscopic high ligation of sac under general anesthesia in Liupanshui People′s Hospital from April 201 2 to September 201 3,were enrolled and their clinical data were retrospectively analyzed.Results All operations were successfully completed.The operating time ranged from 1 0 to 20 minutes (mean 1 5 minutes).No postoperative antibiotics was applied.Appropriate activity and liquid diet could been given in 6 hours after operation.All patients were healing by first intention,and the hospital length of stay was 3 to 4 days.After a follow-up of 6 months,no recurrence,hematoma,edema and other complications was observed;while greater omentum incisional hernia occurred in 1 patient after operation.Conclusion Laparoscopic high ligation hernia sac technique in children reduce postoperative recurrence of hernia,and has few complications,is worthy to be popularized in clinic.

  4. Resorbable biosynthetic mesh for crural reinforcement during hiatal hernia repair.

    Science.gov (United States)

    Alicuben, Evan T; Worrell, Stephanie G; DeMeester, Steven R

    2014-10-01

    The use of mesh to reinforce crural closure during hiatal hernia repair is controversial. Although some studies suggest that using synthetic mesh can reduce recurrence, synthetic mesh can erode into the esophagus and in our opinion should be avoided. Studies with absorbable or biologic mesh have not proven to be of benefit for recurrence. The aim of this study was to evaluate the outcome of hiatal hernia repair with modern resorbable biosynthetic mesh in combination with adjunct tension reduction techniques. We retrospectively analyzed all patients who had crural reinforcement during repair of a sliding or paraesophageal hiatal hernia with Gore BioA resorbable mesh. Objective follow-up was by videoesophagram and/or esophagogastroduodenoscopy. There were 114 patients. The majority of operations (72%) were laparoscopic primary repairs with all patients receiving a fundoplication. The crura were closed primarily in all patients and reinforced with a BioA mesh patch. Excessive tension prompted a crural relaxing incision in four per cent and a Collis gastroplasty in 39 per cent of patients. Perioperative morbidity was minor and unrelated to the mesh. Median objective follow-up was one year, but 18 patients have objective follow-up at two or more years. A recurrent hernia was found in one patient (0.9%) three years after repair. The use of crural relaxing incisions and Collis gastroplasty in combination with crural reinforcement with resorbable biosynthetic mesh is associated with a low early hernia recurrence rate and no mesh-related complications. Long-term follow-up will define the role of these techniques for hiatal hernia repair.

  5. [Laparoscopic treatment of abdominal wall hernias: prosthesis material comparison].

    Science.gov (United States)

    Biondi, A; Tropea, A; Monaco, N; Musmeci, G; Basile, G; Basile, F

    2011-12-01

    Hernia is due to abdominal wall weakening. This allows the contents of the abdomen to protrude from normal boundaries. Hernias are repaired by implanting a sterile surgical mesh to strengthen the weakened abdominal wall. Aim of this study is to compare the results obtained by bard Composix® L/P mesh or Dualmesh Plus Gore® implanting. The mesh has various beneficial characteristics. It is a reinforcing material for the abdominal wall, even when in the direct contact with the intestinal tract does not cause adhsion problems. The use of biocompatible materials is necessary in laparoscopic hernia repair. e-PTFE prosthesis and Dual Mesh® were the first to be used for laparoscopic treatment of the abdominal wall defects. These prosthesis are the result of many improvements, actually they are 1-mm thick and the two surfaces have different characteristics. Compound meshes are composed by e-PTFE and polypropylene with different percentage of the two materials and methods of interactions. The incidence of early complications were poor in relation to both types of implants, only seroma cases e-PTFE treated showed a prevalence of complication, in agreement with literature. About relapses in our experience we found that e-PTFE cases were predominantly. Dual Mesh® has better adaptability than Bard Composix®, which allows easier placement of the prosthesis as well as a better adaptation to the wall surface. The Bard Composix®, thanks to rigidity due to the polypropylene component has better handling than the Dual Mesh®, as it promotes a rapid and easy deployment of the prosthesis inside the abdominal cavity, favoring its positioning. The use of both prosthesis depends also on the experience specific to each operator, moreover, a rigorous surgical technique remains fundamental for the application of the mesh used.

  6. Composite mesh and gluteal fasciocutaneous rotation flap for perineal hernia repair after abdominoperineal resection: a novel technique.

    Science.gov (United States)

    Papadakis, Marios; Hübner, Gunnar; Bednarek, Marzena; Arafkas, Mohamed

    2017-03-01

    Perineal hernia is an uncommon complication following abdominoperineal rectum resection. Several surgical procedures have been proposed for perineal hernia repair, including perineal, laparoscopic and abdominal approaches. Repair techniques can be classified into primary suture techniques, mesh placements and repairs with autogenous tissue. We report a 68-year-old man with a perineal hernia, who underwent a pelvic floor reconstruction with a transperineal composite mesh and a gluteal fasciocutaneous rotation flap. We conclude that a combined approach with transperineal mesh reconstruction and gluteal fasciocutaneous flap could be an alternative choice in perineal hernia repair after abdominoperineal resection.

  7. Anti-adhesive composix mesh in laparoscopic hiatal hernia repair%防粘连复合补片在腹腔镜食管裂孔疝修补术中的应用

    Institute of Scientific and Technical Information of China (English)

    田书瑞; 马松松; 吴继敏; 汪忠镐; 胡志伟; 纪涛; 邓昌荣; 战秀岚; 田鑫帅; 张玉

    2016-01-01

    Objective To review the experience using anti-adhesive composix mesh in laparoscopic hiatal hernia repair. Methods Laparoscopic hiatal hernia repair was done with anti-adhesive composix mesh on 120 patients from Sep 2009 to Nov 2013. Results All the operations were performed successfully. The duration of surgery was (72 ±22) (42-130) min. Intraoperative blood loss was (12 ±14) (0-50) mL without blood transfusion. Posteperative hospital stay was (3.5 ±1.6) (2-7) days. All the patients were followed up for 6-48 months. The respiratory symptoms disappeared completely in 33%patients and reduced in 59% patients at different extents. Patient satisfaction was 93%. Anatomic recurrence was 6 cases and symptomatic recurrence 2 cases. Mesh complications was not found. Conclusions Based on indications strictly, laparoscopic hiatal hernia repair using anti-adhesive composix mesh is safe and effective.%目的:探讨防粘连复合补片在腹腔镜食管裂孔疝修补术中的应用。方法:2009年9月至2013年11月,对本院120例食管裂孔疝病人应用防粘连复合补片行腹腔镜裂孔疝修补术。结果:手术均成功,平均手术时间(72±22)(42~130) min。平均术中出血量(12±14)(0~50) mL,无输血。术后平均住院时间为(3.5±1.6)(2~7) d。术后随访6~48个月,33%的病人呼吸道症状完全消失,59%的病人不同程度缓解。满意度达93%。解剖学复发6例,其中症状复发2例,无补片并发症发生。结论:严格掌握手术适应证,防粘连复合补片在腹腔镜食管裂孔疝修补术中的应用安全有效。

  8. Chronic pain after childhood groin hernia repair

    DEFF Research Database (Denmark)

    Aasvang, Eske Kvanner; Kehlet, Henrik

    2007-01-01

    BACKGROUND: In contrast to the well-described 10% risk of chronic pain affecting daily activities after adult groin hernia repair, chronic pain after childhood groin hernia repair has never been investigated. Studies of other childhood surgery before the age of 3 months suggest a risk of increased...... pain responsiveness later in life, but its potential relationship to chronic pain in adult life is unknown. METHODS: This was a nationwide detailed questionnaire study of chronic groin pain in adults having surgery for a groin hernia repair before the age of 5 years (n = 1075). RESULTS: The response...

  9. Isokinetic strength of the trunk Xexor muscles after surgical repair for incisional hernia

    NARCIS (Netherlands)

    D. den Hartog (Dennis); H.H. Eker (Hasan); W.E. Tuinebreijer (Wim); G.J. Kleinrensink (Gert Jan); H.J. Stam (Henk); J.F. Lange (Johan)

    2010-01-01

    textabstractPurpose The repair of incisional hernias can be accomplished by open or laparoscopic techniques. The Biodex® dynamometer measures muscle strength during isokinetic movement. The objectives of this study are to compare the strength of the trunk Xexors between patients who underwent repair

  10. Difficulties and Operating Skills of Laparoscopic Total Extraperitoneal Hernia Repair%腹腔镜完全腹膜外疝修补手术难点及操作技巧

    Institute of Scientific and Technical Information of China (English)

    刘忠诚; 徐建; 王守光; 滕世岗

    2011-01-01

    Objective To investigate the difficulties and operating skills of laparoscopic total extraperitoneal hernia repair.Methods Totally 257 patients underwent laparoscopic hernia repair from May 2006 to May 2010 in our hospital, and the difficulties and operating skills were analyzed. Results Among the patients, TEP was carried out in 254 patients, the other 3 patients were converted to transabdominal preperitoneal prosthesis (TAPP) for rupture of the peritoneum. After the operation, 5 patients showed hematoma of the scrotum, and then was cured by conservative therapies. Hematoma in the hernial sac stump was detected in 1 patient,who thus underwent hematoma evacuation and residual hernia capsule resection. A mean of 28 months (6 -51 months) follow-up was achieved in the patients, during the period, 3 cases ( 1.2% ) developed contralateral hernia at 6, 14 and 23 months, and thus received a second TEP; 2 cases had recurrent hernia at 20 and 60 days postoperation, and then underwent second non-tension hernia repair; one patient complained of pain at the nail site, and was cured by removing the nail under local anesthesia. No complications were shown in the other patients. Conclusions The key techniques of TEP include setting up accurate extraperitoneal space, using anatomic landmark in laparoscopy, detaching hernial sac accurately, and placing and fixing the patch and treating occult inguinal hernia reasonably.%目的 探讨腹腔镜完全腹膜外疝修补术(totally extraperitoneal,TEP)难点及操作技巧.方法 2006年5月~2010年5月,施行257例腹腔镜疝修补手术,对术中遇到的操作难点及手术技巧进行总结分析.结果 254例行TEP,3例因腹膜破裂中转为经腹腔腹膜前疝修补术(transabdominal preperitoneal,TAPP).术后5例出现阴囊血肿,经非手术治愈;1例出现疝囊残端血肿,手术行血肿清除及残留疝囊切除.257例随访时间6~51个月,平均28个月,其中3例(1.2%)分别于术后6、14、23

  11. 腹腔镜胃底180°前折叠术治疗食管裂孔疝疗效分析%Curative effect analysis of laparoscopic esophageal hiatal hernia repair and anterior 180 degrees partial fundoplication

    Institute of Scientific and Technical Information of China (English)

    张重阳; 田志强; 田霖; 周立芳; 肖彬; 秦鸣放

    2014-01-01

    Objective To explore the feasibility and safety of laparoscopic hiatal hernia repair and anterior 180 degrees partial fundoplication for the treatment of esophageal hiatal hernia. Methods The clinical data of 180 patients who under went laparoscopic surgery for esophageal hiatal hernia from September 2008 to June 2013 at Cangzhou hospital of ITWM and Nankai hospital of Tianjin were retrospectively analyzed.All cases were conducted anterior 180 degrees partial fundoplication,including patch repair was used in 30 patients and silk sutures were used for the repair of esophageal perforation in the rest patients. Results All operations were performed smoothly,no conversions were needed.After the follow up period of 3 ~ 60 months,the satisfaction rate of operation was 92.31%. The symptoms in most cases were adequately relieved after operation.Endoscopy,radiology were repeated 3 months after surgery. Seven cases had mild symptom recurrence of acid reflux relieved with in 4 months ,no case occurred severely dysphagia and recurrence. Conclusion Laparoscopic repair of esophageal hiatal hernia and 180 degrees partial fundoplication has the following advantages:minimized trauma,quick recovery,safe and reliable effect procedures for hiatal hernia.%目的:探讨腹腔镜食管裂孔疝修补联合胃底180°前折叠术治疗食管裂孔疝疾病的可行性和安全性。方法回顾性分析了沧州市中西医结合医院与天津南开医院2008年9月至2013年6月采用腹腔镜技术治疗的180例食管裂孔疝患者资料,其中30例应用补片修补裂孔,剩余患者丝线缝合裂孔,均加做胃底180°前折叠(Dor手术)。结果手术顺利,无中转开腹者。术后随访3~60个月,手术效果满意率92.31%,术后3个月复查胃镜、上消化道造影等检查基本恢复正常。其中7例患者术后早期出现轻度反酸、烧心症状,均在4个月内通过保守治疗好转,无复发病例,无严重吞咽

  12. Lichtenstein versus Onstep for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2013-01-01

    Inguinal hernia is a common condition that affects millions of people world-wide every year. In Denmark (population of 5.5 million), more than 10,000 repairs of inguinal hernias are performed annually. The optimal surgical procedure for mesh placement and fixation is still being debated because...... of long-term complications such as persisting pain and impairment of sexual function. The Onstep approach is a newer type of groin hernia repair with promising preliminary results in terms of very few cases of chronic pain and recurrences. This protocol describes a randomised clinical trial the objective...... of which is to evaluate chronic pain and sexual dysfunction after inguinal hernia repair using the Lichtenstein repair compared with the Onstep approach....

  13. Lichtenstein versus Onstep for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2013-01-01

    Inguinal hernia is a common condition that affects millions of people world-wide every year. In Denmark (population of 5.5 million), more than 10,000 repairs of inguinal hernias are performed annually. The optimal surgical procedure for mesh placement and fixation is still being debated because...... of which is to evaluate chronic pain and sexual dysfunction after inguinal hernia repair using the Lichtenstein repair compared with the Onstep approach....... of long-term complications such as persisting pain and impairment of sexual function. The Onstep approach is a newer type of groin hernia repair with promising preliminary results in terms of very few cases of chronic pain and recurrences. This protocol describes a randomised clinical trial the objective...

  14. Chronic pain after inguinal hernia repair

    OpenAIRE

    2008-01-01

    : BACKGROUND: Chronic post herniorrhaphy groin pain is defined as pain lasting > 6 months after surgery, which is one of the most important complication occurring after inguinal hernia repair, occurs with greater frequency than previously thought. Chronic groin pain is one of the most significant complications following inguinal hernia repair, and majority of chronic pain has been attributed to ilioinguinal nerve entrapment. Various other factors are involved in development of...

  15. Umbilical hernia repair - series (image)

    Science.gov (United States)

    Umbilical hernias are fairly common. They are obvious at birth and are caused by a small defect in ... surgically. In most cases, by age 3 the umbilical hernia shrinks and closes without treatment. The indications for ...

  16. 腹腔镜食管裂孔疝修补术143例临床分析%Laparoscopic hiatal hernia repair: a clinical analysis of 143 cases

    Institute of Scientific and Technical Information of China (English)

    赵宏志; 秦鸣放; 王庆; 勾承月; 李宁

    2011-01-01

    Objective To explore the feasibility and clinical value of laparoscopic surgery in treating patients with hiatal hernia. Methods From June 2001 to February 2010, 143 cases of hiatal hernia were enrolled to undertake laparoscopic hiatal hernia repair at Nankai Hospital of Tianjin City. Laparoscopic fundoplication was performed concomitantly in some cases if appropriate. Paraoperative clinical parameters were recorded and analyzed. All cases were followed up routinely. Clinical outcomes were collected and analyzed. Results All 143 cases of laparoscopic operations were accomplished successfully. No conversions were needed. Mean operation time was 86 minutes (range: 55-210 minutes). Mean intraoperative blood lose was 76 mL (range: 40-150 mL). Mean postoperative hospital stay was 4.6 days (range: 3-21 days). Clinical symptoms were relieved in all cases. No mortality and severe complications were noted.Mean follow up period was 3.8 years (range: 3 months to 9 years). Rate of satisfaction for operation was 91.67%. Mild dysphagia occurred in 8 cases. Reflux recurrence occurred in 5 cases, in whom 4 cases were controlled by antacid medicine and 1 case need open surgical revision. Conclusion Laparoscopic hiatal hernia repair has the advantages of minimal trauma, fast recovery, safe and high reliability.%目的 探讨腹腔镜手术治疗食管裂孔疝的可行性和临床应用价值.方法 对2001年6月至2010年2月天津市南开医院143例食管裂孔疝行腹腔镜食管裂孔疝修补术的资料进行分析.结果 143例均完成腹腔镜手术,无中转开腹病例,手术时间55~210min,平均86min;术中出血量40~150mL,平均76mL;术后住院时间3~21d.平均4.6d.术后临床症状均得到缓解,无严重并发症及死亡病例.134例得到随访,随访时间3个月至9年,平均3.8年,手术结果满意率91.67%.8例进固体食物时有轻度哽噎感,5例反酸症状复发,其中4例应用抑酸药物后可控制,1例行开腹手术治疗.结论

  17. Inguinal hernia repair: toward Asian guidelines.

    Science.gov (United States)

    Lomanto, Davide; Cheah, Wei-Keat; Faylona, Jose Macario; Huang, Ching Shui; Lohsiriwat, Darin; Maleachi, Andy; Yang, George Pei Cheung; Li, Michael Ka-Wai; Tumtavitikul, Sathien; Sharma, Anil; Hartung, Rolf Ulrich; Choi, Young Bai; Sutedja, Barlian

    2015-02-01

    Groin hernias are very common, and surgical treatment is usually recommended. In fact, hernia repair is the most common surgical procedure performed worldwide. In countries such as the USA, China, and India, there may easily be over 1 million repairs every year. The need for this surgery has become an important socioeconomic problem and may affect health-care providers, especially in aging societies. Surgical repair using mesh is recommended and widely employed in Western countries, but in many developing countries, tissue-to-tissue repair is still the preferred surgical procedure due to economic constraints. For these reason, the development and implementation of guidelines, consensus, or recommendations may aim to clarify issues related to best practices in inguinal hernia repair in Asia. A group of Asian experts in hernia repair gathered together to debate inguinal hernia treatments in Asia in an attempt to reach some consensus or develop recommendations on best practices in the region. The need for recommendations or guidelines was unanimously confirmed to help overcome the discrepancy in clinical practice between countries; the experts decided to focus mainly on the technical aspects of open repair, which is the most common surgery for hernia in our region. After the identification of 12 main topics for discussion (indication, age, and sex; symptomatic and asymptomatic hernia: type of hernia; type of treatment; hospital admission; preoperative care; anesthesia; surgical technique; perioperative care; postoperative care; early complications; and long-term complications), a search of the literature was carried out according to the five levels of the Oxford Classification of Evidence and the four grades of recommendation.

  18. Hybrid NOTES transvaginal intraperitoneal onlay mesh in abdominal wall hernias: an alternative to traditional laparoscopic procedures.

    Science.gov (United States)

    Descloux, Alexandre; Pohle, Sebastian; Nocito, Antonio; Keerl, Andreas

    2015-12-01

    Abdominal wall hernias are increasingly treated by laparoscopic placement of an intraperitoneal onlay mesh (IPOM). We present an alternative technique for women: the laparoscopic-assisted transvaginal IPOM. Before surgery, all patients underwent a gynecological examination. The patients agreed to IPOM repair via a transvaginal approach, and written informed consent for surgery was obtained. Pneumoperitoneum was established with a Veress needle at the umbilicus. This access was subsequently dilated to 5 mm (VersaStep), and a 5-mm laparoscope was inserted. Under laparoscopic view, the transvaginal trocars (12-mm VersaStep and 5-mm flexible accesses) were safely inserted after lifting the uterus with a uterus manipulator. After preparation of the falciform ligament, the ligamentum teres and the preperitoneal fat, a lightweight composite mesh was introduced through the transvaginal access and fixed with absorbable tacks using the double-crown technique. From September 2011 to December 2012, we performed six laparoscopic-assisted transvaginal IPOM procedures (one epigastric, three umbilical, two combined epigastric and umbilical hernias; all were primary hernias). In the initial phase, only patients with small or medium primary abdominal wall hernia were selected (max. 3 cm diameter). Median hospital stay was 3 days (range 2-6 days). One minor complication occurred perioperatively (second-degree skin burn to the labia majora). At 1-year follow-up, we identified one recurrence in a high-risk patient with a body mass index higher than 35 kg/m(2). No infection and no mortality were observed. Although no final conclusion can be made regarding the presumed non-inferiority of this technique in terms of recurrence and mesh infection compared with traditional laparoscopic IPOM, laparoscopic-assisted transvaginal IPOM is a feasible alternative to treat abdominal wall hernias.

  19. A systematic review of laparoscopic port site hernias in gastrointestinal surgery.

    LENUS (Irish Health Repository)

    Owens, M

    2012-02-01

    INTRODUCTION: Port site hernia is an important yet under-recognised complication of laparoscopic surgery, which carries a high risk of strangulation due to the small size of the defect involved. The purpose of this study was to examine the incidence, classification, and pathogenesis of this complication, and to evaluate strategies to prevent and treat it. METHODS: Medline was searched using the words "port site hernia", "laparoscopic port hernia" "laparoscopic complications" and "trocar site hernias". The search was limited to articles on cholecystectomy, colorectal, bariatric or anti-reflux surgery published in English. A total of 42 articles were analysed and of these 35 were deemed eligible for review. Inclusion criteria were laparoscopic gastrointestinal surgery in English only with reported incidence of port site herniation. Studies were excluded if insufficient data was provided. Eligible studies were also cross-referenced. RESULTS: Analysis of 11,699 patients undergoing laparoscopic gastrointestinal procedures demonstrated an incidence of port site hernias of 0.74% with a mean follow-up of 23.9 months. The lowest incidence of port site herniation was for bariatric surgery with 0.57% in 2644 patients with a mean follow-up of 67.4 months while the highest incidence was for laparoscopic colorectal surgery with an incidence of 1.47% in 477 patients with a mean follow-up of 71.5 months. CONCLUSION: All fascial defects larger than or equal to 10mm should be closed with peritoneum, while smaller defects may require closure in certain circumstances to prevent herniation. Laparoscopic port site herniation is a completely preventable cause of morbidity that requires a second surgical procedure to repair.

  20. Umbilical Hernia Repair: Analysis After 934 Procedures.

    Science.gov (United States)

    Porrero, José L; Cano-Valderrama, Oscar; Marcos, Alberto; Bonachia, Oscar; Ramos, Beatriz; Alcaide, Benito; Villar, Sol; Sánchez-Cabezudo, Carlos; Quirós, Esther; Alonso, María T; Castillo, María J

    2015-09-01

    There is a lack of consensus about the surgical management of umbilical hernias. The aim of this study is to analyze the medium-term results of 934 umbilical hernia repairs. In this study, 934 patients with an umbilical hernia underwent surgery between 2004 and 2010, 599 (64.1%) of which were evaluated at least one year after the surgery. Complications, recurrence, and the reoperation rate were analyzed. Complications were observed in 5.7 per cent of the patients. With a mean follow-up time of 35.5 months, recurrence and reoperation rates were 3.8 per cent and 4.7 per cent, respectively. A higher percentage of female patients (60.9 % vs 29 %, P = 0.001) and a longer follow-up time (47.4 vs 35 months, P = 0.037) were observed in patients who developed a recurrence. No significant differences were observed between complications and the reoperation rate in patients who underwent Ventralex(®) preperitoneal mesh reinforcement and suture repair; however, a trend toward a higher recurrence rate was observed in patients with suture repair (6.5 % vs 3.2 %, P = 0.082). Suture repair had lower recurrence and reoperation rates in patients with umbilical hernias less than 1 cm. Suture repair is an appropriate procedure for small umbilical hernias; however, for larger umbilical hernias, mesh reinforcement should be considered.

  1. A Collective Review on Mesh-Based Repair of Umbilical and Epigastric Hernias.

    Science.gov (United States)

    Ponten, Jeroen E H; Thomassen, Irene; Nienhuijs, Simon W

    2014-10-01

    In accordance with the tension-free principles for other hernias, umbilical and epigastric hernia repair should probably be mesh-based. The number of randomized studies is increasing, most of them showing significantly less recurrences with the use of a mesh. Different devices are available and are applicable by several approaches. The objective of this review was to evaluate recent literature for the different types of mesh for umbilical and epigastric hernia repair and recurrences after mesh repair. A multi-database search was conducted to reveal relevant studies since 2001 reporting mesh-based repair of primary umbilical/epigastric hernia and their outcomes in adult patients. A total of 20 studies were included, 15 of them solely involved umbilical hernias, whereas the remaining studies included epigastric hernias as well. A median of 124 patients (range, 17-384) was investigated per study. Three quarters of the included studies had a follow-up of at least 2 years. Six studies described the results of laparoscopic approach, of which one reported a recurrence rate of 2.7 %; in the remaining studies, no recurrences occurred. Two comparative studies reported a lower incidence of complications and postoperative pain after laparoscopic repair compared to open repair. Seventeen studies reported results of open techniques, of which seven studies showed no recurrence. Other studies reported recurrence rates up to 3.1 %. A wide range of complication rates were reported (0-33 %). This collective review showed acceptable recurrence rates for mesh-based umbilical and epigastric hernia repair. A wide range of devices was investigated. A tendency toward more complications after laparoscopic repair was found compared to open repair.

  2. Clinical effect analysis of four-port laparoscopic hiatal hernia repair%四孔法行腹腔镜食管裂孔疝修补术的疗效分析

    Institute of Scientific and Technical Information of China (English)

    阿依都·阿不都热依木; 张辅江; 朱学鹏; 米力坎; 郭文江; 克力木; 张成

    2014-01-01

    Objective To investigate the superiority and feasibility of four-port laparoscopic hiatal hernia repair.Methods A total of 1 2 patients of hiatal hernia underwent four-port laparoscopic hiatal hernia repair between April 2009 and January 201 3 at Xinjiang Bazhou People′s Hospital,and their clinical data were retrospectively analyzed,including 6 Nissen,4 Toupet and 2 Dor fundoplication.Results All operations were successfully completed,and the mean operation time was 1 20 minutes (range 60 to 200 minutes),blood loss was 20 to 1 00 ml,no intraoperative complications occurred.After repair,the mean duration of hospitalization was 6.4 days,food taking and drain removal were after 2 days.During 7 to 46 months follow-up,there was postoperative subcutaneous pneumomediastinum in 1 case.2 patients with Nissen procedure developed obvious dysphagia,which improved at the 1-year follow-up.Conclusions Four-port laparoscopic hiatal hernia repair has the advantages of safety,short operation time,minimally invasion,less short-term recurrence,and few postoperative comlications.It has proven to be a safe and effective procedure for esophageal hiatus.%目的:探讨四孔法腹腔镜食管裂孔疝修补术的优越性及可应用性。方法回顾性分析2009年4月至2013年1月,新疆巴州人民医院收治的12例食管裂孔疝患者的临床资料,患者均行四孔法腹腔镜裂孔疝修补术,其中Nissen胃底折叠术6例,Toupet胃底折叠术4例,Dor胃底折叠术2例。结果12患者手术均顺利完成,手术时间60~200 min,平均120 min,失血量20~100 ml,术后平均住院6.4 d,术后2 d内进食,引流管在术后2 d内拔出。随访7~46个月,术后皮下纵膈气肿1例,其中2例行 Nissen 胃底折叠术术后1年内有明显吞咽困难,1年后吞咽困难症状逐渐缓解。结论四孔法行腹腔镜食管裂孔疝修补术具有安全可靠、手术时间短、创伤小、短期复发少、术后并发症

  3. Open, intraperitoneal, ventral hernia repair: lessons learned from laparoscopy.

    Science.gov (United States)

    Ponsky, Todd A; Nam, Arthur; Orkin, Bruce A; Lin, Paul P

    2006-03-01

    Recent literature suggests that laparoscopic repair of ventral hernias may have very low recurrence rates. However, laparoscopy may not be feasible in certain situations. We describe an open technique that uses the tension-free retrofascial principles of laparoscopic repair without the need for subcutaneous flaps. Through an incision in the hernia, the peritoneum is entered and adhesions are taken down. A piece of DualMesh (W.L. Gore & Associates, Inc, Newark, Del) is trimmed to fit with a 5-cm circumferential overlap. A vertical incision is made in the mid portion of the mesh. The mesh is fixed in an intraperitoneal retrofascial position using GORE-TEX sutures (W.L. Gore & Associates, Inc). The sutures are brought through the abdominal wall using a laparoscopic suture passer and tied into place on one side of the mesh. That side is then tacked to the posterior fascia with a spiral tacking device. The other side is sutured into place in a similar fashion and then tacked to the fascia by passing the spiral tacking device through the incision in the mesh. The mesh incision is closed with a running GORE-TEX suture. The overlying tissues are closed in layers.

  4. Repair of umbilical and epigastric hernias.

    Science.gov (United States)

    Earle, David B; McLellan, Jennifer A

    2013-10-01

    Umbilical and epigastric hernias are primary midline defects that are present in up to 50% of the population. In the United States, only about 1% of the population carries this specific diagnosis, and only about 11% of these are repaired. Repair is aimed at symptoms relief or prevention, and the patient's goals and expectations should be explicitly identified and aligned with the health care team. This article details some relevant and interesting anatomic issues, reviews existing data, and highlights some common and important surgical techniques. Emphasis is placed on a patient-centered approach to the repair of umbilical and epigastric hernias.

  5. Open preperitoneal groin hernia repair with mesh

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Rosenberg, Jacob

    2017-01-01

    A systematic review was conducted and reported according to the PRISMA statement. PubMed, Cochrane library and Embase were searched systematically. Studies were included if they provided clinical data with more than 30 days follow up following repair of an inguinal hernia with an open preperitoneal mesh......Background For the repair of inguinal hernias, several surgical methods have been presented where the purpose is to place a mesh in the preperitoneal plane through an open access. The aim of this systematic review was to describe preperitoneal repairs with emphasis on the technique. Data sources...

  6. Sequelae of Endoscopic Inguinal Hernia Repair : Incidence, evaluation and management

    NARCIS (Netherlands)

    Burgmans, J.P.J.

    2015-01-01

    The endoscopic preperitoneal technique (TEP) is an appealing inguinal hernia repair technique, theoretically superior to other approaches. In practice some problems remain unsolved. Real incidences of chronic postoperative inguinal pain (CPIP) and other important sequelae of endoscopic hernia repair

  7. Risk of Morbidity, Mortality, and Recurrence After Parastomal Hernia Repair

    DEFF Research Database (Denmark)

    Helgstrand, Frederik; Rosenberg, Jacob; Kehlet, Henrik

    2013-01-01

    Surgical outcome results after repair for parastomal hernia are sparsely reported and based on small-scale studies.......Surgical outcome results after repair for parastomal hernia are sparsely reported and based on small-scale studies....

  8. Sequelae of Endoscopic Inguinal Hernia Repair : Incidence, evaluation and management

    NARCIS (Netherlands)

    Burgmans, J.P.J.

    2015-01-01

    The endoscopic preperitoneal technique (TEP) is an appealing inguinal hernia repair technique, theoretically superior to other approaches. In practice some problems remain unsolved. Real incidences of chronic postoperative inguinal pain (CPIP) and other important sequelae of endoscopic hernia repair

  9. Is pooled data analysis of ventral and incisional hernia repair acceptable?

    Directory of Open Access Journals (Sweden)

    Ferdinand eKöckerling

    2015-05-01

    Full Text Available AbstractPurpose: In meta-analyses and systematic reviews comparing laparoscopic with open repair of ventral hernias, data on umbilical, epigastric and incisional hernias are pooled. Based on data from the Herniamed Registry, we aimed to investigate whether the differences in the therapy and treatment results justified such an approach.Methods: Between 1 September 2009 and 31 August 2013, 31,664 patients with a ventral hernia were enrolled in the Herniamed Hernia Registry. The implicated hernias included 16,206 umbilical hernias, 3,757 epigastric hernias, and 11,701 incisional hernias. Data on the surgical techniques, postoperative complication rates and one-year follow-up results were subjected to statistical analysis.Results: The laparoscopic IPOM technique was used significantly more often for incisional hernia than for epigastric hernia, 31.3 % vs. 24.0 %, respectively, and was used for 12.9 % of umbilical hernias (p < 0.0001. Likewise, the open technique with suturing of defect was used significantly more often for umbilical hernia than for epigastric hernia, 56.1 % vs. 35.4 %, respectively, and was used for 12.5 % of incisional hernias (p < 0.0001. The postoperative complication rates of 3.2 % for umbilical hernia and 3.5 % for epigastric hernia were significantly lower than for incisional hernia, at 9.2 % (p < 0.0001. That was also true for the reoperation rates due to postoperative complications, of 1.0 % vs. 1.2 % vs. 4.2 % (p < 0.0001. The one-year follow-up revealed significantly higher recurrence rates as well as rates of chronic pain needing treatment of 6.3 % and 7.9 %, respectively, for incisional hernia, compared with 4.1 % and 4.3 %, respectively, for epigastric hernia, and 2 % and 1.9 %, respectively, for umbilical hernia (p < 0.0001.Conclusion: Since significant differences were identified in the therapy and outcome between umbilical, epigastric and incisional hernias, scientific studies should be conducted only for a single

  10. Inguinal hernia repair: anaesthesia, pain and convalescence

    DEFF Research Database (Denmark)

    Callesen, Torben

    2003-01-01

    Elective surgical repair of an inguinal or femoral hernia is one of the most common surgical procedures. The treatment, however, presents several challenges regarding anaesthesia for the procedure, the postoperative analgesic therapy and convalescence, as well as planning of the procedure. Local......, general, and regional anaesthesia are all used for hernia repair, but to different degrees, primarily depending on traditions and whether the institution has specific interest in hernia surgery. Thus, the use of local anaesthesia varies from a few percent in Sweden, 18% in Denmark and up to almost 100......% in specialised institutions, dedicated to hernia surgery. The feasibility of local anaesthesia is high, as judged by the rate of conversion to general anaesthesia (

  11. Laparoscopic repair of incarcerated indirect inguinal hernia in children%腹腔镜治疗儿童嵌顿性腹股沟斜疝的临床疗效

    Institute of Scientific and Technical Information of China (English)

    范国勇; 姚干; 张庆峰; 梁健升; 杨庆堂; 郭健童; 吴志强

    2014-01-01

    Objective To investigate the safety and effectiveness of laparoscopic repair of incarcerated indirect inguinal hernia in children.Methods A retrospective analysis was done based on the clinical data of the patients who had undergone laparoscopic repair of incarcerated inguinal hernia in the First People′s Hospital of Foshan from January 2009 to November 201 3.Results 63 patients received the laparoscopic exploration,5 of them reduced spontaneously after anesthesia,58 of them had the reduction with the help of external manual pressure,6 patients were converted to open operation(9.52%).The operation time was 1 0 to 200 minutes (mean 45 .7 ±35 .9 minutes),the intraoperative blood loss was 1 to 5 ml (mean 1 .5 ±1 .0 ml),and the length of hospital stay was 1 to1 5 days (an average of 4.5 ±2.2 days).All of the patients were followed up for 1 month to 48months and no recurrence was found.Conclusions Whether the hernia conents are strangulated or not could be clearly observed under laparoscopy.Compared to the traditional operation,laparoscopic repair of incarcerated indirect inguinal in children is more simple,safer, and less complications.%目的:观察腹腔镜治疗儿童嵌顿性腹股沟斜疝的安全性及有效性。方法回顾性分析2009年1月至2013年11月,佛山市第一人民医院行腹腔镜治疗的儿童嵌顿疝患者的临床资料。结果63例患者行腹腔镜探查治疗,麻醉后自行复位5例,58例麻醉下手法复位,其中中转开腹6例(9.52%)。手术时间10~200 min,平均(45.7±35.9)min,出血量1~5 ml,平均(1.5±1.0)ml,住院时间1~15 d,平均(4.5±2.2)d。随访1~48个月,无复发。结论腹腔镜治疗儿童嵌顿疝不但能清楚地观察疝内容物有无绞窄,而且处理较传统手术简单安全,并发症少,值得临床推广。

  12. Stratification of surgical site infection by operative factors and comparison of infection rates after hernia repair.

    Science.gov (United States)

    Olsen, Margaret A; Nickel, Katelin B; Wallace, Anna E; Mines, Daniel; Fraser, Victoria J; Warren, David K

    2015-03-01

    To investigate whether operative factors are associated with risk of surgical site infection (SSI) after hernia repair. Retrospective cohort study. Patients Commercially insured enrollees aged 6 months-64 years with International Classification of Diseases, Ninth Revision, Clinical Modification procedure or Current Procedural Terminology, fourth edition, codes for inguinal/femoral, umbilical, and incisional/ventral hernia repair procedures from January 1, 2004, through December 31, 2010. SSIs within 90 days after hernia repair were identified by diagnosis codes. The χ2 and Fisher exact tests were used to compare SSI incidence by operative factors. A total of 119,973 hernia repair procedures were analyzed. The incidence of SSI differed significantly by anatomic site, with rates of 0.45% (352/77,666) for inguinal/femoral, 1.16% (288/24,917) for umbilical, and 4.11% (715/17,390) for incisional/ventral hernia repair. Within anatomic sites, the incidence of SSI was significantly higher for open versus laparoscopic inguinal/femoral (0.48% [295/61,142] vs 0.34% [57/16,524], P=.020) and incisional/ventral (4.20% [701/16,699] vs 2.03% [14/691], P=.005) hernia repairs. The rate of SSI was higher following procedures with bowel obstruction/necrosis than procedures without obstruction/necrosis for open inguinal/femoral (0.89% [48/5,422] vs 0.44% [247/55,720], P<.001) and umbilical (1.57% [131/8,355] vs 0.95% [157/16,562], P<.001), but not incisional/ventral hernia repair (4.01% [224/5,585] vs 4.16% [491/11,805], P=.645). The incidence of SSI was highest after open procedures, incisional/ventral repairs, and hernia repairs with bowel obstruction/necrosis. Stratification of hernia repair SSI rates by some operative factors may facilitate accurate comparison of SSI rates between facilities.

  13. Simultaneous Abdominoplasty and Umbilical Hernia Repair via Laparoscopy: a Preliminary Report

    Directory of Open Access Journals (Sweden)

    Shipkov Hristo D.

    2017-06-01

    Full Text Available Background: Umbilical hernias (UH are common in postpartum patients seeking abdominal contouring surgery and the question of simultaneous abdominoplasty and UH repair is raised. This presents, however, a risk to the umbilicus vascularisation with possible umbilical necrosis. To minimize this risk we associated abdominoplasty with laparoscopic UH repair. The aim of this study was to present the technique of simultaneous abdominoplasty and UH repair and the first results.

  14. Incisional hernia after open versus laparoscopic sigmoid resection

    DEFF Research Database (Denmark)

    Andersen, L.P.H.; Klein, M.; Gogenur, I.;

    2008-01-01

    Background Incisional hernia after open surgery is a well-known complication with an incidence of up to 20% after a 10-year period. Data regarding the long-term hernia risk after laparoscopic colonic surgery are lacking in the literature. In the present study we compared the long-term hernia...... department in the same period. Patients were contacted by telephone, and a questionnaire was completed for each patient. If the patient was believed to have a hernia or if there was any suspicion of a hernia, a consultant surgeon examined the patient and completed the questionnaire. Factors related...... to the primary operation, the hernia and general risk factors were registered for all patients. Results A total of 201 patients answered the questionnaire (95.3%). The laparoscopy group was comprised of 58 patients and 143 patients were included in the laparotomy group. The patients had a median follow-up of 4...

  15. Laparoscopic repair of esophageal hiatal hernia: an analysis of 129 cases%腹腔镜食管裂孔疝修补术治疗食管裂孔疝129例

    Institute of Scientific and Technical Information of China (English)

    王帅; 秦鸣放

    2011-01-01

    目的 探讨两种腹腔镜食管裂孔疝修补联合胃底折叠术治疗食管裂孔疝疾病的有效性.方法 回顾性分析了天津市微创外科中心于2001-03/2009-02 采用腹腔镜技术治疗的129 例食管裂孔疝患者资料.按照术式的不同分成2 组:Nissen 组53 例,采用Nissen 全360°胃底折叠术; Dor 组76 例,采用Dor 前180°胃底折叠术.结果 手术顺利,无死亡病例.30 例患者(N 组16 例,D 组14 例)术后早期出现吞咽不适,21 例4 mo 内自行缓解.3 例(Nissen 组)持续吞咽困难患者半年后行内镜下食管扩张治疗.6 例疝复发(Nissen 组1例,Dor 组5例).手术总体满意率89.15%.结论 腹腔镜食管裂孔疝修补和胃底折叠术能够有效的治疗食管裂孔疝疾病.Dor 前180°胃底折叠术能够降低Nissen 全360°胃底折叠术由于折叠过紧、迷走神经分支损伤带来的腹胀、吞咽不畅等相关并发症的发生率,但是抗反流效果仍较后者为弱.%AIM: To evaluate the clinical effects of two dif ferent laparoscopic procedures in the manage ment of esophageal hiatal hernia.METHODS: The clinical data for 129 patients who underwent laparoscopic surgery for esoph ageal hiatal hernia from March 2001 to February 2009 at our hospital were retrospectively ana lyzed. All patients were divided into two groups based on the laparoscopic procedure used: Nis sen group (360° fundoplication, n = 53) or Dor group (anterior 180° fundoplication, n = 76).RESULTS: All operations were performed smoothly. No death occurred. Thirty patients (16 in the Nissen group and 14 in the Dor group) de veloped dysphagia after surgery, and 21 of them relieved within four months. Three patients in the Nissen group received esophageal dilata tion for persistent dysphagia. Six months later, six patients had recurrence. The satisfaction rate was 89.51%.CONCLUSION: Laparoscopic repair of esophageal hiatal hernia is an effective way to treat hiatal hernia. Dor anterior 180

  16. Laparoscopic total extraperitoneal repair under spinal anesthesia versus general anesthesia: a randomized prospective study

    OpenAIRE

    2016-01-01

    Turgut Donmez,1 Vuslat Muslu Erdem,2 Oguzhan Sunamak,3 Duygu Ayfer Erdem,2 Huseyin Imam Avaroglu1 1Department of General Surgery, 2Department of Anesthesiology and Reanimation, Lutfiye Nuri Burat State Hospital, 3Department of General Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey Background: Laparoscopic total extraperitoneal (TEP) inguinal hernia repair is a well-known approach to inguinal hernia repair that is usually performed under general anesthesia (GA). ...

  17. A comparative study between Total Extra-Peritoneal (TEP repair and Trans Abdominal Pre-Peritoneal (TAPP repair in management of inguinal hernia

    Directory of Open Access Journals (Sweden)

    Nimesh Verma

    2015-03-01

    Full Text Available Background: Groin hernias are the most common conditions referred to surgeons all over the world and over five lakh hernia repairs are performed annually. Our purpose in this study is to compare the results of laparoscopic hernioplasty by Total Extra-Peritoneal (TEP technique and laparoscopic Trans Abdominal Pre-Peritoneal (TAPP technique. Methodology: This was the prospective study conducted on cases of inguinal hernia in which half cases were operated by Laparoscopic Trans Abdominal Pre-Peritoneal (TAPP mesh repair while other half were treated by Total Extra-Peritoneal (TEP mesh repair of inguinal hernia in New Civil Hospital, Surat. All the patients were admitted and a detailed history and clinical examination were carried out as per written proforma. Results: This comparative study consisted of 60 patients. The most common diagnosis was right indirect inguinal hernia followed by left direct inguinal hernia in the both the groups. Overall the TEP was far better procedure compared to TAPP. The indicators like mean operative, Post-op pain, post-op hospital stay (in days and return to normal work (in days were far better than TAPP. Conclusion: Our study supports the view that laparoscopic TEP and TAPP mesh repair of inguinal hernia is safe and efficacious, but long term Randomized Control Trials with enhanced sample size and reduced confounding factors are still required to establish the absolute superiority of TEP over TAPP. [Natl J Med Res 2015; 5(1.000: 64-66

  18. Application of 3D Laparoscopic Hernia Repair:A Report of 12 Cases%3D腹腔镜在腹腔镜疝修补术中的应用体会(附12例报告)

    Institute of Scientific and Technical Information of China (English)

    袁挺; 王峻峰; 王兆伟

    2015-01-01

    Objective To investigate the feasibility and surgical skil s of 3D laparoscopic hernia repair. Methods 12 patients who suf ered from Inguinal hernia , undergoing operation from September 2012 to March 2014 were analyzed retrospectively. Al of them were operation with 3D laparoscopic hernia repair. The operative time , intraoperative blood loss, postoperative hospital stay were recorded.Results Al of the operations were successful y performed without postoperative complications. The mean operation time was (40.2±10.7) minutes. The mean blood loss was (7.2±3.5) ml. The mean postoperative hospital stay was (3.5±0.8) days. Conclusion 3D Laparoscopic devices ,which give doctors the 3D view, clear Surgical field, make the anatomy as clear as possible, was easy to be accepted by surgeons. The use of it is conducive to decrease the incidence of operative complications, especial y in laparoscopic suture.%目的:探讨3D腹腔镜在疝修补术中应用的可行性及术中感受、手术技巧。方法从2012年9月~2014年3月对12例单侧腹股沟疝患者在3D腹腔镜系统辅助下行经腹膜前疝修补术,对术中感受、手术技巧进行总结,同时统计手术时间、术中出血量、术后住院时间。结果12例3D腹腔镜系统辅助下行腹膜前疝修补术均获得成功,术中无重要血管、神经的损伤,均无手术并发症。手术时间平均(40.2±10.7)min,术中出血平均(7.2±3.5)ml,术后住院时间(3.5±0.8)d。结论3D腹腔镜系统能使手术医师术中获得三维视觉效果,更容易学习及适应,容易被外科医师接受,在3D腹腔镜系统辅助下行经腹膜前疝修补术,术中视野清晰、层次分明、定位准确,有利于提高医师对组织辨认的精确性,特别有利于镜下缝合,不易造成副损伤,可降低并发症的发生率,不增加住院费用,值得推广应用。

  19. Enhanced recovery after giant ventral hernia repair

    DEFF Research Database (Denmark)

    Jensen, K K; Brøndum, T L; Harling, H.

    2016-01-01

    PURPOSE: Giant ventral hernia repair is associated with a high risk of postoperative morbidity and prolonged length of stay (LOS). Enhanced recovery (ERAS) measures have proved to lead to decreased morbidity and LOS after various surgical procedures, but never after giant hernia repair. The current....... Pain, nausea and fatigue were registered prospectively in all patients treated according to ERAS, as well as continuous measurement of transcutaneous capillary oxygen saturation. Postoperative morbidity and LOS were compared between patients treated according to ERAS and a historic group treated...

  20. Quality of life and outcomes for femoral hernia repair: does laparoscopy have an advantage?

    Science.gov (United States)

    Cox, T C; Huntington, C R; Blair, L J; Prasad, T; Heniford, B T; Augenstein, V A

    2017-02-01

    Due to their relative scarcity and to limit single-center bias, multi-center data are needed to study femoral hernias. The aim of this study was to evaluate outcomes and quality of life (QOL) following laparoscopic vs. open repair of femoral hernias. The International Hernia Mesh Registry was queried for femoral hernia repairs. Laparoscopic vs. open techniques were assessed for outcomes and QOL, as quantified by the Carolinas Comfort Scale (CCS), preoperatively and at 1, 6, 12, and 24 months postoperatively. Outcomes were evaluated using the standard statistical analysis. A total of 80 femoral hernia repairs were performed in 73 patients: 37 laparoscopic and 43 open. There was no difference in mean age (54.7 ± 14.6 years), body mass index (24.2 ± 3.8 kg/m(2)), gender (60.3 % female), or comorbidities (p > 0.05). The hernias were recurrent in 21 % of the cases with an average of 1.23 ± 0.6 prior repairs (p > 0.1). Preoperative CCS scores were similar for both groups and indicated that 59.7 % of patients reported pain and 46.4 % had movement limitations (p > 0.05). Operative time was equivalent (47.2 ± 21.2 vs. 45.9 ± 14.8 min, p = 0.82). There was no difference in postoperative complications, with an overall 8.2 % abdominal wall complications rate (p > 0.05). The length of stay was shorter in the laparoscopic group (0.5 ± 0.6 vs. 1.3 ± 1.6 days, p = 0.02). Follow-up was somewhat longer in the open group (23.8 ± 10.2 vs. 17.3 ± 10.9 months, p = 0.02). There was one recurrence, which was in the laparoscopic group (3.1 vs. 0 %, p = 0.4). QOL outcomes at all time points demonstrated no difference for pain, movement limitation, or mesh sensation. Postoperative QOL scores improved for both groups when compared to preoperative scores. In this prospective international multi-institution study of 80 femoral hernia repairs, no difference was found for operative times, long-term outcomes, or QOL in the treatment of femoral

  1. 腹腔镜腹股沟疝修补术式选择的回顾性分析%Retrospective analysis on the selection of surgical procedures for laparoscopic inguinal hernia repair

    Institute of Scientific and Technical Information of China (English)

    张云; 李健文; 陈鑫; 郑民华; 蒋渝; 王明亮; 陆爱国; 胡伟国; 毛志海

    2013-01-01

    Objective To investigate the choice of approach to laparoscopic inguinal hernia repair (LIHR).Methods The clinical data of 2 056 consecutive patients (2 473 hernias) undergoing LIHR between Jan 2001 and Dec 2011 at our hospital was retrospectively analyzed.There were 1 005 TAPP in 871 cases,1 458 TEP in 1 175 cases and 10 IPOM in 10 cases.All procedures were performed by the same surgical team,and the selection of the techniques was based by the surgeons.The follow-up period ranged from 15-60 months(median 42 months).Results There was significant difference between TAPP and TEP with respect to sex,age,disease duration,history of lower abdominal surgery,hernia type and classification(P<0.05).TAPP was preferable procedure for female(P<0.001),younger patients(P=0.006),and those with longer disease duration (P<0.001) and with history of lower abdominal surgery (P<0.001).TAPP was used more frequently in type Ⅳ(81.4%),while less frequently in type Ⅰ (27.4%)、type Ⅱ (29.2%) and type Ⅲ (44.3%).TAPP was much more used for femoral hernias(61.1%) and recurrent hernias(81.4%),but less for indirect hernias (41.6%),combined hernias(35.0%) and direct hernias (22.9%).TAPP was the prior procedure in the first 3 years of study,and TEP was more frequently later.IPOM was used in 10 cases all recurrent hernias.One conversion to Lichtenstein was done in TAPP,while no conversion in TEP.The mean operation time(P=0.021) and postoperative hospital stay(P<0.001) were in favor of TEP.No significant difference was found in visual analogue pain scale (P=0.173) and proportion of patients returning to usual activities between TAPP and TEP (P=0.479).The recurrence rate in TAPP and TEP were 0.3% and 0.2% respectively with no significant difference between them (P=0.693).The morbidity of TAPP and TEP were 9.3%,6.6%,which is in favor of TEP (P=0.014).TAPP had 2 cases with severe complications (requiring re-operation):port-site hernia and intestinal

  2. Technical modification for laparoscopic giant hiatal hernias repair%腹腔镜巨大食管裂孔疝修补改良术的临床研究

    Institute of Scientific and Technical Information of China (English)

    孙向宇; 秦鸣放; 吴瑜; 赵宏志; 戴其利

    2015-01-01

    Objective To investigate the safety and efficacy of technical modification for laparoscopic repair of giant hiatal hernias.Methods A total of 49 patients with giant hiatal hernia underwent modified laparoscopic repair by dissecting sac, closing hiatal, mesh placement and fundoplication from June 2010 to May 2014.The operation time, hospitalization time, postoperative complications, upper gastrointestinal imaging and improvement of postoperative symptoms were observed.Results The average operation time was (103.6 ±31.7) min(88-173min).The average length of post operation hospitalization was (4.2 ± 1.8) d (range,3-12d).Postoperative complication occurred in 4 patients,including pleural effusion (1 patient),respiratory failure (1 patient), difficulty in swallowing (2 patients)with complication occurrence rate being 8.2% (4/49).No conversion or death occurred.The average time of follow-up was (28.3 ± 12.7) months (6-50 months) in 49 cases.During the follow-up, main symptoms were relieved and no recurrence was found by barium swallow.Conclusion Technical modification for laparoscopic repair of giant hiatal hernias is safe and effective.%目的 探讨腹腔镜食管裂孔疝修补改良术治疗巨大食管裂孔疝的安全性及有效性.方法 2010年6月至2014年5月,采用腹腔镜疝囊完全分离、关闭食管裂孔至正常、放置双面复合补片、联合胃底折叠术的改良技术治疗49例巨大食管裂孔疝.观察手术时间、住院时间、术后并发症,术后上消化道造影和症状改善状况随访.结果 手术时间为(103.6±31.7)min(88~173 min),术后住院时间(4.2±1.8)d(3 ~12 d).4例出现并发症,肺感染伴胸腔积液1例,呼吸衰竭1例,吞咽困难2例,并发症发生率8.2%(4/49).无中转及死亡病例.49例术后平均随访(28.3±12.7)个月(6~50个月),术后主要症状改善显著,上消化道造影无食管裂孔疝复发.结论 腹腔镜食管裂孔疝修补改良术治疗巨大食管裂孔疝是安全、有效的.

  3. Tension free femoral hernia repair with plug

    Institute of Scientific and Technical Information of China (English)

    Milivoje Vukovi; Neboja Moljevi; Sinia Crnogorac

    2013-01-01

    Objective: To investigate the conventional technique involves treatment of femoral hernia an approximation inguinal ligament to pectineal ligament. In technique which uses mesh closure for femoral canal without tissue tension. Method: A prospective study from January 01. 2007-May 30. 2009. We analyzed 1 042 patients with inguinal hernia, of which there were 83 patients with 86 femoral hernia. Result: Femoral hernias were present in 7.96% of cases. Males were 13 (15.66%) and 70 women (84.34%). The gender distribution of men: women is 1:5.38. Urgent underwent 69 (83%), and the 14 election (17%) patients. Average age was 63 years, the youngest patient was a 24 and the oldest 86 years. Ratio of right: left hernias was 3.4:1. With bilateral femoral hernias was 3.61% of cases. In 7 patients (8.43%) underwent femoral hernia repair with 9 Prolene plug. Conclusions: The technique of closing the femoral canal with plug a simple. The plug is made from monofilament material and is easily formed. This technique allows the reduction of recurrence and can be used safely, quickly and easily in elective and emergency situations.

  4. Lumbar hernia repaired using a new technique.

    Science.gov (United States)

    Di Carlo, Isidoro; Toro, Adriana; Sparatore, Francesca; Corsale, Giuseppe

    2007-01-01

    Lumbar hernia is uncommon and occurs in Grynfeltt's triangle on the left side, more frequently in men than in women. Acquired lumbar hernias are the result of iliac crest bone harvest or blunt trauma and seat belt injuries in road accidents. Many surgical options have been reported for repairing this hernia through primary closure of the defect or through use of aponeurotic or prosthetic materials. The Dowd technique is the technique most often used. The authors describe a patient with posttraumatic inferior triangle lumbar hernia who underwent laparoscopy and, 10 days later, laparotomy. Both procedures failed. Finally, a novel lumbotomic surgical approach was used, involving the Dowd technique and prosthetic mesh. The patient was free of recurrence 3 months after the procedure.

  5. Laparoscopic repair for vesicouterine fistulae

    Directory of Open Access Journals (Sweden)

    Rafael A. Maioli

    2015-10-01

    Full Text Available ABSTRACT Objective: The purpose of this video is to present the laparoscopic repair of a VUF in a 42-year-old woman, with gross hematuria, in the immediate postoperative phase following a cesarean delivery. The obstetric team implemented conservative management, including Foley catheter insertion, for 2 weeks. She subsequently developed intermittent hematuria and cystitis. The urology team was consulted 15 days after cesarean delivery. Cystoscopy indicated an ulcerated lesion in the bladder dome of approximately 1.0cm in size. Hysterosalpingography and a pelvic computed tomography scan indicated a fistula. Materials and Methods: Laparoscopic repair was performed 30 days after the cesarean delivery. The patient was placed in the lithotomy position while also in an extreme Trendelenburg position. Pneumoperitoneum was established using a Veress needle in the midline infra-umbilical region, and a primary 11-mm port was inserted. Another 11-mm port was inserted exactly between the left superior iliac spine and the umbilicus. Two other 5-mm ports were established under laparoscopic guidance in the iliac fossa on both sides. The omental adhesions in the pelvis were carefully released and the peritoneum between the bladder and uterus was incised via cautery. Limited cystotomy was performed, and the specific sites of the fistula and the ureteral meatus were identified; thereafter, the posterior bladder wall was adequately mobilized away from the uterus. The uterine rent was then closed using single 3/0Vicryl sutures and two-layer watertight closure of the urinary bladder was achieved by using 3/0Vicryl sutures. An omental flap was mobilized and inserted between the uterus and the urinary bladder, and was fixed using two 3/0Vicryl sutures, followed by tube drain insertion. Results: The operative time was 140 min, whereas the blood loss was 100ml. The patient was discharged 3 days after surgery, and the catheter was removed 12 days after surgery

  6. Incarcerated Pediatric Hernias.

    Science.gov (United States)

    Abdulhai, Sophia A; Glenn, Ian C; Ponsky, Todd A

    2017-02-01

    Indirect inguinal hernias are the most commonly incarcerated hernias in children, with a higher incidence in low birth weight and premature infants. Contralateral groin exploration to evaluate for a patent processus vaginalis or subclinical hernia is controversial, given that most never progress to clinical hernias. Most indirect inguinal hernias can be reduced nonoperatively. It is recommended to repair them in a timely fashion, even in premature infants. Laparoscopic repair of incarcerated inguinal hernia repair is considered a safe and effective alternative to conventional open herniorrhaphy. Other incarcerated pediatric hernias are extremely rare and may be managed effectively with laparoscopy. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. The Onstep Method for Inguinal Hernia Repair

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Andresen, Kristoffer

    2016-01-01

    Inguinal hernia repair is one of the most common surgical procedures and several different surgical techniques are available. The Onstep method is a new promising technique. The technique is simple with a number of straightforward steps. This paper provides a full description of the technique...

  8. Changes in the Frequencies of Abdominal Wall Hernias and the Preferences for Their Repair: A Multicenter National Study From Turkey

    Science.gov (United States)

    Şeker, Gaye; Kulacoglu, Hakan; Öztuna, Derya; Topgül, Koray; Akyol, Cihangir; Çakmak, Atıl; Karateke, Faruk; Özdoğan, Mehmet; Ersoy, Eren; Gürer, Ahmet; Zerbaliyev, Elbrus; Seker, Duray; Yorgancı, Kaya; Pergel, Ahmet; Aydın, İbrahim; Ensari, Cemal; Bilecik, Tuna; Kahraman, İzzettin; Reis, Erhan; Kalaycı, Murat; Canda, Aras Emre; Demirağ, Alp; Kesicioğlu, Tuğrul; Malazgirt, Zafer; Gündoğdu, Haldun; Terzi, Cem

    2014-01-01

    Abdominal wall hernias are a common problem in the general population. A Western estimate reveals that the lifetime risk of developing a hernia is about 2%.1–3 As a result, hernia repairs likely comprise the most frequent general surgery operations. More than 20 million hernias are estimated to be repaired every year around the world.4 Numerous repair techniques have been described to date however tension-free mesh repairs are widely used today because of their low hernia recurrence rates. Nevertheless, there are some ongoing debates regarding the ideal approach (open or laparoscopic),5,6 the ideal anesthesia (general, local, or regional),7,8 and the ideal mesh (standard polypropylene or newer meshes).9,10 PMID:25216417

  9. Clinical observation of laparoscopic treatment used in autologous tissue repair for curing children's indirect inguinal hernia (190case reports attached)%腹腔镜小儿疝自体组织修补术的临床观察(附190例报告)

    Institute of Scientific and Technical Information of China (English)

    曹宪洲

    2010-01-01

    Objective Study the clinical value of using laparoscopic treatment in the autologous tissue repair for curing children's indirect inguinal hernia. Method Review and analyze 190 children's indirect inguinal hernia cases cured by using laparoscopic high ligation of hernia sac and autologous tissue repair in the past 5 years. Out of them, 153 cases are unilateral indirect hernia and 37 cases bilateral indirect hernia.183 cases (including 11 recurrent hernia cases) are normal cases of oblique hernia and 7 are urgency cases of incarcerated oblique hernia. Results All 190 cases have successful operations. The average operation time for unilateral indirect hernia is 10 minutes.Forbilateralindirect hernia,it is 18 minutes.The average time of stay in hospital is 1 day and there is no complication occurred after operation. Follow-up visits have been carried out for all cases. The duration ranges from 6 months to 5 years and there are five recurrent cases.Conclusion It is effective to use laparoscopic treatment in the autologous tissue repair for curing children's indirect inguinal hernia. It has many advantages, such as short operation time, few operative damages and complications, low recurrence rate and quick recovery. The treatment can be applied to contra-lateral oblique inguinal hernia or bilateral inguinal hernia repairs.%目的 探讨腹腔镜自体组织修补术治疗小儿腹股沟斜疝的临床应用价值.方法 回顾分析近5年行腹腔镜疝囊高位结扎术加自体组织修补术治疗190例小儿腹股沟斜疝的临床资料,单侧斜疝153例,双侧斜疝(包括对侧隐性疝)37例;其中平诊斜疝183例(包括复发疝11例),急诊嵌顿性斜疝7例.结果 190例均手术成功.平均手术时间单侧10 min,双侧18 min,术后平均住院为1 d,无术后并发症发生.全组病例术后均获得随访,随访时间为6个月~5年,复发5例.结论 腹腔镜自体组织修补术治疗小儿腹股沟斜疝疗效满意,手术时间短,创伤小,

  10. Developments in inguinal hernia repair

    NARCIS (Netherlands)

    Voorbrood, C.E.H.

    2016-01-01

    Performing inguinal hernia surgery in a high volume clinic allows for gaining expertise and achieving considerable experience and knowledge. This results in the recognition of benefits of tailored treatment, selection of patients, and structured aftercare rendering improvement of patients' outcome a

  11. Developments in inguinal hernia repair

    NARCIS (Netherlands)

    Voorbrood, C E H

    2016-01-01

    Performing inguinal hernia surgery in a high volume clinic allows for gaining expertise and achieving considerable experience and knowledge. This results in the recognition of benefits of tailored treatment, selection of patients, and structured aftercare rendering improvement of patients´ outcome a

  12. Laparoscopic surgery for treatment of incisional lumbar hernia

    Directory of Open Access Journals (Sweden)

    M. Tobias-Machado

    2005-08-01

    Full Text Available OBJECTIVE: To present results obtained with laparoscopic correction of incisional lumbar hernia in patients with minimum follow-up of 1 year. MATERIALS AND METHODS: We prospectively studied 7 patients diagnosed with incisional lumbar hernia after physical examination and computerized tomography. We used laparoscopic transperitoneal access through 3 ports. One polypropylene mesh was introduced in the abdominal cavity and fixed by titanium clamps to the margins of the hernia ring following release of the peritoneum. RESULTS: All cases were successfully completed with no conversion required. Mean surgical time was 120 minutes and discharge from hospital occurred between the 1st and the 2nd postoperative days. There were no intraoperative complications or hernia recurrence in any case. Postoperatively, we had 2 minor complications: one case of seroma that resolved spontaneously after 60 days and one patient presenting lumbar pain that persisted until the 3rd postoperative month. The return to usual activities occurred on average 3 weeks following intervention. Of the 7 patients, 6 were satisfied with the esthetical and functional effect produced by the procedure. CONCLUSIONS: The surgical correction of incisional lumbar hernia by laparoscopic access is an excellent option for a minimally invasive treatment, with adequate long-term results.

  13. Treatment of a giant inguinal hernia using transabdominal pre-peritoneal repair.

    Science.gov (United States)

    Momiyama, Masato; Mizutani, Fumitoshi; Yamamoto, Tatsuyoshi; Aoyama, Yoshinori; Hasegawa, Hiroshi; Yamamoto, Hideo

    2016-09-25

    We present the case of a male Japanese patient with a giant inguinal hernia that extended to his knees while standing. A transabdominal pre-peritoneal (TAPP) repair was performed under general anesthesia. Complete reduction of the contents of the hernia was achieved within 2 h 50 min. A blood loss of approximately 700 ml was noted. The patient was discharged from the hospital on post-operative Day 12, with no recurrence of the hernia 6 months post-surgery. Factors contributing to the successful outcomes included preparation of several reduction methods before surgery, use of a large size mesh and implementation of pre-operative measures to prevent abdominal compartment syndrome. Further studies are required to evaluate the feasibility of laparoscopic repair in the management of giant inguinal hernia.

  14. Treatment of a giant inguinal hernia using transabdominal pre-peritoneal repair

    Science.gov (United States)

    Momiyama, Masato; Mizutani, Fumitoshi; Yamamoto, Tatsuyoshi; Aoyama, Yoshinori; Hasegawa, Hiroshi; Yamamoto, Hideo

    2016-01-01

    We present the case of a male Japanese patient with a giant inguinal hernia that extended to his knees while standing. A transabdominal pre-peritoneal (TAPP) repair was performed under general anesthesia. Complete reduction of the contents of the hernia was achieved within 2 h 50 min. A blood loss of approximately 700 ml was noted. The patient was discharged from the hospital on post-operative Day 12, with no recurrence of the hernia 6 months post-surgery. Factors contributing to the successful outcomes included preparation of several reduction methods before surgery, use of a large size mesh and implementation of pre-operative measures to prevent abdominal compartment syndrome. Further studies are required to evaluate the feasibility of laparoscopic repair in the management of giant inguinal hernia. PMID:27672103

  15. Incisional hernias after open versus laparoscopic surgery for colonic cancer

    DEFF Research Database (Denmark)

    Jensen, Kristian K.; Krarup, Peter-Martin; Scheike, Thomas;

    2016-01-01

    BACKGROUND: Laparoscopic surgery for colonic cancer decreases the incidence of postoperative complications and length of hospital stay as compared with open surgery, while the oncologic outcome remains equivalent. It is unknown whether the surgical approach impacts on the long-term rate of incisi......BACKGROUND: Laparoscopic surgery for colonic cancer decreases the incidence of postoperative complications and length of hospital stay as compared with open surgery, while the oncologic outcome remains equivalent. It is unknown whether the surgical approach impacts on the long-term rate...... of incisional hernia. Furthermore, risk factors for incisional hernia formation are not fully elucidated. The aim of this study was to evaluate the long-term effect of elective open versus laparoscopic surgery for colonic cancer on development of incisional hernia. METHODS: This nationwide cohort study included...... were performed. RESULTS: A total of 8489 patients were included, with a median follow-up of 8.8 (interquartile range 7.0-10.7) years. The incidence of incisional hernia was increased among patients operated on with open techniques compared with patients undergoing laparoscopic surgery (7.3 vs. 5.2 %, p...

  16. A STUDY OF POSTOPERATIVE COMPLICATIONS FOLLOWING OPEN MESH INGUINAL HERNIA REPAIR

    Directory of Open Access Journals (Sweden)

    Abdul Kalam

    2016-09-01

    amounted to eleven cases, seroma was seen in seven cases, in six cases scrotal swelling was seen, two cases developed keloid at the scar site, wound dehiscence, infection, bleeding from site amounted to one case each. CONCLUSION Open mesh repair for inguinal hernia is a safe method of operation. Newer laparoscopic mesh repairs are on the rise, but they need expertise and there is a learning curve.

  17. Combined paraesophageal hernia repair and partial longitudinal gastrectomy in obese patients with symptomatic paraesophageal hernias.

    Science.gov (United States)

    Rodriguez, John H; Kroh, Matthew; El-Hayek, Kevin; Timratana, Poochong; Chand, Bipan

    2012-12-01

    Obesity is a risk factor for gastroesophageal reflux disease and hiatal hernia. Studies have demonstrated poor symptom control in obese patients undergoing fundoplication. The ideal operation remains elusive. However, addressing both obesity and the anatomic abnormality should be the goal. This study retrospectively identified 19 obese (body mass index [BMI], >30 kg/m(2)) and morbidly obese (BMI, >40 kg/m(2)) patients who presented between December 2007 and November 2011 for management of large or recurrent paraesophageal hernia. All the patients underwent a combined primary paraesophageal hernia repair and longitudinal gastrectomy. Charts were retrospectively reviewed to collect preoperative, operative, and short-term postoperative results. Quantitative data were analyzed using Student's t test and qualitative data with χ(2) testing. Laparoscopy was successful for all 19 patients. The mean preoperative BMI was 37.8 ± 4.1 kg/m(2), and the mean operative time was 236 ± 80 min. Preoperative endoscopy showed that 5 patients who had undergone prior fundoplication experienced anatomic failures, whereas the remaining 14 patients had type 3 and one type 4 paraesophageal Hernia. Mesh was used to reinforce the hiatus in 15 of the 19 cases. The postoperative complications included pulmonary embolism (n = 1) and pulmonary decompensation (n = 2) due to underlying chronic obstructive pulmonary disease. The mean hospital stay was 5.3 ± 3 days. Upper gastrointestinal esophagography was performed for all the patients, with no short-term recurrence of paraesophageal hernia. Weight loss was seen for all the patients during the first month, with a mean BMI drop of 2.7 ± 1 kg/m(2). All the patients experienced near to total resolution of their preoperative symptoms within the first month. Combined laparoscopic paraesophageal hernia repair and longitudinal gastrectomy offer a safe and feasible approach for the management of large or recurrent paraesophageal

  18. Incidental non-inguinals hernias in totally extra-peritoneal hernia repair.

    Science.gov (United States)

    Old, O J; Kulkarni, S R; Hardy, T J; Slim, F J; Emerson, L G; Bulbulia, R A; Whyman, M R; Poskitt, K R

    2015-03-01

    Totally extra-peritoneal (TEP) inguinal hernia repair allows identification and repair of incidental non-inguinal groin hernias. We assessed the prevalence of incidental hernias during TEP inguinal hernia repair and identified the risk factors for incidental hernias. Consecutive patients undergoing TEP repair from May 2005 to November 2012 were the study cohort. Inspection for ipsilateral femoral, obturator and rarer varieties of hernia was undertaken during TEP repair. Patient characteristics and operative findings were recorded on a prospectively collected database. A total of 1,532 TEP repairs were undertaken in 1,196 patients. Ninety-three patients were excluded due to incomplete data, leaving 1,103 patients and 1,404 hernias for analyses (1,380 male; 802 unilateral and 301 bilateral repairs; median age, 59 years). Among the 37 incidental hernias identified (2.6% of cases), the most common type of incidental hernia was femoral (n=32, 2.3%) followed by obturator (n=2, 0.1%). Increasing age was associated with an increased risk of incidental hernia, with a significant linear trend (p60 years of age was 4.0% vs 1.4% for those aged hernias were found in 29.2% of females vs 2.2% of males, (phernia in those with a recurrent inguinal hernia was 3.0% vs 2.6% for primary repair (p=0.79). Incidental hernias during TEP inguinal hernia repair were found in 2.6% of cases and, though infrequent, could cause complications if left untreated. The risk of incidental hernia increased with age and was significantly higher in patients aged >60 years and in females.

  19. Full incorporation of Strattice™ Reconstructive Tissue Matrix in a reinforced hiatal hernia repair: a case report

    Directory of Open Access Journals (Sweden)

    Freedman Bruce E

    2012-08-01

    Full Text Available Abstract Introduction A non-cross-linked porcine acellular dermal matrix was used to reinforce an esophageal hiatal hernia repair. A second surgery was required 11 months later to repair a slipped Nissen; this allowed for examination of the hiatal hernia repair and showed the graft to be well vascularized and fully incorporated. Case presentation A 71-year-old Caucasian woman presented with substernal burning and significant dysphagia. An upper gastrointestinal series revealed a type III complex paraesophageal hiatal hernia. She underwent laparoscopic surgery to repair a hiatal hernia that was reinforced with a xenograft (Strattice™ Reconstructive Tissue Matrix, LifeCell, Branchburg, NJ, USA along with a Nissen fundoplication. A second surgery was required to repair a slipped Nissen; this allowed for examination of the hiatal repair and graft incorporation 11 months after the initial surgery. Conclusion In this case, a porcine acellular dermal matrix was an effective tool to reinforce the crural hiatal hernia repair. The placement of the mesh and method of fixation are believed to be crucial to the success of the graft. It was found to be well vascularized 11 months after the original placement with no signs of erosion, stricture, or infection. Further studies and long-term follow-up are required to support the findings of this case report.

  20. Hiatal Hernia Repair with Gore Bio-A Tissue Reinforcement: Our Experience

    Directory of Open Access Journals (Sweden)

    Agrusa Antonino

    2014-01-01

    Full Text Available Type I hiatal hernia is associated with gastroesophageal reflux disease (GERD in 50–90% of cases. Several trials strongly support surgery as an effective alternative to medical therapy. Today, laparoscopic fundoplication is considered as the procedure of choice. However, primary laparoscopic hiatal hernia repair is associated with upto 42% recurrence rate. Mesh reinforcement of the crural closure decreases the recurrence but can lead to complications, above all nonabsorbable ones. We experiment a new totally absorbable mesh by Gore. Case. We present a case of a 65-year-old female patient with a 6-year classic history of GERD. Endoscopy revealed a large hiatal hernia and esophagitis. pH study was positive for acid reflux; esophageal manometry revealed LES intrathoracic dislocation. With laparoscopic approach, the hiatal hernia defect was identified and primarily repaired, by crural closure. Gore Bio-A Tissue Reinforcement was trimmed to fit the defect accommodating the esophagus. Nissen fundoplication was performed. Result. Bio-A mesh was easily placed laparoscopically. It has good handling and could be cut and tailored intraoperatively for optimal adaptation. There were no short-term complications. Conclusion. Crural closure reinforcement can be done readily with this new totally absorbable mesh replaced by soft tissue over six months. However, further data and studies are needed to evaluate long-term outcomes.

  1. Total Extraperitoneal Hernia Repair: Residency Teaching Program and Outcome Evaluation.

    Science.gov (United States)

    Garofalo, Fabio; Mota-Moya, Pau; Munday, Andrew; Romy, Sébastien

    2017-01-01

    Total extraperitoneal (TEP) hernia repair has been shown to offer less pain, shorter postoperative hospital stay and earlier return to work when compared to open surgery. Our institution routinely performs TEP procedures for patients with primary or recurrent inguinal hernias. The aim of this study was to show that supervised senior residents can safely perform TEP repairs in a teaching setting. All consecutive patients treated for inguinal hernias by laparoscopic approach from October 2008 to June 2012 were retrospectively analyzed from a prospective database. A total of 219 TEP repairs were performed on 171 patients: 123 unilateral and 48 bilateral. The mean patient age was 51.6 years with a standard deviation (SD) of ± 15.9. Supervised senior residents performed 171 (78 %) and staff surgeons 48 (22 %) TEP repairs, respectively. Thirty-day morbidity included cases of inguinal paresthesias (0.4 %, n = 1), umbilical hematomas (0.9 %, n = 2), superficial wound infections (0.9 %, n = 2), scrotal hematomas (2.7 %, n = 6), postoperative urinary retentions (2.7 %, n = 6), chronic pain syndromes (5 %, n = 11) and postoperative seromas (6.7 %, n = 14). Overall, complication rates were 18.7 % for staff surgeons and 19.3 % for residents (p = 0.83). For staff surgeons and residents, mean operative times for unilateral hernia repairs were 65 min (SD ± 18.9) and 77.6 min (SD ± 29.8) (p = 0.043), respectively, while mean operative times for bilateral repairs were 115 min (SD ± 40.1) and 103.6 (SD ± 25.9) (p = 0.05). TEP repair is a safe procedure when performed by supervised senior surgical trainees. Teaching of TEP should be routinely included in general surgery residency programs.

  2. 腹腔镜手术治疗1岁以内婴儿食管裂孔疝%Laparoscopic repair of esophageal hiatal hernia in infants Less than one year old.

    Institute of Scientific and Technical Information of China (English)

    胡明; 严志龙; 蔡金晶

    2012-01-01

    目的 探讨腹腔镜手术治疗1岁以内婴儿先天性食管裂孔疝的疗效及预后.方法 1999年3月 至2011年7月作者对19例先天性食管裂孔疝患儿实施腹腔镜下胃底折叠术.患儿平均年龄0 52岁,其中0~30 d 3例,31 d至1岁16例.对患儿术前及术后 3个月、6个月、12个月进行评估,以"呕吐、恶心","呼吸道感染"和"营养情况"做视觉模拟评分(VAS),以及食管钡餐造影(GI)和24 h食管PH值监测,并对比结果.结果 均采用腹腔镜食管裂孔疝修补术及胃底折叠术,其中Nissen-Rosetti's术8例,改良Thal术11例,无中转开腹病例.平均手术时间120(90~170)min,平均住院时间9.25(5~12)d.术后随访伴呕吐及胃食管反流2例,吞咽困难1例,复发1例.食管裂孔疝引起的综合症状 VAS评分术前为5.84±1.54,术后 1、6、12个月分别为1.74±1.85、1.22±1.78、0 61±1 79,手术前后比较,差异均有统计学意义 (P<0 01).结论 采用腹腔镜胃底折叠术治疗婴儿严重胃食管反流的先天性食管裂孔疝,疗效好,恢复快,微创美观、安全可靠.%Objective To investigate the efficacy and outcome of laparoscopic repair for esophageal hiatal hernia in infant Less than one year old. Method Retrospectively analyzed for 19 infants with esophageal hiatal hernia underwent laparoscopic hiatal hernia repair between March 1999 and July 2011 in our hospital. The mean age was 0. 515 years old. (3 cases less than 30 days, 16 cases from 31 days to 1 year old) . Symptoms of gastroesophageal reflux disease, including " Vomit and nausea " , " Respiratory tract infection " , " Nutritional status " were evaluated by using visual analogue scales(VAS) preoperatively,and 3,6 and 12 months postoperatively. Results Laparoscopic fundoplication procedure ( 8 cases by Nissen - Rosetti' s fundoplication ,11 cases by modified Thai' s fundoplication) was completed in all the patients. There was no conversion to open surgery. The average operating time was

  3. Effects of different combined anesthesia to laparoscopic inguinal hernia repair%不同复合麻醉方式在腹股沟疝腹腔镜修补术中的影响

    Institute of Scientific and Technical Information of China (English)

    李双宝

    2014-01-01

    Objective To compare the effects of different combined anesthesia to laparoscopic inguinal hernia repair.Methods Between May 201 0 and December 201 3,a retrospective analysis was performed in 1 1 2 cases of inguinal hernia who were admitted to Yutian Family Planning Center Hospital.All patients were divided into two groups with equal amount (56 cases in each group ) based on different anesthetic methods:intravenous-inhalation combined anesthesia in Group A and combined spinal-epidural anesthesia in Group B. The anesthesia effect, onset time, duration, postoperative duration, and complications were compared between two groups.Results Good anesthesia rate was 94.6% in Group A, and 96.4% in Group B,this difference was statistically significant(χ2 =19.13,P=0.02).There was significant difference in anesthesia onset time between Group A and Group B (9.0 ±1 .2 minutes vs.6.3 ± 1 .6 minutes,t=1 5.01 ,P=0.001 ).The adverse effects of anesthesia occurred more frequently in Group A than Group B (1 0.7% vs.8.9%,χ2 =0.32,P =0.002 ).Conclusion Both intravenous-inhalation combined anesthesia and combined spinal-epidural anesthesiacan play a good effect in laparoscopic inguinal hernia repair.We promote the use of combined spinal-epidural anesthesia popularized,as it shows a shorter onset time of anesthesia and less complications.%目的:比较不同复合麻醉方式对腹腔镜手术效果的影响。方法回顾性分析2010年5月至2013年12月,唐山市玉田县计生中心医院收治的腹股沟疝患者112例,随机分为二组,每组各56例,A组采用静吸复合全身麻醉,B组采用腰硬联合麻醉,比较二组患者的麻醉效果、麻醉起效时间、麻醉持续时间、术毕持续时间、并发症发生情况。结果 A组的麻醉优良率为94.6%,B组为96.4%,二组之间比较差异有统计学意义(χ2=19.13,P=0.02)。A组麻醉起效时间(9.0±1.2)min, B组麻醉起效时间(6.3±1.6)min

  4. Laparoscopic repair for giant hiatal hernia:A clinical analysis of 75 patients%腹腔镜巨大食管裂孔疝修补术75例临床分析

    Institute of Scientific and Technical Information of China (English)

    孙向宇; 秦鸣放; 赵宏志; 王庆; 勾承月; 李宁

    2014-01-01

    Objective To investigate the safety and effectiveness of laparoscopic repair for giant hiatal hernia. Methods The clinical data of 75 patients with giant hiatal hernia performed laparoscopic repair between January 2006 and August 2012 in Tianjin Nankai Hospital were analyzed retrospectively. The operation time, hospitalization time, intraoperative and postoperative complications, postoperative improvement of symptoms and upper gastrointestinal imaging were studied. Results All the patients were treated by laparoscopy successfully. Fifty-one patients were reinforced with meshes. Twenty-four patients were reinforced without mesh. Hiatal pillars in 40 patients were partly contracted and closed with meshes. Hiatal pillars in 35 patients were directly closed up to normal diameter by interrupted stitches. Among them, 11 patients were placed with meshes. Laparoscopic repair complicated with fundoplication was performed in 64 patients with average operation time of (97.2±2.1)min, average operative blood loss of (82.0±1.7)mL and average hospital stay of (5.0±1.2)d. No conversion and death occurred. Seventeen patients (22.7%) had short-term or long-term complications. Seventy-five patients were followed up for 3 months to 62 months with average of (31.0 ± 2.1)months. Main symptoms of 66 patients (88%) were disappeared. Nine patients (12%)had recurrence of symptoms. Four patients(5.3%)were found recurrence by barium swallow. Conclusion Laparoscopic repair for giant hiatal hernia is safe and reliable. Mesh repair can reduce the recurrence rate but accompanied with risk of complication.%目的:探讨腹腔镜治疗巨大食管裂孔疝手术安全性及有效性。方法回顾性分析2006年1月至2012年8月天津市南开医院微创外科采用腹腔镜治疗75例巨大食管裂孔疝病人的病例资料。观察手术时间、住院时间、术中及术后并发症、术后主观症状和客观检查随访结果。结果75例成功行腹腔镜巨

  5. Outcomes After Emergency Versus Elective Ventral Hernia Repair

    DEFF Research Database (Denmark)

    Helgstrand, Frederik; Rosenberg, Jacob; Kehlet, Henrik;

    2013-01-01

    BACKGROUND: Early surgical results after emergency repairs for the most frequent ventral hernias (epigastric, umbilical, and incisional) are not well described. Thus, the aim of present study was to investigate early results and risk factors for poor 30-day outcome after emergency versus elective...... repair for ventral hernias. METHODS: All patients undergoing epigastric, umbilical, or incisional hernia repair registered in the Danish Hernia Database during the period 1 January 2007 to 31 December 2010 were included in the prospective study. Follow-up was obtained through administrative data from...... significantly more patients with concomitant bowel resection after emergency repairs than after elective repairs (p 2-7 cm, and repair for a primary hernia (vs recurrent hernia) (all p ...

  6. Spinal versus general anesthesia for transabdominal preperitoneal (TAPP) repair of inguinal hernia: Interim analysis of a controlled randomized trial.

    Science.gov (United States)

    Sarakatsianou, Chamaidi; Georgopoulou, Stavroula; Baloyiannis, Ioannis; Chatzimichail, Maria; Vretzakis, George; Zacharoulis, Dimitris; Tzovaras, George

    2017-08-01

    General anesthesia has been used as standard for laparoscopic hernia repair by the transabdominal preperitoneal (TAPP) approach. Regional anesthesia has been occasionally applied in high risk patients where general anesthesia is contraindicated. This randomized clinical trial compares spinal anesthesia with general anesthesia for TAPP inguinal hernia repair in non-high risk patients. Seventy adult American Society of Anesthesiologists I, II and III patients undergoing elective TAPP inguinal hernia repair were randomized to either general or spinal anesthesia. Postoperative morphine consumption was significantly less immediately postoperatively (p spinal anesthesia group. Postoperative pain was also significantly decreased within the first 8 h postoperatively (p spinal anesthesia group. Spinal anesthesia offers some advantages in patient analgesia during the early postoperative period after TAPP inguinal hernia repair and can be proposed as an effective alternative method of anesthesia for TAPP repair. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Occult hernias and bilateral endoscopic total extraperitoneal inguinal hernia repair: is there a need for prophylactic repair? : Results of endoscopic extraperitoneal repair over a period of 10 years.

    Science.gov (United States)

    Saggar, V R; Sarangi, R

    2007-02-01

    An advantage of the endoscopic total extraperitoneal approach over the conventional hernia repair is detection of an unsuspected, asymptomatic hernia on the contralateral side. A high incidence of occult contralateral hernias has been reported in the literature. However, few studies have examined the incidence of development of a hernia on the healthy side evaluated previously during an endoscopic unilateral hernia repair. This study aims to evaluate the incidence of development of a contralateral hernia after a previous bilateral exploration. The need for a prophylactic contralateral repair is also addressed. We retrospectively reviewed the results of 822 endoscopic total extraperitoneal inguinal hernia repairs done in 634 patients over a period of 10 years from May 1993 to 2003. Incidence of hernia undetected clinically and during previous contralateral repair was assessed over a follow up period ranging from 10 to 82 months. About 7.97% of bilateral hernias were clinically occult hernias. Only 1.12% of unilateral hernia repairs (who had undergone a contralateral evaluation at surgery) subsequently developed a hernia on the other side. The endoscopic approach to inguinal hernia repair is an excellent tool to detect and treat occult contralateral hernias. The incidence of hernia occurring at the contralateral side after a previous bilateral exploration is low, hence a prophylactic repair on the contralateral side is not recommended on a routine basis.

  8. Endoscopic totally extraperitoneal repair of bilateral inguinal hernias

    NARCIS (Netherlands)

    M.T.T. Knock (M. T T); W.F. Weidema (Wibo); L.P. Stassen (Laurents); R.U. Boelhouwer (Roelof Ubbo); C.J. van Steensel (C.)

    1999-01-01

    textabstractBackground: Recurrence rates associated with bilateral inguinal hernia repair with a giant prosthesis (Stoppa procedure) are low. Endoscopic totally extraperitoneal bilateral inguinal hernia repair with a giant prosthesis combines the low recurrence rate of the Stoppa repair and the adva

  9. Chronic Pain after Inguinal Hernia Repair

    OpenAIRE

    2014-01-01

    Background. Chronic postherniorrhaphy groin pain is defined as pain lasting >6 months after surgery, which is one of the most important complications occurring after inguinal hernia repair, which occurs with greater frequency than previously thought. Material and Methods. Patients undergoing elective inguinal hernioplasty in Victoria Hospital from November 2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for followup at end of ...

  10. Chronic Pain after Inguinal Hernia Repair.

    Science.gov (United States)

    Manangi, Mallikarjuna; Shivashankar, Santhosh; Vijayakumar, Abhishek

    2014-01-01

    Background. Chronic postherniorrhaphy groin pain is defined as pain lasting >6 months after surgery, which is one of the most important complications occurring after inguinal hernia repair, which occurs with greater frequency than previously thought. Material and Methods. Patients undergoing elective inguinal hernioplasty in Victoria Hospital from November 2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for followup at end of six months. Detailed preoperative, intraoperative, and postoperative details of cases were recorded according to proforma. The postoperative pain and pain at days two and seven and at end of six months were recorded on a VAS scale. Results. Chronic pain at six-month followup was present in 89 patients constituting 39.4% of all patients undergoing hernia repair. It was seen that 26.9% without preoperative pain developed chronic pain whereas 76.7% of patients with preoperative pain developed chronic pain. Preemptive analgesia failed to show statistical significance in development of chronic pain (P = 0.079). Nerve injury was present in 22 of cases; it was found that nerve injury significantly affected development of chronic pain (P = 0.001). On multivariate analysis, it was found that development of chronic pain following hernia surgery was dependent upon factors like preoperative pain, type of anesthesia, nerve injury, postoperative local infiltration, postoperative complication, and most importantly the early postoperative pain. Conclusions. In the present study, we found that chronic pain following inguinal hernia repair causes significant morbidity to patients and should not be ignored. Preemptive analgesia and operation under local anesthesia significantly affect pain. Intraoperative identification and preservation of all inguinal nerves are very important. Early diagnosis and management of chronic pain can remove suffering of the patient.

  11. Free airbags, free fixed completely peritoneal laparoscopic inguinal hernia repair clinical research%免气囊、免固定完全腹膜外腹腔镜腹股沟疝修补术的临床研究

    Institute of Scientific and Technical Information of China (English)

    白庆阳; 万智恒; 侴丽鸿; 李瑞斌

    2013-01-01

    目的 探讨免气囊、免固定完全腹膜外腹腔镜腹股沟疝修补术(TEP)治疗腹股沟疝开展的可行性及适用性.方法 选择2010年1月-2012年12月在包头医学院第一附属医院普外科确诊并手术的40例腹股沟疝患者作为观察对象,根据手术方法的不同,分为TEP组和开放手术组,观察统计二者的术后疼痛程度、胃肠功能恢复时间、术后离床活动时间、住院天数、术后并发症发病率、住院费用等指标.结果 TEP组手术时间较开放组长,相差近20 min,差异有统计学意义(P<0.05);但TEP组与开放组相比,患者术后疼痛程度轻、术后进食时间早、术后离床活动时间早、术后排气时间早、住院天数短、术后并发症发病率低;二者住院费用相比较,差异无统计学意义(P>0.05).结论 与传统开放手术相比,用TEP治疗腹股沟疝有较大优势,在临床可适度开展.%Objective To investigate the feasibility and applicability of free airbags,free fixed totally extraperitoneal laparoscopic inguinal hernia repair (TEP) treatment of inguinal hernia.Methods In Baotou Medical College,Department of General Surgery,the First Affiliated Hospital,the 40 cases of patients confirmed with inguinal hernia surgery were choosed from Jan.2010 to Dec.2012 as the observed object,depending on the surgical methods.Divided the cases into the TEP group and the open surgery group to observe statistics including postoperative pain,extent of gastrointestinal function recovery time,the time of bedside movement,the number of days of hospitalization,the incidence of postoperative complications,hospital fees indicators.Results The operation time of TEP group was about 20 minutes longer than the open group and the difference was statistically significant (P < 0.05).Compared with the open group,TEP group' s postoperative pain was milder,postoperative feeding time,the time of bedside movement and postoperative exhaust time were earlier

  12. GAINT INGUINOSCROTAL HERNIA – LICHTENSTEIN’S TENSION FREE REPAIR WITHOUT LOSS OF DOMAIN: CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sreekant

    2015-03-01

    Full Text Available Inguinal hernia is one of the most surgical common diseases in clinical practice. The history of inguinal hernia repair originated in the ancient times and the treatment has evolved, developed and changed since. [1] The most recent one is the concept of tension - free repair which remains popular among surgeons today. It is interesting to note, though, that numerous literatures have been published on this disease in the small anatomical space despite its simplicity. In the past couple of years, most publications focused on laparoscopic surgery and the different types of prosthetic mesh. Giant inguinal hernia, however, is more unusual and significantly challenging in terms of surgical management. It is defined as an ingu inal hernia that extends below the midpoint of inner thigh when the patient is in standing position. [2] No treatment has been adopted as standard procedure for this uncommon disease and several repair techniques are suggested by published articles and case reports. Further, the absence of large scale comparative study is expected to continue due to the relatively low number of cases. As a result, choosing a surgical procedure is made difficult and the decision must be made intraoperatively. A 55 - year - old ma le patient presented with Left Giant inguinal hernia and compromised quality of life due to pain and sexual discomfort. Lichtenstein’s polypropylene mesh repair was done after reducing the sac contents (omentum and ileum with partial omentectomy. There wa s no loss of intra - abdominal domain. Postoperative period was uneventful. In literature many techniques are available to increase the intra - abdominal cavity (a Creating progressive preoperative pneumoperitoneum (b Creation of ventral wall defect (c surg ical debulking of hernia contents. Recurrence is prevented by reconstruction of the abdominal wall using Marlex mesh and a Tensor fasciae lata flap. Laparoscopic repair is associated with more recurrence

  13. The vermiform appendix presenting in a laparoscopic port site hernia

    Directory of Open Access Journals (Sweden)

    Rafiq Latyf

    2011-01-01

    Full Text Available Laparoscopic port site hernias (PSHs are uncommon but present a potential source of morbidity due to incarceration of the hernial contents which is usually omental fat or small bowel. We report only the third case of the vermiform appendix presenting in a symptomatic PSH; we discuss the appropriate management of this condition as well as ways in which the incidence of PSHs may be reduced.

  14. REAPPRAISAL OF DARNING METHOD OF INGUINAL HERNIA REPAIR

    OpenAIRE

    2014-01-01

    OBJECTIVE: To evaluate the darning method of inguinal hernia repair with polypropylene. MATERIAL AND METHODS: 125 Patient of unilateral or bilaterally inguinal hernia were admitted. After thorough investigations, all patients were operated for hernia repair by standard procedure using no-1 polypropylene. Patients were operated under spinal, general anesthesia or local anesthesia. Patients were followed up at one week, four weeks and six months after operation for wound hea...

  15. Tumescent local anesthetic technique for inguinal hernia repairs

    OpenAIRE

    2014-01-01

    Purpose We evaluated the adequacy and feasibility of a tumescent solution containing lidocaine and bupivacaine for inguinal hernia repairs. Methods The medical records of 146 consecutive inguinal hernia patients with 157 hernia repairs using the tumescent local anesthesia technique performed by a single surgeon between September 2009 and December 2013 were retrospectively reviewed. Results The mean operation time (±standard deviation) and hospital stay were 64.5 ± 17.6 minutes and 2.7 ± 1.5 d...

  16. Vitello-intestinal duct injury after transabdominal preperitoneal inguinal hernia repair.

    Science.gov (United States)

    Albeyatti, Amina; Hussain, Abdulzahra; El-Hasani, Shamsi

    2013-02-01

    A 71-year-old patient underwent a transabdominal preperitoneal right inguinal hernia repair and presented to the emergency department 48 hours postoperatively with nonspecific abdominal and chest pain and was diagnosed an abdominal abscess at the umbilicus by computed tomography. Laparotomy showed a vitello-intestinal duct injury caused by the umbilical trocar at his previous laparoscopic surgery. We will discuss this rare complication and how to avoid it in future practice.

  17. Nerve-identifying inguinal hernia repair : A surgical anatomical study

    NARCIS (Netherlands)

    Wijsmuller, A. R.; Lange, J. F. M.; Kleinrensink, G. J.; van Geldere, D.; Simons, M. P.; Huygen, F. J. P. M.; Jeekel, J.; Lange, J. F.

    2007-01-01

    Background: Pain syndromes of somatic and neuropathic origin are considered to be the main causes of chronic pain after open inguinal hernia repair. Nerve-identification during open hernia repair is suggested to be associated with less postoperative chronic pain. The aim of this study was to define

  18. Reoperation versus clinical recurrence rate after ventral hernia repair

    DEFF Research Database (Denmark)

    Helgstrand, Frederik; Rosenberg, Jacob; Kehlet, Henrik

    2012-01-01

    OBJECTIVE:: To compare the clinical recurrence rate with reoperation rate for recurrence after ventral hernia repair. BACKGROUND:: Reoperation is often used as an outcome measure after ventral hernia repair, but it is unknown whether reoperation rate reflects the overall clinical risk for recurre...

  19. Laparoscopic total extraperitoneal repair under spinal anesthesia versus general anesthesia: a randomized prospective study

    Science.gov (United States)

    Donmez, Turgut; Erdem, Vuslat Muslu; Sunamak, Oguzhan; Erdem, Duygu Ayfer; Avaroglu, Huseyin Imam

    2016-01-01

    Background Laparoscopic total extraperitoneal (TEP) inguinal hernia repair is a well-known approach to inguinal hernia repair that is usually performed under general anesthesia (GA). To date, no reports compare the efficacy of spinal anesthesia (SA) with that of GA for laparoscopic hernia repairs. The purpose of this study was to compare the surgical outcome of TEP inguinal hernia repair performed when the patient was treated under SA with that performed under GA. Materials and methods Between July 2015 and July 2016, 50 patients were prospectively randomized to either the GA TEP group (Group I) or the SA TEP group (Group II). Propofol, fentanyl, rocuronium, sevoflurane, and tracheal intubation were used for GA. Hyperbaric bupivacaine (15 mg) and fentanyl (10 µg) were used for SA to achieve a sensorial level of T3. Intraoperative events related to SA, operative and anesthesia times, postoperative complications, and pain scores were recorded. Each patient was asked to evaluate the anesthetic technique by using a direct questionnaire filled in 3 months after the operation. Results All the procedures were completed by the allocated method of anesthesia as there were no conversions from SA to GA. Pain was significantly less for 1 h (Pinguinal hernia repair can be safely performed under SA, and SA was associated with less postoperative pain, better recovery, and better patient satisfaction than GA. PMID:27822053

  20. Laparoscopic repair of vesicovaginal fistula

    Directory of Open Access Journals (Sweden)

    Miłosz Wilczyński

    2011-06-01

    Full Text Available A vesicovaginal fistula is one of the complications that a gynaecologist is bound to face after oncological operations, especially in postmenopausal women. Over the years there have been introduced many techniques of surgical treatment of this entity, including transabdominal and transvaginal approaches.We present a case of a 46-year-old patient who suffered from urinary leakage via the vagina due to the presence of a vesicovaginal fistula that developed after radical abdominal hysterectomy and subsequent radiotherapy. The decision was made to repair it laparoscopically due to retracted, fibrous and scarred tissue in the vaginal apex that precluded a transvaginal approach. A small cystotomy followed by an excision of fistula borders was performed. After six-month follow-up no recurrence of the disease has been noted.We conclude that laparoscopy is an interesting alternative to traditional approaches that provides comparable results.

  1. Current options in local anesthesia for groin hernia repairs.

    Science.gov (United States)

    Kulacoglu, Hakan; Alptekin, Alp

    2011-01-01

    Inguinal hernia repair is one of the most common procedures in general surgery. All anesthetic methods can be used in inguinal hernia repairs. Local anesthesia for groin hernia repair had been introduced at the very beginning of the last century, and gained popularity following the success reports from the Shouldice Hospital, and the Lichtenstein Hernia Institute. Today, local anesthesia is routinely used in specialized hernia clinics, whereas its use is still not a common practice in general hospitals, in spite of its proven advantages and recommendations by current hernia repair guidelines. In this review, the technical options for local anaesthesia in groin hernia repairs, commonly used local anaesthetics and their doses, potential complications related to the technique are evaluated. A comparison of local, general and regional anesthesia methods is also presented. Local anaesthesia technique has a short learning curve requiring simple training. It is easy to learn and apply, and its use is in open anterior repairs a nice way for health care economics. Local anesthesia has been shown to have certain advantages over general and regional anesthesia in inguinal hernia repairs. It is more economic and requires a shorter time in the operating room and shorter stay in the institution. It causes less postoperative pain, requires less analgesic consumption; avoids nausea, vomiting, and urinary retention. Patients can mobilize and take oral liquids and solid foods much earlier. Most importantly, local anesthesia is the most suitable type of anesthesia in elder, fragile patients and patients with ASA II-IV scores.

  2. Randomized trial comparing the Prolene Hernia System, mesh plug repair and Lichtenstein method for open inguinal hernia repair.

    NARCIS (Netherlands)

    Nienhuijs, S.W.; Oort, I.M. van; Keemers-Gels, M.E.; Strobbe, L.J.; Rosman, C.

    2005-01-01

    BACKGROUND: Most surgeons favour the use of a mesh for open inguinal hernia repair as it has a low recurrence rate. Procedures used most frequently are the Lichtenstein method, mesh plug repair and the Prolene Hernia System. The choice of technique may be influenced by the effects on postoperative p

  3. Combined epigastric hernia repair and mini-abdominoplasty. Case report.

    Science.gov (United States)

    Grella, Roberto; Razzano, Sergio; Lamberti, Rossella; Trojaniello, Biagio; D'Andrea, Francesco; Nicoletti, Giovanni Francesco

    2015-01-01

    The objectives of abdominal hernia repair are to restore the structural integrity of the abdominal wall. Current techniques include primary closure, staged repair and the use of prosthetic materials. Techniques for mini-abdominoplasty include the use of the transverse lower abdominal incision and the resection of excess skin. We report a case of epigastric hernia repair through a transverse lower abdominal incision with the resection of excess of skin. Our purpose is to evaluate the results of the procedure by incorporating these aspects into an epigastric hernia repair, we found out that the procedures are made safer and the results are improved. Proper indication and details of the technique are described.

  4. Hiatal hernia repair with biologic mesh reinforcement reduces recurrence rate in small hiatal hernias.

    Science.gov (United States)

    Schmidt, E; Shaligram, A; Reynoso, J F; Kothari, V; Oleynikov, D

    2014-01-01

    The utility of mesh reinforcement for small hiatal hernia found especially during antireflux surgery is unknown. Initial reports for the use of biological mesh for crural reinforcement during repair for defects greater than 5 cm have been shown to decrease recurrence rates. This study compares patients with small hiatal hernias who underwent onlay biologic mesh buttress repair versus those with suture cruroplasty alone. This is a single-institution retrospective review of all patients undergoing repair of hiatal hernia measuring 1-5 cm between 2002 and 2009. The patients were evaluated based on surgical repair: one group undergoing crural reinforcement with onlay biologic mesh and other group with suture cruroplasty only. Seventy patients with hiatal hernia measuring 1-5 cm were identified. Thirty-eight patients had hernia repair with biologic mesh, and 32 patients had repair with suture cruroplasty only. Recurrence rate at 1 year was 16% (5/32) in patients who had suture cruroplasty only and 0% (0/38) in the group with crural reinforcement with absorbable mesh (statistically significant, P = 0.017). Suture cruroplasty alone appears to be inadequate for hiatal hernias measuring 1-5 cm with significant recurrence rate and failure of antireflux surgery. Crural reinforcement with absorbable mesh may reduce hiatal hernia recurrence rate in small hiatal hernias. © 2013 Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

  5. Mini-mesh repair for femoral hernia

    National Research Council Canada - National Science Library

    Kulacoglu, Hakan

    2014-01-01

    Femoral hernia consists only 4% of all primary groin hernias. It is described as "the Bête Noire of Hernias" because of its nature and anatomy which is difficult to understand for the surgeons and tendency to recurrence...

  6. Pain following the repair of an abdominal hernia

    DEFF Research Database (Denmark)

    Hansen, Mark Berner; Andersen, Kenneth Geving; Crawford, Michael Edward

    2010-01-01

    Pain and other types of discomfort are frequent symptoms following the repair of an abdominal hernia. After 1 year, the incidence of light to moderate pain following inguinal hernia repair is as high as 10% and 2% for severe disabling chronic pain. Postoperative chronic pain not only affects......, psychosocial characteristics, and surgical procedures) related to the postoperative pain conditions. Furthermore, the mechanisms for both acute and chronic pain are presented. We focus on inguinal hernia repair, which is the most frequent type of abdominal hernia surgery that leads to chronic pain. Finally...... the individual patient, but may also have a great impact on relatives and society, and may be a cause of concern for the responsible surgeon. This paper provides an overview of the anatomy, surgical procedures, and disposing factors (age, gender, ethnicity, genotype, previous hernia repair, pain prior to surgery...

  7. REAPPRAISAL OF DARNING METHOD OF INGUINAL HERNIA REPAIR

    Directory of Open Access Journals (Sweden)

    Pawan

    2014-05-01

    Full Text Available OBJECTIVE: To evaluate the darning method of inguinal hernia repair with polypropylene. MATERIAL AND METHODS: 125 Patient of unilateral or bilaterally inguinal hernia were admitted. After thorough investigations, all patients were operated for hernia repair by standard procedure using no-1 polypropylene. Patients were operated under spinal, general anesthesia or local anesthesia. Patients were followed up at one week, four weeks and six months after operation for wound healing and complications. RESULTS: Out of 125 patients, ranging in age from 18 to 85 Years, 90 patients (72% were given spinal anesthesia, 28 Patients, (22.4% were operated under general anesthesia, 7 patients under local anesthesia. Patients were discharged from the hospital after 4 days. 20 Patients were above 50 yr. who were operated under spinal anesthesia were catheterized to prevent urinary retentions. Recurrence rate was 1.6% CONCLUSION: Darning methods of inguinal hernia repair with polypropylene is a safe and cheaper method of hernia repair

  8. Acceptable nationwide outcome after paediatric inguinal hernia repair

    DEFF Research Database (Denmark)

    Bisgaard, Thue; Kehlet, H; Oehlenschlager, J;

    2014-01-01

    PURPOSE: The primary objective was to describe 30-day outcomes after primary inguinal paediatric hernia repair. METHODS: Prospectively collected data from the National Patient Registry covering a 2-year study period 1 January 2005 to 31 December 2006 were collected. Unexpected outcomes were defined...... was not associated with the inguinal hernia repair. The usual technique was a simple sutured plasty (96.5 %). Emergency repair was performed in 54 patients (2.2 %) mainly in children between 0 and 2 years (79.6 %). During the 1 year follow-up, reoperation for recurrent inguinal hernia was performed in 8 children...... after elective repair (recurrence rate 0.3 %). Paediatric repairs were for most parts performed in surgical public hospitals, and most departments performed less than 10 inguinal hernia repairs within the 2 years study period. CONCLUSION: These nationwide results are acceptable with low numbers...

  9. Clinical curative effect analysis and selection of laparoscopic inguinal hernia repair treatment of inguinal hernia%两种腹腔镜腹股沟疝修补术临床疗效分析与术式选择

    Institute of Scientific and Technical Information of China (English)

    刘继东; 李德宁; 鲍兴; 叶进军; 阎玉矿

    2014-01-01

    目的:探讨腹腔镜经腹腹膜前疝修补术(TAPP)、腹腔镜全腹膜外疝修补术(TEP)治疗腹股沟疝的手术疗效及术式选择。方法回顾性分析我院2007年1月至2013年1月接受 TAPP、TEP 两种手术治疗的478例腹股沟疝患者临床资料,比较两组患者的手术时间、术后住院时间、住院费用、术后并发症发生率、术后复发率等临床指标。结果138例 TAPP 组患者均成功完成手术;340例TEP 组患者中335例成功完成手术,2例中转开放手术,3例中转 TAPP。 TAPP 组患者的平均手术时间、平均术后住院时间分别为(63±18.5)min、(4.8±1.5)d,TEP 组分别为(57±14.8)min、(4.0±1.2)d (P >0.05),但 TAPP 组患者的住院费用(10623.6±413.6)元高于 TEP 组(8128.4±458.7)元(P <0.05)。TAPP 组12例(8.7%)患者出现术后并发症,TEP 组为30例患者(9.0%),两组术后并发症发生率差异无统计学意义(P >0.05)。术后随访12~48个月(平均20个月),TAPP 组患者复发2例(1.45%), TEP 组患者复发4例(1.19%),两组差异无统计学意义(P >0.05)。结论 TAPP、TEP 均是治疗腹股沟疝的安全、有效的手术方式,两者手术疗效相当但各有优缺点,应根据患者具体情况、术者临床经验选择术式。%Objective To investigate the clinical curative effect and selection of transabdominal preperitoneal prosthesis (TAPP) and totally extraperitoneal prosthesis (TEP) treatment of inguinal hernia. Methods The clinical data of 478 patients,who underwent TAPP or TEP inguinal heruia repair,between January 2007 and January 2013 in our hospital were retrospectively analyzed. The Clinical indicators such as operation time,postoperative hospital stay,hospital costs,the incidence of postoperative complications and recurrence rate between the two groups were compared. Results 138 operations of TAPP groups were all successful. In 340

  10. Timing of traumatic lumbar hernia repair: is delayed repair safe? Report of two cases and review of the literature.

    Science.gov (United States)

    Bathla, L; Davies, E; Fitzgibbons, R J; Cemaj, S

    2011-04-01

    Fewer than 100 cases of traumatic lumbar hernias are described in the English literature. The herniation has been described as a consequence of a combination of local tangential shearing forces combined with an acute increase in intra-abdominal pressure secondary to sudden deceleration sustained during blunt abdominal trauma. Delayed diagnosis is not uncommon, as nearly a quarter of these are missed at initial presentation. These hernias are best managed by operative intervention; however, there is no well-defined treatment strategy regarding either the timing or the type of repair. Several approaches, including laparoscopy, have been described to repair these defects. Various techniques, including primary repair, musculoaponeurotic reconstruction, and prosthetic mesh repair, have been described. These repairs are usually complicated because of the lack of musculoaponeurotic tissue inferiorly near the iliac crest. We describe here two cases of traumatic lumbar hernia managed by initial watchful waiting and subsequent elective repair using a combined laparoscopic and open technique and one with and one without bone anchor fixation.

  11. Richter hernia: surgical anatomy and technique of repair.

    Science.gov (United States)

    Skandalakis, Panagiotis N; Zoras, Odyseas; Skandalakis, John E; Mirilas, Petros

    2006-02-01

    Richter hernia (partial enterocele) is the protrusion and/or strangulation of only part of the circumference of the intestine's antimesenteric border through a rigid small defect of the abdominal wall. The first case was reported in 1606 by Fabricius Hildanus. The first definition of partial enterocele was given by August Gottlieb Richter in 1785. Sir Frederick Treves discriminated it from Littre hernia (hernia of the Meckel diverticulum). More often these hernias are diagnosed in the sixth and seventh decades of life. They comprise 10 per cent of strangulated hernias. Their common sites are the femoral ring, inguinal ring, and at incisional trauma. The most-often entrapped part of the bowel is the distal ileum, but any part of the intestinal tube may be incarcerated. These hernias progress more rapidly to gangrene than other strangulated hernias, and obstruction is less frequent. The gold standard technique for repair is the preperitoneal approach, followed by laparotomy and resection if perforation is suspected.

  12. CHRONIC PAIN AFTER INGUINAL HERNIA REPAIR

    Directory of Open Access Journals (Sweden)

    Suresh

    2014-09-01

    Full Text Available : BACKGROUND: Chronic post herniorrhaphy groin pain is defined as pain lasting > 6 months after surgery, which is one of the most important complication occurring after inguinal hernia repair, occurs with greater frequency than previously thought. Chronic groin pain is one of the most significant complications following inguinal hernia repair, and majority of chronic pain has been attributed to ilioinguinal nerve entrapment. Various other factors are involved in development of chronic pain. MATERIAL AND METHODS: Patients undergoing elective inguinal hernioplasty in Victoria hospital from November2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for follow up at end of six months. A detailed preoperative, intraoperative and post-operative details of cases were recorded according to proforma. The postoperative pain and pain at two, seven days and at end of six months were recorded on a VAS scale. RESULTS: Chronic pain at six month follow up was present in 89 patients constituting 39.4% of all patients undergoing hernia repair. It was seen that 26.9% without preoperative pain developed chronic pain whereas 76.7 % of patients with preoperative pain developed chronic pain. Patients with significant preoperative pain had higher chances of developing chronic pain (p<.0001. Preemptive analgesia failed to show statistical significance in development of chronic pain (p=0.079. Nerve injury were present in 22 of cases it was found that nerve injury significantly affected development of chronic pain (p=0.001.Post-operative infiltration of local anesthesia was practiced in 16.3 % of cases and it was found that local infiltration at incision site significantly reduced incidence of chronic pain (p=0.001.Postoperative complications in the form of hematoma, seroma or infection was present in 8.5 % of cases. It was found that post-operative complication not only increased early post-operative pain

  13. Repair of inguinal hernia: a comparison between extraperitoneal laparoscopy and Lichtenstein open surgery

    Directory of Open Access Journals (Sweden)

    Tavassoli A

    2010-06-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: The inguinal hernia is a common disorder in general surgery. Different methods have been described for repair of these hernias. In modern methods, synthetic mesh is used to cover the wall defect and the most known method is Lichtenstein surgical repair. The laparoscopic totally extra peritoneal procedure (TEP is a newer technique of repairing hernia. The aim of this study is to compare the outcomes of totally extraperitoneal laparoscopic inguinal hernia repair versus Lichtenstein open repair in patients with inguinal hernia."n"nMethods: Among 50 patients, 25 cases underwent Lichtenstein procedure and 25 patients underwent TEP technique for repairing primary unilateral inguinal hernia. Findings during the operation have been recorded and the 12-months follow-up of patients in different views was performed through a questionnaire and then the results were compared."n"nResults: The operation duration, the rate of complications and frequency of recurrence were similar in two groups; but the hospital stay, postoperative pain, chronic groin pain and the required time to return to normal activity were significantly lower in patients who underwent the TEP method compared to the patients who underwent the

  14. COMPARATIVE STUDY OF LICHTENSTEIN VERSUS DESARDA REPAIR FOR INGUINAL HERNIA

    Directory of Open Access Journals (Sweden)

    Sowmya

    2015-12-01

    Full Text Available BACKGROUND Inguinal hernia repair is the most frequently performed operation in any general surgical unit. The Bassini’s, Shouldice and other tissue-based techniques are still being acceptable for primary inguinal hernia repair. Desarda’s technique is originally a tissue based hernia repair using an undetached strip of external oblique aponeurosis to strengthen the posterior wall of the inguinal canal. The aim of the present study was to compare Lichtenstein hernia repair and Desarda herniorrhaphy. METHODS A total of 40 patients with primary unilateral inguinal hernia were subjected either to Desarda herniorrhaphy or Lichtenstein hernioplasty. The patients were followed in terms of recurrence rate, post-operative complications, convalescence, chronic pain and cost effectiveness. RESULTS During the followup all patients had either mild or moderate pain, but the pain intensity was more in Lichtenstein repair compared to Desarda repair in the immediate postoperative period. In Lichenstein repair patients had chronic groin pain even at the end of one year, but none of the patients in Desarda repair had chronic groin pain. Complications such as seroma and wound infection were less in Desarda repair. Time taken to resume normal activities was significantly less in case of Desarda herniorrhaphy; however, there was no recurrence observed in both the groups during the followup period. Average cost incurred for Desarda repair was significantly less than Lichtenstein repair. CONCLUSION Lichtenstein method of hernia repair is simple and safe. But the mesh prosthesis has its drawbacks. Desarda hernia repair is based on physiological principles and the results are good with less convalescence period and fewer recurrences and no chronic groin pain. It is more cost effective.

  15. The prevalence of umbilical and epigastric hernia repair

    DEFF Research Database (Denmark)

    Burcharth, J; Pedersen, M.S.; Pommergaard, H C;

    2015-01-01

    PURPOSE: Umbilical and epigastric hernia repair are common surgical procedures; however, the nationwide gender and age-specific prevalence of these repairs is unknown, and this knowledge could form the basis for new studies. METHODS: A nationwide register-based study covering all people living...... in Denmark on December 31st, 2010 was performed. Within this population all umbilical and epigastric hernia repairs from January 1st, 2006 to December 31st, 2010 were identified using data from the Danish National Hospital Register, and 5-year prevalence estimates were calculated. RESULTS: The study...... population covered 5,639,885 persons (49 % males). A total of 10,107 patients (68 % males) were operated for an umbilical hernia and 2412 patients (55 % males) were operated for an epigastric hernia. The age-specific 5-year prevalence differed for both hernia types. The highest 5-year prevalence of umbilical...

  16. The search for ideal hernia repair; mesh materials and types.

    Science.gov (United States)

    Bilsel, Yilmaz; Abci, Ilker

    2012-01-01

    Hernia surgery continues to draw the attention of surgeons, patients, and the industry. This strong interest has driven the establishment of professional medical societies with the sole purpose of furthering the understanding of hernias and hernia repair. In the more than 100 years of development, industry has played a major role in advancing the technology to perfect the performance of hernia repair with the hope of establishing the "best" technique and its associated technology. However, with the development of newer prosthetics and approaches to hernia repair, many surgeons do not fully understand the properties of the available prosthetics. The goal of this review is to highlight the different types of meshes in an effort to clarify to surgeons what types of materials are available to them and how to select an appropriate one for a given case.

  17. Laparoscopic totally extraperitoneal preperitoneal hernia repair assisted with puncture and degassing method∶a modified technique for contralateral occult hernia%完全腹膜外疝修补术中辅助使用穿刺排气法治疗对侧隐匿疝的临床价值

    Institute of Scientific and Technical Information of China (English)

    曹赣; 葛永祥; 田野; 刘庆宏

    2015-01-01

    Objective To explore the clinical effect of puncture and degassing method in laparoscopic totally extraperitoneal (TEP)hernia repair when the contralateral occult hernia exists.Methods A total of 40 cases of inguinal hernia were treated by TEP in Taizhou People′s Hospital from February 2010 to June 2013,and their clinical datas were retrospectively analyzed.8 cases with contralateral occult hernia found in operation were applied with puncture and degassing method,then TEP was continued. Results The operation time was 30 to 70 minutes,Postoperative hospital stay was 2 to 4 days.During the follow-up of 5 to 12 months,there was no recurrence.In the case of peritoneal perforation,the puncture and degassing method could be used to assist TEP,without significantly prolonging the operative time or increasing the operating difficulty.Conclusion When a contralateral occult hernia exists,the method of puncture and degassing can be applied in TEP to reduce operative time,and decrease the incidence of peritoneal injury and complications.%目的:探讨在完全腹膜外疝修补术(TEP)中发现对侧隐匿疝,应用穿刺排气法行 TEP治疗的临床效果。方法回顾性分析2010年2月至2013年6月,南通大学附属泰州市人民医院收治的腹股沟疝患者40例的临床资料,行 TEP 术,术中发现对侧隐匿疝8例,均辅助使用穿刺排气法行对侧 TEP。结果40例手术时间30~70 min,8例双侧疝 TEP 修补术时间50~70 min,术后2~4 d 出院,随访5~12个月,无疝复发。在腹膜破损的情况下,穿刺排气法可以辅助完成 TEP,不会明显延长手术时间和增加手术难度。结论TEP 术中探查发现对侧隐匿疝,可辅助使用穿刺排气法行 TEP 治疗,缩短手术时间,减少腹膜损伤与腹腔镜疝修补术并发症。

  18. Indications for incisional hernia repair: An international questionnaire among hernia surgeons

    NARCIS (Netherlands)

    J. Nieuwenhuizen (Jeroen); G.J. Kleinrensink (Gert Jan); W.C.J. Hop (Wim); J. Jeekel (Hans); J.F. Lange (Johan)

    2008-01-01

    textabstractBackground: Incisional hernia repair can be a significant challenge for both surgeon and patient. Despite the growing amount of literature describing various methods of surgical techniques, little has been published regarding the natural course of incisional hernia and the opinions about

  19. Endoscopic TEP inguinal hernia repair in the management of occult obturator and femoral hernias.

    Science.gov (United States)

    Rath, Alok; Bhatia, Parveen; Kalhan, Sudhir; John, Suviraj; Khetan, Mukund; Bindal, Vivek; Ali, Asfar; Singh, Rahul

    2014-08-01

    The gold standard technique for the repair of groin hernias has always been a controversial issue. Richard Ger introduced the endoscopic approach for the repair of groin hernias in 1991.The endoscopic technique follows the basic principle of preperitoneal placement of a polypropylene mesh over the myopectineal orifice. During the course of dissection of the preperitoneal space, occult obturator and femoral hernias were discovered. Patients who underwent endoscopic totally extraperitoneal repair of inguinal hernias over a period of 2 years were included in this retrospective study. A total of 305 cases of groin hernias were operated in 208 patients over a period of 2 years from January 2010 to January 2012 in a single institution. Eleven synchronous clinically occult obturator hernias were found in 8 patients (3.84%) and 5 synchronous clinically occult femoral hernias were found in 5 patients (2.40%) during repair. Preoperative and perioperative findings were discordant in quite a few cases. Preperitoneal dissection discovered coincidental occult hernias in 6.25% of patients.

  20. Nationwide Prospective Study of Outcomes after Elective Incisional Hernia Repair

    DEFF Research Database (Denmark)

    Helgstrand, Frederik; Rosenberg, Jacob; Kehlet, Henrik

    2013-01-01

    BACKGROUND: Incisional hernia repair is a frequent surgical procedure, but perioperative risk factors and outcomes have not been prospectively assessed in large-scale studies. The aim of this nationwide study was to analyze surgical risk factors for early and late outcomes after incisional hernia...

  1. Correção de hérnia laparoscópica: tela sem fixação é viável? Laparoscopic hernia repair: nonfixation mesh is feasibly?

    Directory of Open Access Journals (Sweden)

    Alberto Meyer

    2013-03-01

    Full Text Available RACIONAL: Várias técnicas cirúrgicas têm sido desenvolvidas ao longo dos últimos anos, e a correção de hérnia inguinal pré-peritoneal totalmente extraperitoneal e transabdominal são as técnicas endoscópicas que são mais comumente utilizadas. OBJETIVOS: Descrever e discutir a técnica de Dulucq e as modificações do uso da tela 3-D na correção de hérnia inguinal totalmente extraperitoneal. MÉTODOS: Foram incluídos prospectivamente neste estudo pacientes submetidos à correção de hérnia inguinal eletiva. Foram estudados os aspectos operatórios e pós-operatórios. RESULTADOS: Um total de 261 correções herniárias foram incluídas neste estudo. Elas foram realizadas pela técnica totalmente extraperitoneal; duas (0,75% foram convertidos para técnica anterior de Liechtenstein. O tempo operatório médio foi de 43,38 min em hérnia unilateral e 53,36 min em hérnia bilateral. A maioria dos pacientes (95% teve alta no mesmo dia da operação. A taxa de morbidade pós-operatória foi de 5,7%. A incidência de recidiva foi de 0,0% em média de 26 meses. CONCLUSÃO: Hernioplastia totalmente extraperitoneal é procedimento eficaz e seguro nas mãos de cirurgiões experientes e com formação específica. É uma opção interessante para hérnia bilateral e recidivante, uma vez que obtém resultados satisfatórios em termos de dor pós-operatória e morbidade.BACKGROUND: Several surgical techniques have been developed over the past years, and total extraperitoneal and transabdominal preperitoneal inguinal hernia repair are the endoscopic techniques that are most commonly used. AIM: To describe and discuss Dulucq's technique and the modifications of using 3-D mesh in total extraperitoneal inguinal hernia repair. METHODS: Patients who underwent an elective inguinal hernia repair were enrolled prospectively in this study. Operative and postoperative course were studied. RESULTS: A total of 261 hernia repairs were included in the

  2. 腹腔镜腹膜前疝修补术与普理灵疝装置无张力疝修补术的比较分析%Comparative Study of Abdominal Preperitoneal Laparoscopic and Prolene Hernia System of Tension-Lee of Hernia Repair

    Institute of Scientific and Technical Information of China (English)

    金海敏; 黄海; 李晔

    2011-01-01

    [Objective]To compare the efficacy of treatment of inguinal hernia by abdominal preperitoneal laparoscopjc hernia repair (Transabdominal Preperitoneal Herniorrhaphy, TAPP) and by Prolene hernia system tension-free hernia repair(Prolene Hernia System,PHS). [Methods]A retrospective analysis from September 2008 to May 2010 a total of 90 patients with clinica'l data of inguinal hernia repair,TAPP group of 36 cases,PHS group of 54 patients. [Results]Both complications were low;compared with PHS, TAPP group,the average hospital stay shorter(3. 54±1. 42 vs. 5. 36±1.35,P<0. 05),Operation time and relatively high cost of surgery(P<0. 05). [Conclusion] TAPP and PHS are both safe and effective surgical inguinal hernia repairs. TAPP has feature of shorter postoperative hospital stay,rapid recovery,especially for recurrent hernia,bilateral hernia,and hidden hernia.%[目的]比较腹腔镜腹膜前疝修补术(Transabdominal Preperitoneal Herniorrhaphy,TAPP)与普理灵疝装置无张力疝修补术(Prolene Hernia System,PHS)治疗腹股沟疝的疗效。[方法]回顾性分析2008年9月至2010年5月共90例腹股沟疝修补术病例资料,TAPP组36例,PHS组54例。[结果]二者术后并发症均低下;与PHS组相比,TAPP组平均住院时间更短(P<0.05),手术时间及手术费用相对较高(P<0.05),TAPP另具探查对侧及隐匿疝的独特优势。[结论]TAPP术后住院时间短、恢复快,尤其对复发性疝、双侧疝及隐匿疝更具优势。

  3. Application of Laparoscopic High Ligation of Hernia Sac and Median Umbilical Fold in Surgical Repair of Inguinal Hernia in Children%腹腔镜疝囊高位结扎加脐正中襞修补手术在小儿腹股沟斜疝中的应用

    Institute of Scientific and Technical Information of China (English)

    周晓波; 段永福; 赵成鹏; 李付奎

    2016-01-01

    Objective To investigate the clinical value of laparoscopic high ligation combined with autologous tissue repair for indirect inguinal hernia in children . Methods We selected 322 in-hospital cases of pediatric indirect inguinal hernia as the objects of study from August 2013 to August 2014 in our department .According to different surgical options performed by different doctors , the patients were divided into 2 groups:laparoscopic and autologous tissue repair group ( group A, n=168) or laparoscopic group ( group B, n=154).The clinical data of the two groups were compared and analyzed . Results In this study, we found contra-lateral occult hernia in 21 patients in the group A and 16 patients in the group B .No statistical differences were found in the operation time [(26.9 ±7.6) min vs.(25.9 ±8.1) min, t=1.097, P=0.273], postoperative visual analogue scale (VAS) score [(22.6 ±8.0) points vs.(22.4 ±8.0) points, t=0.179, P=0.858], postoperative hospital stay [(2.9 ±1.3) d vs.(2.8 ±1.6) d, t=0.502, P=0.616], and postoperative complications [2.4% (4/168) vs.4.5% (7/154), χ2 =1.141, P=0.285] between the group A and the group B .In one year of follow-up, there was no recurrence in the group A and 8 cases of recurrence in the group B , the recurrence rate being significantly lower in the group A than the group B [0 (0/168) vs.5.2%(8/154), P=0.002]. Conclusion Laparoscopy combined with autologous tissue repair surgery can effectively reduce the rate of recurrence of indirect inguinal hernia in children, being worthy of clinical popularization .%目的:探讨腹腔镜疝囊高位结扎加脐正中襞修补手术在小儿腹股沟斜疝中的应用价值。方法2013年8月~2014年8月对小儿腹股沟斜疝322例行腹腔镜疝囊高位结扎术,不同术者采取不同手术方案,其中联合脐正中襞修补168例( A组),未联合154例( B组),对2组的临床资料进行比较分析。结果发现对侧隐匿疝A组21例,B组16

  4. Herniorrafia inguinal laparoscópica totalmente extraperitoneal: vinte e sete complicações graves após 4565 operações consecutivas Laparoscopic totally extraperitoneal inguinal hernia repair: twenty-seven serious complications after 4565 consecutive operations

    Directory of Open Access Journals (Sweden)

    Alberto Meyer

    2013-02-01

    Full Text Available OBJETIVO: identificar e avaliar as complicações do tratamento da hérnia inguinal com a colocação de tela totalmente extraperitoneal. MÉTODOS: Foram incluídos, em uma série consecutiva de 4565 reparos de hérnia laparoscópica, pacientes que haviam sido submetidos ao procedimento TEP entre janeiro de 2001 e janeiro de 2011. Os critérios de inclusão foram: diagnóstico com hérnia inguinal sintomática, incluindo recorrência após correção de hérnia inguinal e cirurgia prévia em abdômen inferior e pelve. Todos os pacientes > 18 anos de idade. Pacientes com hérnia encarcerada na urgência foram excluídos do estudo. RESULTADOS: Um total de 4565 hérnias foram incluídas no estudo. Ocorreram 27 complicações graves (0,6%: 12 hemorragias (0,25%, duas lesões da bexiga (0,04%, cinco oclusões (0,11%, quatro perfuraç��es intestinais (0,09%, uma lesão da veia ilíaca (0,02%, uma lesão do nervo femoral (0,02%, duas lesões dos vasos deferentes (0,04% e dois óbitos (0,02% (embolia pulmonar, peritonite. CONCLUSÃO: A taxa de complicações com o procedimento TEP é baixa. Correção de hérnia laparoscópica é uma técnica reprodutível e confiável. Em nossa experiência, existem contraindicações para o procedimento de TEP. A técnica TEP deve ser minuciosa para evitar complicações intraoperatórias (diatermia bipolar. As complicações podem ocorrer mesmo após o cirurgião ter adquirido experiência substancial.OBJECTIVE: To identify and assess the complications of laparoscopic inguinal hernia treatment with totally extraperitoneal mesh placement (TEP. METHODS: We included patients who had undergone the TEP procedure in a consecutive series of 4565 laparoscopic hernia repairs between January 2001 and January 2011. Inclusion criteria were diagnosis with symptomatic inguinal hernia, including recurrence after inguinal hernia repair and previous surgery in the lower abdomen and pelvis. All patients were 18 years of age or

  5. Recurrence and complications of pediatric inguinal hernia repair ...

    African Journals Online (AJOL)

    complications of inguinal hernia repair in pediatric patients who underwent ... were complications such as pain, wound infection, and fever. Results. In this study ... incidence of recurrence within 1 year after the surgery .... Treatment strategy of.

  6. Post operative pain control in inguinal hernia repair: comparison of ...

    African Journals Online (AJOL)

    Post operative pain control in inguinal hernia repair: comparison of tramadol versus ... Log in or Register to get access to full text downloads. ... postoperative pain control effects and cost effectiveness of Tramadol versus Bupivaaine in wound ...

  7. Transthoracic repair of asymptomatic morgagni hernia in an adult.

    Science.gov (United States)

    Pousios, Dimitrios; Panagiotopoulos, Nikolaos; Piyis, Anastasios; Gourgiotis, Stavros

    2012-10-01

    Morgagni hernia represents a rare type of diaphragmatic hernia which usually occurs on the right side, in the anterior mediastinum. Predisposing factors of Morgagni hernia include pregnancy, obesity or other causes of increased intraabdominal pressure, and a history of trauma. Most of adults diagnosed with a foramen of Morgagni are asymptomatic. We report a case of an overweight 23-year-old asymptomatic patient with a Morgagni hernia incidentally diagnosed on chest x-ray. There was a satisfactory result after the repair by a transthoracic approach.

  8. The Anterior Preperitoneal Approach for Repair of Complex Inguinal Hernias

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    Safa Onel

    2014-08-01

    Results: A total of 40 patients (Male:32, Female:8 underwent hernia repair with our technique during the study period. The mean age was (+/-SD 44+/-6.8 years. Four patients had giant direct hernia,12 patients had giant inguino-scrotal hernia, 14 patients had recurrent and 10 patients had femoral hernia. 4 patients were underwent emergent surgery due to incarceration. The mean operation time was (+/-SD 61+/-11 min. There was no recurrence with the mean follow-up time of 7+/-2.2 years. Cnclusion: Our surgical technique allows to repair all types of inguinal hernia with one piece of prolene mesh by covering all potential defects. [Cukurova Med J 2014; 39(4.000: 822-828

  9. Comparison of dexmedetomidine and propofol given Combined spinal-epidural anesthesia laparoscopic hernia repair applications%腰硬联合麻醉腹腔镜疝修补术中应用右美托咪定与丙泊酚的比较

    Institute of Scientific and Technical Information of China (English)

    李梦良; 纪宇; 胡志向

    2015-01-01

    目的:比较腰硬联合麻醉腹腔镜疝修补术中应用右美托咪定与丙泊酚对患者安全性、有效性以及对呼吸循环功能的影响。方法选择应用右美托咪定辅助腰硬联合麻醉腹腔镜疝修补患者60例,性别不限,平均年龄62±4岁,ASA分级Ⅰ-Ⅱ级,设为A组;选择应用丙泊酚辅助腰硬联合麻醉腹腔镜疝修补术患者60例,性别不限,平均年龄63±3岁,ASA分级Ⅰ-Ⅱ级,设为B组。比较两组患者在术中不同时段的血压、心率、脉搏氧饱和度、有无躁动和注药后呼吸暂停情况。结果两种麻醉方法均能满足手术需要,患者均能顺利安全的度过围术期,但A组患者术中较B组呼吸循环功能更加平稳,躁动和注药后呼吸暂停次数也明显少于B组。结论右美托咪定能产生镇静、镇痛和抗交感作用,同时具有可唤醒的特点,在辅助腰硬联合麻醉腹腔镜疝修补术中安全有效,并且能使术中患者的呼吸循环功能更加平稳,减少躁动次数,在锥管内麻醉腹腔镜手术中将有更加广阔的应用价值。%Objective To compare Combined spinal-epidural anesthesia laparoscopic hernia repair application security, effectiveness and impact of dexmedetomidine and propofol given to patients with respiratory and circulatory functions. Methods Application dexmedetomidine given Combined spinal-epidural anesthesia assisted laparoscopic hernia repair in 60 patients, male or female, mean age 62 ± 4 years old, ASA gradeⅠ -Ⅱ grade, Make A Group;select propofol auxiliary CSEA 60 cases of laparoscopic hernia repair patients, male or female, mean age 63 ± 3 years old, ASA gradeⅠ -Ⅱ grade, to group B. Two groups were compared in different time intraoperative blood pressure, heart rate, pulse oximetry, with or without agitation and apnea after injection case. Results Both methods can meet the surgery requires anesthesia, the patient can successfully secure through

  10. Laparoscopic total extraperitoneal repair under spinal anesthesia versus general anesthesia: a randomized prospective study

    Directory of Open Access Journals (Sweden)

    Donmez T

    2016-10-01

    Full Text Available Turgut Donmez,1 Vuslat Muslu Erdem,2 Oguzhan Sunamak,3 Duygu Ayfer Erdem,2 Huseyin Imam Avaroglu1 1Department of General Surgery, 2Department of Anesthesiology and Reanimation, Lutfiye Nuri Burat State Hospital, 3Department of General Surgery, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey Background: Laparoscopic total extraperitoneal (TEP inguinal hernia repair is a well-known approach to inguinal hernia repair that is usually performed under general anesthesia (GA. To date, no reports compare the efficacy of spinal anesthesia (SA with that of GA for laparoscopic hernia repairs. The purpose of this study was to compare the surgical outcome of TEP inguinal hernia repair performed when the patient was treated under SA with that performed under GA. Materials and methods: Between July 2015 and July 2016, 50 patients were prospectively randomized to either the GA TEP group (Group I or the SA TEP group (Group II. Propofol, fentanyl, rocuronium, sevoflurane, and tracheal intubation were used for GA. Hyperbaric bupivacaine (15 mg and fentanyl (10 µg were used for SA to achieve a sensorial level of T3. Intraoperative events related to SA, operative and anesthesia times, postoperative complications, and pain scores were recorded. Each patient was asked to evaluate the anesthetic technique by using a direct questionnaire filled in 3 months after the operation. Results: All the procedures were completed by the allocated method of anesthesia as there were no conversions from SA to GA. Pain was significantly less for 1 h (P<0.0001 and 4 h (P=0.002 after the procedure for the SA and GA groups, respectively. There was no difference between the two groups regarding complications, hospital stay, recovery, or surgery time. Generally, patients were more satisfied with SA than GA (P<0.020. Conclusion: TEP inguinal hernia repair can be safely performed under SA, and SA was associated with less postoperative pain, better recovery, and better

  11. Current concepts in the management of inguinal hernia and hydrocele in pediatric patients in laparoscopic era.

    Science.gov (United States)

    Esposito, Ciro; Escolino, Maria; Turrà, Francesco; Roberti, Agnese; Cerulo, Mariapina; Farina, Alessandra; Caiazzo, Simona; Cortese, Giuseppe; Servillo, Giuseppe; Settimi, Alessandro

    2016-08-01

    The surgical repair of inguinal hernia and hydrocele is one of the most common operations performed in pediatric surgery practice. This article reviews current concepts in the management of inguinal hernia and hydrocele based on the recent literature and the authors׳ experience. We describe the principles of clinical assessment and anesthetic management of children undergoing repair of inguinal hernia, underlining the differences between an inguinal approach and minimally invasive surgery (MIS). Other points discussed include the current management of particular aspects of these pathologies such as bilateral hernias; contralateral patency of the peritoneal processus vaginalis; hernias in premature infants; direct, femoral, and other rare hernias; and the management of incarcerated or recurrent hernias. In addition, the authors discuss the role of laparoscopy in the surgical treatment of an inguinal hernia and hydrocele, emphasizing that the current use of MIS in pediatric patients has completely changed the management of pediatric inguinal hernias. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Study of a new method for inguinal hernia repair

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    Noori M.

    2007-11-01

    Full Text Available Background: Inguinal hernia accounts for about 80% of all hernias and are the most common surgical procedure done in infants. There are different methods for repairing of inguinal hernia such as tissue repair; rate of recurrence by this method is 1-3%. The purpose of this study was to introduce new method for this surgery and assessing recurrence and complications.Methods: This was a semi clinical trial. 174 patients were considered after five years. (During 1998-2002. In this method after removing of hernia's sac, the floor of inguinal canal was torn in two layers continuously. One of them was torn from cooper ligament to fascia transversalis and the other one was torn from inguinal ligament to conjoint tendon and finally the fascia of external muscle was torn on spermatic cord. The patients were assessed by a questionnaire composed of two sections; one about the site of inguinal hernia and age of patients and the other was composed of questions about complication and recurrence of surgery. Data was compared to other conventional tissue repair using Z test. Results: The mean age of patients were 28-48 years, 164(94% were males and 10(5/7% were females, 59(34% of patients had left inguinal hernia (56 male and 3 female, 92(52% had right inguinal hernia (88 male and 4 female and 23(13% had bilateral inguinal hernia (20 male and 3 female. Two patients (1/1% had recurrence two years after surgery and no complication were seen after 5 years. Conclusions: There were no significant difference between methods of surgery (1/1% recurrence and other conventional tissue repair methods (1-3% recurrence. More long evaluation is required to recommend this fast and simple method for routine repair of inguinal hernias.

  13. Open femoral hernia repair: one skin incision for all

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    El-Masry Nabil S

    2009-11-01

    Full Text Available Abstract Background Femoral hernias are relatively uncommon, however they are the most common incarcerated abdominal hernia, with strangulation of a viscus carrying significant mortality. Classically three approaches are described to open femoral hernia repair: Lockwood's infra-inguinal, Lotheissen's trans-inguinal and McEvedy's high approach. Each approach describes a separate skin incision and dissection to access the femoral sac. The decision as to which approach to adopt, predominantly dependent on the suspicion of finding strangulated bowel, is often a difficult one and in our opinion an unnecessary one. Methods We propose a technique for open femoral hernia repair that involves a single skin incision 1 cm above the medial half of the inguinal ligament that allows all of the above approaches to the hernia sac depending on the operative findings. Thus the repair of simple femoral hernias can be performed from below the inguinal ligament. If found, inguinal hernias can be repaired. More importantly, resection of compromised bowel can be achieved by accessing the peritoneal cavity with division of the linea semilunaris 4 cm above the inguinal ligament. This avoids compromise of the inguinal canal, and with medial retraction of the rectus abdominis muscle enables access to the peritoneal cavity and compromised bowel. Discussion This simple technique minimises the preoperative debate as to which incision will allow the best approach to the femoral hernia sac, allow for alteration to a simple inguinal hernia repair if necessary, and more importantly obviate the need for further skin incisions if compromised bowel is encountered that requires resection.

  14. Use of composite polyester/collagen mesh in the repair of recurrent congenital diaphragmatic hernias

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    Lin C. Wang

    2015-09-01

    Full Text Available Case 1 is an 18 year-old woman with a third recurrence of a left congenital diaphragmatic hernia (CDH. She had previously undergone a primary repair of a recurrence via laparotomy and an additional repair of a second recurrence with PTFE mesh via a thoracotomy. Following her third recurrence she underwent successful laparoscopic repair utilizing composite polyester/collagen (Parietex™ Composite, Covidien, Sofradim, France mesh. Six years following surgery, she has carried a pregnancy to term and has not recurred. Case 2 is a 5 month-old infant who presented with a recurrent right-sided CDH. She initially underwent primary repair via thoracotomy along with a right pneumonectomy at an outside institution. She presented with incarceration of her liver, hepatic venous thrombosis, mediastinal shift, and respiratory distress. She underwent successful repair with composite mesh through a right thoracoabdominal incision. At 8 months post-operatively, she has no evidence of recurrence in spite of the expected mediastinal deviation to the right and right thoracic volume loss as a result of being status post right pneumonectomy. Recurrences occur in a significant number of patients following repair of congenital diaphragmatic hernia, particularly cases in which a mesh implant are utilized. Historically, PTFE has been the product of choice for a diaphragmatic implant by pediatric surgeons. However, this product does not incorporate into surrounding tissues which theoretically places patients at risk for recurrence. Polyester/collagen composite mesh has been used for decades in adults undergoing complex groin and ventral hernia repairs with excellent results. However, its use for congenital diaphragmatic hernias has not been previously described. We present the successful utilization of this product in two cases which were at extremely high risk for future recurrence. Additional investigations should be done and long term follow up regarding application of

  15. Laparoscopic Inguinal Hernia Repair Using an Anatomically Contoured Three-dimensional Mesh without Fixation%应用三维立体补片行免固定腹腔镜经腹膜前腹股沟疝修补术

    Institute of Scientific and Technical Information of China (English)

    张伟国; 安伟德; 邓中慧

    2013-01-01

      目的总结应用三维立体补片(3DMAX补片)行免固定腹腔镜下经腹腹膜前补片植入术(TAPP)的经验、技巧及体会。方法回顾性分析2009年7月至2012年1月大连医科大学附属第一医院普通外科应用3DMax补片行免固定腹腔镜腹股沟疝修补术的47例患者。结果全部手术均获成功,47例患者行56侧腹腔镜TAPP术,单侧疝手术时间28~85 min,双侧疝手术时间38~98 min,术后第3周96%患者恢复正常活动,57%恢复运动,发生阴囊血清肿3例,1例轻度疼痛,肠梗阻1例。随访6~28个月,1例复发。结论三维立体补片(3DMax补片)免固定腹腔镜下经腹腹膜前补片植入术(TAPP)是一种安全可靠的疝修补术,具有操作简便易行,复发率低等优点,特别适于复发疝、双侧疝等,值得推广应用。但有补片移位的风险。%Objective To summary the experience and skills of laparoscopic transabdominal preperitoneal hernia repair(TAPP) using three-dimensional mesh ( 3DMax mesh ) without fixation. Methods Retrospectively analysis laparoscopic inguinal hernia repair using 3DMax mesh without fixation which was applicated in 47 patients by General Surgery department in the First Affiliated Hospital of Dalian Medical University, from July 2009 to January 2012. Results The operation for all patients was performed successfully under the laparoscope, in which 47 patients with the laparoscopic TAPP surgery 56 cases,with operating time from 28 to 85 minutes for unilateral hernioplasty, from 38 to 98 minutes for bilateral hernioplasty.About 96%of the patients return to normal activities and 57%of the patients restore movement after three weeks, Only 3 case of scrotal serum happened after operation,1 case had minor pain, and small bowel obstruction was occurred in 1 case. Only 1 case recurrence was found in follow-up for 6~28 months.Conclusions Laparoscopic transabdominal preperitoneal hernia repair

  16. 免钉合双网片交叠腹腔镜腹膜外腹股沟疝修补术的应用体会%The clinical application of laparoscopic extraperitoneal inguinal hernia repair with overlapped double meshes without using stapling

    Institute of Scientific and Technical Information of China (English)

    刘晓辉; 李桂良; 陈建富; 谢开斌; 宋文周; 张正雄

    2011-01-01

    目的:总结免钉合双网片交叠腹腔镜腹膜外腹股沟疝修补术的手术经验,并探讨其安全性、可行性、有效性及手术技巧.方法:回顾分析2008年8月至2010年12月19例腹股沟疝患者的临床资料,其中斜疝13例,直疝6例;右侧11例,左侧5例,双侧3例.结果:18例手术获得成功,1例中转开放手术.手术时间70~180 min,单侧平均92 min,双侧平均140 min,术中出血量15~30 ml.术后无需应用镇痛剂,2例发生阴囊血清肿.住院5~10d,平均7d.随访18例患者6~24个月,无复发及腹股沟区慢性疼痛.结论:免钉合双网片交叠腹腔镜腹膜外腹股沟疝修补术安全、有效、可行,值得临床推广应用.%Objective: To explore the operative experience, the safety, the feasibility and operative skills of laparoscopic extrap-eritoneal inguinal hernia repair with overlapped double meshes without using stapling. Methods: The clinical data of 19 patients with inguinal hernia between Aug. 2008 and Dec. 2010 were retrospectively analyzed. Out of the 19 patients, there were 13 patients with indirect inguinal hernia and 6 patients with direct inguinal hernia. The hernia was right-sided in 11 patients, left-sided in 5 , and bilateral in 3. Results:The operation was successfully accomplished in 18 cases,and 1 case was converted to open surgery. The operative time was 70-180 min (the mean of unilateral hernia was 92 min and bilateral hernia was 140 min). The intraoperative blood loss was 15-30 ml. The patients didn't need analgesics.2 cases occurred seroma of scrotum. The hospital stay was 5-10 d (mean 7 d). Follow-up observation for 6-24 months in the 18 patients found no recurrence and chronic pain of inguinal area. Conclusions: Laparoscopic extraperitoneal inguinal hernia repair with overlapped double meshes without using stapling is a safe,effective and feasible method,and worth popularization.

  17. Outcomes of 157 V-Patch(TM) Implants in the Repair of Umbilical, Epigastric, and Incisional Hernias.

    Science.gov (United States)

    Keating, Jane J; Kennedy, Gregory T; Datta, Jashodeep; Schuricht, Alan

    2016-01-01

    Umbilical, epigastric, and incisional hernias have traditionally been repaired using a Mayo or tensioned suture technique, with recurrence rates of approximately 50 per cent. Recent studies have shown that a tension-free repair using mesh can drastically decrease recurrence rates. Reinforced deployment prostheses are preferred because they enable retrofascial placement through a small incision, thus avoiding the potential morbidity of a larger incision and the costs associated with a laparoscopic approach. A retrospective chart review was performed of all umbilical, epigastric and incisional hernias repaired with V-Patch, a reinforced deployment prosthesis, by a single surgeon. Data analysis included patient characteristics, operative and postoperative metrics, hernia recurrence, and complication rates. Between 2009 and 2012, 157 implantations were performed in 152 patients during 156 procedures. Patient age ranged from 20 to 85 (mean 48). There were 88 females (57.9%) and 64 males (42.1%) with average body mass index of 30.6. Patch size distribution was 78 small (49.7%), 55 medium (35.0%), and 24 large (15.3%). There were 81 umbilical hernias (51.6%), 36 epigastric hernias (22.9%), 39 incisional hernias (24.8%), and 1 multiple recurrent inguinal hernia (0.6%) repaired. Follow-up time ranged from 18 months to 4.3 years. There were six hernia recurrences (3.2%). Complications included three patients (1.9%) with mesh infection, one with an enterocutaneous fistula (0.6%), and one patient with a postoperative small bowel obstruction (0.6%). Four patients required patch explantation (2.5%). The V-Patch reinforced deployment prosthesis is effective in the treatment of umbilical, epigastric, and incisional hernias, and has a low rate of complications.

  18. Perineal hernia: surgical anatomy, embryology, and technique of repair.

    Science.gov (United States)

    Stamatiou, Dimitrios; Skandalakis, John E; Skandalakis, Lee J; Mirilas, Petros

    2010-05-01

    Perineal hernia is the protrusion into the perineum of intraperitoneal or extraperitoneal contents through a congenital or acquired defect of the pelvic diaphragm. The first case was reported by de Garangeot in 1743. Perineal hernias may occur anteriorly or posteriorly to the superficial transverse perineal muscles. Congenital perineal hernia is a rare entity. Failure of regression of the peritoneal cul de sac of the embryo is considered a predisposing factor for hernia formation. Acquired perineal hernias are primary or secondary. Primarily acquired perineal hernias are caused by factors associated with increased intra-abdominal pressure. They are more common in females as a result of the broader female pelvis and the attenuation of the pelvic floor during pregnancy and childbirth. Secondarily acquired perineal hernias are incisional hernias associated with extensive pelvic operations such as abdominoperineal resection of the anorectum and pelvic exenteration. Pain in the perineal area, intestinal obstruction, topical skin erosion, and difficulty with urination necessitate the surgical repair of a perineal hernia. This can be accomplished through transabdominal, perineal, or combined abdominoperineal approaches. The defect in the muscles of the pelvic diaphragm may be closed either with direct suturing or by using autogenous tissues or synthetic mesh.

  19. Danish Hernia Database recommendations for the management of inguinal and femoral hernia in adults

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Bisgaard, Thue; Kehlet, Henrik

    2011-01-01

    The nationwide Danish Hernia Database, recording more than 10,000 inguinal and 400 femoral hernia repairs annually, provides a unique opportunity to present valid recommendations in the management of Danish patients with groin hernia. The cumulated data have been discussed at biannual meetings...... or laparoscopic technique, depends on local expertise, economical considerations and patient preference. Compared to the Lichtenstein operation laparoscopic repair is associated with less acute pain and faster recovery. Furthermore, available data suggest less chronic long-term pain after laparoscopic repair...... be available at the website for the Danish Hernia Database (www.herniedatabasen.dk). The guidelines will be updated when new substantial evidence becomes available....

  20. Laparoscopic Pelvic Floor Repair Using Polypropylene Mesh

    Directory of Open Access Journals (Sweden)

    Shih-Shien Weng

    2008-09-01

    Conclusion: Laparoscopic pelvic floor repair using a single piece of polypropylene mesh combined with uterosacral ligament suspension appears to be a feasible procedure for the treatment of advanced vaginal vault prolapse and enterocele. Fewer mesh erosions and postoperative pain syndromes were seen in patients who had no previous pelvic floor reconstructive surgery.

  1. Treatment of giant hiatal hernia by laparoscopic Roux-en-Y gastric bypass

    NARCIS (Netherlands)

    L.E. Duinhouwer (Lucia); L.U. Biter (L. Ulas); B.P.L. Wijnhoven (Bas); G.H.H. Mannaerts (Guido)

    2015-01-01

    textabstractIntroduction Obesity is a risk factor for hiatal hernia. In addition, much higher recurrence rates are reported after standard surgical treatment of hiatal hernia in morbidly obese patients. Laparoscopic Roux-en-Y gastric bypass (LRYGB) is an effective surgical treatment for morbid obesi

  2. Successful laparoscopic management of paraesophageal hiatal hernia with upside-down intrathoracic stomach: a case report.

    Science.gov (United States)

    Siow, Sze Li; Tee, Sze Chee; Wong, Chee Ming

    2015-03-04

    Paraesophageal hernia with intrathoracic mesentericoaxial type of gastric volvulus is a rare clinical entity. The rotation occurs because of the idiopathic relaxation of the gastric ligaments and ascent of the stomach adjacent to the oesophagus through the hiatus defect, while the gastroesophageal junction remains in the abdomen. The open approach remains the gold standard therapy for most patients. Here we report the case of a patient with such a condition who underwent a successful laparoscopic surgery. A literature search revealed that this is the first case report from Southeast Asia. A 55-year-old Chinese woman presented to us with symptoms suggestive of gastric outlet obstruction for one year. A chest radiograph showed an air bubble with air-fluid level in her left thoracic cavity, where a diaphragmatic hernia was initially suspected. A computed tomography scan and barium swallow study demonstrated the presence of a type III paraesophageal hernia with intrathoracic upside-down stomach. A laparoscopy was performed and the herniated stomach was successfully reduced into the abdomen. The mediastinal part of the hernial sac was excised. Adequate intraabdominal length of oesophagus was achieved after resection of the sac and circumferential oesophageal dissection. A lateral releasing incision was made adjacent to the right crus to facilitate crural closure. The diaphragmatic defect and the hiatal closure were covered with a composite mesh. A Toupet fundoplication was performed to recreate the antireflux valve. She had an uneventful recovery. She had no relapse of previous symptoms at her six-month follow-up assessment. Laparoscopic repair of such a condition can be accomplished successfully and safely when it is performed with meticulous attention to the details of the surgical technique.

  3. Integrating a novel shape memory polymer into surgical meshes to improve device performance during laparoscopic hernia surgery

    Science.gov (United States)

    Zimkowski, Michael M.

    About 600,000 hernia repair surgeries are performed each year. The use of laparoscopic minimally invasive techniques has become increasingly popular in these operations. Use of surgical mesh in hernia repair has shown lower recurrence rates compared to other repair methods. However in many procedures, placement of surgical mesh can be challenging and even complicate the procedure, potentially leading to lengthy operating times. Various techniques have been attempted to improve mesh placement, including use of specialized systems to orient the mesh into a specific shape, with limited success and acceptance. In this work, a programmed novel Shape Memory Polymer (SMP) was integrated into commercially available polyester surgical meshes to add automatic unrolling and tissue conforming functionalities, while preserving the intrinsic structural properties of the original surgical mesh. Tensile testing and Dynamic Mechanical Analysis was performed on four different SMP formulas to identify appropriate mechanical properties for surgical mesh integration. In vitro testing involved monitoring the time required for a modified surgical mesh to deploy in a 37°C water bath. An acute porcine model was used to test the in vivo unrolling of SMP integrated surgical meshes. The SMP-integrated surgical meshes produced an automated, temperature activated, controlled deployment of surgical mesh on the order of several seconds, via laparoscopy in the animal model. A 30 day chronic rat model was used to test initial in vivo subcutaneous biocompatibility. To produce large more clinical relevant sizes of mesh, a mold was developed to facilitate manufacturing of SMP-integrated surgical mesh. The mold is capable of manufacturing mesh up to 361 cm2, which is believed to accommodate the majority of clinical cases. Results indicate surgical mesh modified with SMP is capable of laparoscopic deployment in vivo, activated by body temperature, and possesses the necessary strength and

  4. Clinical Observation of Laparoscopic Repair and Fundoplication for Esophageal Hiatal Hernia%腹腔镜食管裂孔疝修补术联合胃底折叠术治疗食管裂孔疝的临床观察

    Institute of Scientific and Technical Information of China (English)

    张文星; 孙作成; 孙充兵

    2013-01-01

      目的探讨腹腔镜食管裂孔疝修补联合胃底折叠术治疗食管裂孔疝疾病的可行性和临床应用价值.方法回顾性分析了潍坊市人民医院于2010年9月~2012年6月采用腹腔镜技术治疗的65例食管裂孔疝患者资料.其中 Nissen 全360°胃底折叠术24例,Toupet270°胃底折叠术20例,Dor 前180°胃底折叠术21例,52例应用补片修补裂孔,剩余患者丝线缝合裂孔.结果手术顺利,无中转开腹者.术后随访3~20个月,手术效果满意率92.31%,术后3个月复查胃镜、上消化道造影等检查基本恢复正常.其中11例患者术后早期出现轻度反酸、烧心症状,6例4个月内自行缓解,3例出现吞咽困难(Nissen 组2例,Toupet 组1例),1例出现严重反酸、腹胀(Dor 组),1例疝复发(Dor 组,单纯丝线缝合裂孔).结论腹腔镜食管裂孔疝修补和胃底折叠术治疗食管裂孔疝疾病有微创手术创伤小、恢复快、安全可行、疗效可靠等特点,胃底折叠术式根据病人具体情况应用.%Objective To explore the feasibility and clinical value of laparoscopic hiatal hernia repair and fundoplication for the treatment of esophageal hiatal hernia .Methods The clinical data of 65 patients who underwent laparoscopic surgery for esophageal hiatal hernia from September 2010 to June 2012 at our hospital were retrospectively analyzed ,including 24 cases of Nissen fundoplication,20 Toupet fundoplication,and 21 anterior 180 degrees partial fundoplication .Results All operations were performed smoothly ,no conversions were nee-ded.After the follow up period of 3 months ~20 months,the satisfaction rate of operation was 92.31%.The symptoms in most cases were ade-quately relieved after operation.Endoscopy,radiology were repeated 3 months after surgery.Eleven cases had mild symptom recurrence of acid reflux,6 cases relieved within 4 months,developed dysphagia occurred in 3 cases(2 in the Nissen group and 1 in the Dor group),1 case had severly acid

  5. Acute diaphragmatic rupture following open type IV paraesophageal hernia repair.

    Science.gov (United States)

    Reames, Bradley N; Reddy, Rishindra M

    2011-06-01

    Open primary transthoracic repair is a well established treatment for large paraesophageal hernias. The rate of major post-operative complications has been reported to be low, and no cases of acute diaphragmatic injury have previously been reported. Here we present a case of open primary transthoracic repair of a type IV paraesophageal hernia that was complicated by rupture of the left diaphragm in the immediate post-operative period, and was successfully repaired with Gore DualMesh® (W.L Gore and Assoc. Flagstaff, AZ). © JSCR.

  6. Biology of biological meshes used in hernia repair.

    Science.gov (United States)

    Novitsky, Yuri W

    2013-10-01

    Successful repair of most hernias requires the use of a prosthetic implant for reinforcement of the defect. Because of the need for prosthetic implants to resist infections as well to support repairs in contaminated or potentially contaminated fields, biological meshes have been developed to take the place of nondegradable synthetic meshes in cases where mesh infection is of high concern. The ideal is a biological matrix that resists infection while providing durable reinforcement of a hernia repair. This article reviews the validity of assumptions that support the purported notion of the biological behavior of biological meshes.

  7. Combined epigastric hernia repair and mini-abdominoplasty. Case report

    Directory of Open Access Journals (Sweden)

    Grella Roberto

    2015-01-01

    Full Text Available The objectives of abdominal hernia repair are to restore the structural integrity of the abdominal wall. Current techniques include primary closure, staged repair and the use of prosthetic materials. Techniques for mini-abdominoplasty include the use of the transverse lower abdominal incision and the resection of excess skin. We report a case of epigastric hernia repair through a transverse lower abdominal incision with the resection of excess of skin. Our purpose is to evaluate the results of the procedure by incorporating these aspects into an epigastric hernia repair, we found out that the procedures are made safer and the results are improved. Proper indication and details of the technique are described.

  8. An animal model to train Lichtenstein inguinal hernia repair

    DEFF Research Database (Denmark)

    Rosenberg, J; Presch, I; Pommergaard, H C

    2013-01-01

    PURPOSE: Inguinal hernia repair is a common surgical procedure, and the majority of operations worldwide are performed ad modum Lichtenstein (open tension-free mesh repair). Until now, no suitable surgical training model has been available for this procedure. We propose an experimental surgical...... training model for Lichtenstein's procedure on the male and female pig. METHODS: In the pig, an incision is made 1 cm cranially to the inguinal sulcus where a string of subcutaneous lymph nodes is located and extends toward the pubic tubercle. The spermatic cord is located in a narrow sulcus in the pig...... pigs, and a total of 55 surgeons have been educated to perform Lichtenstein's hernia repair in these animals. CONCLUSIONS: This new experimental surgical model for training Lichtenstein's hernia repair mimics the human inguinal anatomy enough to make it suitable as a training model. The operation...

  9. Standardized measurement of quality of life after incisional hernia repair

    DEFF Research Database (Denmark)

    Jensen, Kristian K; Henriksen, Nadia A; Harling, Henrik

    2014-01-01

    repair. The aim of this systematic review was to analyze existing standardized methods to measure quality of life after incisional hernia repair. DATA SOURCES: A PubMed and Embase search was carried out together with a cross-reference search of eligible papers, giving a total of 26 included studies...

  10. First human use of hybrid synthetic/biologic mesh in ventral hernia repair: a multicenter trial.

    Science.gov (United States)

    Bittner, James G; El-Hayek, Kevin; Strong, Andrew T; LaPinska, Melissa Phillips; Yoo, Jin S; Pauli, Eric M; Kroh, Matthew

    2017-07-19

    Mesh options for reinforcement of ventral/incisional hernia (VIH) repair include synthetic or biologic materials. While each material has known advantages and disadvantages, little is understood about outcomes when these materials are used in combination. This multicenter study reports on the first human use of a novel synthetic/biologic hybrid mesh (Zenapro(®) Hybrid Hernia Repair Device) for VIH repair. This prospective, multicenter post-market clinical trial enrolled consecutive adults who underwent elective VIH repair with hybrid mesh placed in the intraperitoneal or retromuscular/preperitoneal position. Patients were classified as Ventral Hernia Working Group (VHWG) grades 1-3 and had clean or clean-contaminated wounds. Outcomes of ventral and incisional hernia were compared using appropriate parametric tests. In all, 63 patients underwent VIH repair with hybrid mesh. Most were females (54.0%), had a mean age of 54.8 ± 10.9 years and mean body mass index of 34.5 ± 7.8 kg/m(2), and classified as VHWG grade 2 (87.3%). Most defects were midline (92.1%) with a mean area of 106 ± 155 cm(2). Cases were commonly classified as clean (92.1%) and were performed laparoscopically (60.3%). Primary fascial closure was achieved in 82.5% with 28.2% requiring component separation. Mesh location was frequently intraperitoneal (69.8%). Overall, 39% of patients available for follow-up at 12 months suffered surgical site events, which were generally more frequent after incisional hernia repair. Of these, seroma (23.7%) was most common, but few (8.5%) required procedural intervention. Other surgical site events that required procedural intervention included hematoma (1.7%), wound dehiscence (1.7%), and surgical site infection (3.4%). Recurrence rate was 6.8% (95% CI 2.2-16.6%) at 12-months postoperatively. Zenapro(®) Hybrid Hernia Repair Device is safe and effective in VHWG grade 1-2 patients with clean wounds out to 12 months. Short-term outcomes and recurrence

  11. Incisional, epigastric and umbilical hernia repair using the Prolene Hernia System: describing a novel technique.

    Science.gov (United States)

    Khera, Goldie; Berstock, David A

    2006-08-01

    The Prolene Hernia System (PHS) is already widely in use in the United Kingdom for inguinal hernias. We describe the novel technique of using the three-in-one design of the PHS (Ethicon Endo-Surgery, Bracknell, UK) for repairing incisional, epigastric and umbilical herniae. This is a three-dimensional device and consists of an onlay patch, a tubular connector and an underlay patch. We recommend a four 'corner' suturing of the underlay patch under vision (and then) through the full thickness of abdominal wall layers to ensure a flat underlay mesh. These four sutures flatten out the underlay patch and can be tied or removed with equal effect. The sutures are placed at 3, 6, 9 and 12 o'clock, which simplifies the procedure and ensures that the underlay lays correctly and is corrugation-free and tension-free, thereby providing a two-layer repair for those herniae with a high rate of recurrence.

  12. Spigelian hernia: surgical anatomy, embryology, and technique of repair.

    Science.gov (United States)

    Skandalakis, Panagiotis N; Zoras, Odyseas; Skandalakis, John E; Mirilas, Petros

    2006-01-01

    Spigelian hernia (1-2% of all hernias) is the protrusion of preperitoneal fat, peritoneal sac, or organ(s) through a congenital or acquired defect in the spigelian aponeurosis (i.e., the aponeurosis of the transverse abdominal muscle limited by the linea semilunaris laterally and the lateral edge of the rectus muscle medially). Mostly, these hernias lie in the "spigelian hernia belt," a transverse 6-cm-wide zone above the interspinal plane; lower hernias are rare and should be differentiated from direct inguinal or supravescical hernias. Although named after Adriaan van der Spieghel, he only described the semilunar line (linea Spigeli) in 1645. Josef Klinkosch in 1764 first defined the spigelian hernia as a defect in the semilunar line. Defects in the aponeurosis of transverse abdominal muscle (mainly under the arcuate line and more often in obese individuals) have been considered as the principal etiologic factor. Pediatric cases, especially neonates and infants, are mostly congenital. Embryologically, spigelian hernias may represent the clinical outcome of weak areas in the continuation of aponeuroses of layered abdominal muscles as they develop separately in the mesenchyme of the somatopleura, originating from the invading and fusing myotomes. Traditionally, repair consists of open anterior herniorraphy, using direct muscle approximation, mesh, and prostheses. Laparoscopy, preferably a totally extraperitoneal procedure, or intraperitoneal when other surgical repairs are planned within the same procedure, is currently employed as an adjunct to diagnosis and treatment of spigelian hernias. Care must be taken not to create iatrogenic spigelian hernias when using laparoscopy trocars or classic drains in the spigelian aponeurosis.

  13. A nationwide study on readmission, morbidity, and mortality after umbilical and epigastric hernia repair

    DEFF Research Database (Denmark)

    Bisgaard, T; Kehlet, H; Bay-Nielsen, M

    2011-01-01

    stay, risk of readmission, complications, and mortality  1 day. Readmissions occurred in 5.3% of cases (open 4.9%; laparoscopic 10.5%). In the majority of patients readmissions were due to wound-related problems (haematoma, bleeding and/or infection) (46%), seroma (19%), or pain (7%). At 30 days...... of wound problems, seroma formation, or pain. Future research should focus on early outcomes in terms of wound problems, seroma formation, and pain after umbilical and epigastric hernia repair....

  14. Emergency inguinal hernia repair under local anesthesia: a 5-year experience in a teaching hospital

    OpenAIRE

    2016-01-01

    Background Local anesthesia (LA) has been reported to be the best choice for elective open inguinal hernia repair because it is cost efficient, with less post-operative pain and enables more rapid recovery. However, the role of LA in emergency inguinal hernia repair is still controversial. The aim of this study is to investigate the safety and effectiveness of LA in emergency inguinal hernia repair. Methods All patients underwent emergency inguinal hernia repair in our hospital between Januar...

  15. Female 'groin' hernia: totally extraperitoneal (TEP) endoscopic repair seems the most appropriate treatment modality.

    Science.gov (United States)

    Schouten, N; Burgmans, J P J; van Dalen, T; Smakman, N; Clevers, G J; Davids, P H P; Verleisdonk, E J M M; Elias, S G; Simmermacher, R K J

    2012-08-01

    About 30% of all female 'groin' hernias are femoral hernias, although often only diagnosed during surgery. A Lichtenstein repair though, as preferred treatment modality according to guidelines, would not diagnose and treat femoral hernias. Totally extraperitoneal (TEP) hernia repair, however, offers the advantage of being an appropriate modality for the diagnosis and subsequent treatment of both inguinal and femoral hernias. TEP therefore seems an appealing surgical technique for women with groin hernias. This study included all female patients ≥ 18 years operated for a groin hernia between 2005 and 2009. A total of 183 groin hernias were repaired in 164 women. TEP was performed in 85% of women; the other 24 women underwent an open anterior (mesh) repair. Peroperatively, femoral hernias were observed in 23% of patients with primary hernias and 35% of patients with recurrent hernias. There were 30 cases (18.3%) of an incorrect preoperative diagnosis. Peroperatively, femoral hernias were observed in 17.3% of women who were diagnosed with an inguinal hernia before surgery. In addition, inguinal hernias were found in 24.0% of women who were diagnosed with a femoral hernia preoperatively. After a follow-up of 25 months, moderate to severe (VAS 4-10) postoperative pain was reported by 8 of 125 patients (6.4%) after TEP and 5 of 23 patients (21.7%) after open hernia repair (P = 0.03). Five patients had a recurrent hernia, two following TEP (1.4%) and three following open anterior repair (12.5%, P = 0.02). Two of these three patients presented with a femoral recurrence after a previous repair of an inguinal hernia. Femoral hernias are common in women with groin hernias, but not always detected preoperatively; this argues for the use of a preperitoneal approach. TEP hernia repair combines the advantage of a peroperative diagnosis and subsequent appropriate treatment with the known good clinical outcomes.

  16. Prolene Hernia System in the Tension-Free Repair of Primary Inguinal Hernias

    Directory of Open Access Journals (Sweden)

    Jayesh Gohel

    2012-06-01

    Full Text Available Objective: The aim of this study was to determine the feasibility of using the Prolene (polypropylene Hernia System for open tension-free repair on inguinal hernias, and study the results in terms of operation time, patient comfort, hospital stay, return to normal activity and postoperative complications. Material and Methods: From February 2002 through April 2003, we performed 50 open tension-free hernia repairs on 47 patients (46 men, 1 woman with a mean age of 55.8 years. There were 26 right and 18 left hernias, and 3 were bilateral. Of these, 39 were direct, 10 were indirect and 1 was femoral type. All were primary hernias. Results: The duration of surgery averaged 35 minutes (range 20 to 90 min. There was no perioperative mortality. Four patients developed mild self-limiting neuralgias. There were no subcutaneous wound infections, no haematomas, no seromas and no testicular atrophy. The average duration of postoperative hospitalisation was 3.5 days. The length of follow-up ranged from 1 month to 15 months (mean= 6.24 months. We have had no recurrences so far. Conclusion: The Prolene Hernia System is a novel approach in the management of inguinal hernias, with encouraging initial results. Its long-term efficacy needs to be studied with larger, prospective double-blind randomized trials, with longer follow-up. [National J of Med Res 2012; 2(3.000: 302-305

  17. RESULTS OF INGUINAL HERNIA REPAIRS PERFORMED UNDER LOCAL ANESTHSEIA

    OpenAIRE

    2001-01-01

    Aim: The aim of this study was to investigate the results of inguinal hernia repairs performed under local anesthesia with respect to operation duration, hospitalization period, postoperative complications, need for analgesics, and duration for recovery to normal life style. Material and Methods: Patients admitted to our hospital between January 1998 to January 2001 with diagnose of inguinal hernia were involved in this study. Of these patients whose with cardiovasculary and respiratory prob...

  18. Laparoscopic rectocele repair using polyglactin mesh.

    Science.gov (United States)

    Lyons, T L; Winer, W K

    1997-05-01

    We assessed the efficacy of laparoscopic treatment of rectocele defect using a polyglactin mesh graft. From May 1, 1995, through September 30, 1995, we prospectively evaluated 20 women (age 38-74 yrs) undergoing pelvic floor reconstruction for symptomatic pelvic floor prolapse, with or without hysterectomy. Morbidity of the procedure was extremely low compared with standard transvaginal and transrectal approaches. Patients were followed at 3-month intervals for 1 year. Sixteen had resolution of symptoms. Laparoscopic application of polyglactin mesh for the repair of the rectocele defect is a viable option, although long-term follow-up is necessary.

  19. 从循证医学角度谈腹腔镜腹股沟疝修补术20年进展%Progression of laparoscopic inguinal hernia repair in 20 years:Evidence based medicine interpretation for IEHS Guideline

    Institute of Scientific and Technical Information of China (English)

    陈鑫; 李健文

    2014-01-01

    解读国际腔镜疝协会(IEHS)发布的《腹腔镜腹股沟疝治疗指南(2011版)》,可以看到从循证医学角度评价腹腔镜腹股沟疝修补术(LIHR)在最初20年中(1990-2009年)的一些主要变化和进展。术式的进展包括:腹腔内修补术(IPOM)目前不作为腹股沟疝的主流术式(B级建议);而经腹腹膜前修补术(TAPP)或全腹膜外修补术(TEP)均为可选术式,无证据显示孰优孰劣,具全麻禁忌证病人可选择区域性麻醉行TEP(B级建议)。技术的进展包括:补片尺寸至少为10 cm×15 cm(A级建议),更大的缺损可应用更大的补片(≥12 cm×17 cm)(D级建议);Ⅰ、Ⅱ型疝可不固定补片,如固定,采用医用胶可降低急慢性疼痛的风险(B级建议);Ⅲ型直疝建议固定补片,但不能降低补片的尺寸(D级建议)。材料学进展包括:轻量型补片(LWM)至少可减少术后3个月内与补片相关的不适感(B级建议)。%To interpret the Guidelines for Laparoscopic (TAPP) and Endoscopic (TEP) Treatment of Inguinal Hernia constituted by International Endohernia Society (IEHS) in 2011,and evaluate the improvement and progression of laparoscopic inguinal hernia repair (LIHR) in the first 20 years (1990-2009) in an evidence-based way. Progression in operation methods:IPOM is not recommended for main stream inguinal hernia repair at present (Grade B). Both TAPP and TEP are acceptable options for inguinal hernia repair,but there is insufficient data to allow conclusion to be made about relative effectiveness of TAPP compared with TEP. In selected patients having a contraindication for general anesthesia,TEP in region anesthesia can be done (Grade B). Progression in surgical technique: A mesh size of at least 10 cm × 15 cm is recommended (Grade A); For larger hernias,a bigger mesh (12cm×17cm or greater) can be used (Grade D);In TAPP/TEP technique,nonfixation could be

  20. The Surgical Results of Onlay Mesh Repair for Incisional Hernia

    Directory of Open Access Journals (Sweden)

    Bülent Kaya

    2012-10-01

    Full Text Available Aim: İncisional hernia after abdominal surgery is an important problem. We aimed to evaluate the longterm recurrence rate as well as surgical complications in patients operated with onlay mesh repair technique for incisional hernia. Material and Method: We studied a serial of 139 patients retrospectively, operated due to incisional hernia in between January 2001 to November 2009 in Vakıf Gureba Training and Research Hospital General Surgery Department. The patient’s age, sex, location and size of the defect, operation findings, duration of hospitalization, early and late complications and recurrences were recorded. Result: There were 56 men and 83 women inour serial. The mean age was 55 (age range, 30-85 years. The most commonincisions that hernia had been developed were upper midline incision (51 patients and lower midline incision (37 patients. The size of the hernia defect was 0-5 cm in 118 patients , 6-10 cm in 5 patients 11-15 cm in 12 patients, and above 15 cm in 4 patients. The postoperative complications were wound infection in 22 patients, seroma in 12 patients. The mean duration of hospital stay was 4.53 (range 1-10 days. The recurrence was detected in 6 patients. Discussion: It seems to be that onlay mesh repair is safe and effective technique for incisional hernia repair.

  1. Managing intra-operative complications during totally extraperitoneal repair of inguinal hernia

    Directory of Open Access Journals (Sweden)

    Lomanto Davide

    2006-01-01

    Full Text Available Laparoscopic inguinal hernia repairs are looked upon as technically demanding procedures having have a stiff ′learning curve′ associated with its performance in terms of clinical outcome and patient′s satisfaction. Complication rates have been shown to drop with increased surgical experience. The complication rate for laparoscopic repair of inguinal hernia ranges from less than 3% to as high as 20%. Complications of a totally extraperitoneal (TEP repair include general complications that occur with any surgical procedure and anesthesia, mesh-related complications and those specific to the TEP procedure, like visceral injury, vascular injury, nerve injury and injury to the cord. Intraoperative complications can occur at every step of the operation, even though some of them are only occasionally reported. However, it is important to analyze all of them chronologically, so that we can define methods to prevent them or tackle them if they occur. Risk reduction strategies are required to improve the clinical outcome of TEP and this must be adopted for each individual surgical step.

  2. Mesh Plug Repair of Inguinal Hernia; Single Surgeon Experience

    Directory of Open Access Journals (Sweden)

    Ahmet Serdar Karaca

    2013-10-01

    Full Text Available Aim: Mesh repair of inguinal hernia repairs are shown to be an effective and reliable method. In this study, a single surgeon%u2019s experience with plug-mesh method performs inguinal hernia repair have been reported. Material and Method: 587 patients with plug-mesh repair of inguinal hernia, preoperative age, body / mass index, comorbid disease were recorded in terms of form. All of the patients during the preoperative and postoperative hernia classification of information, duration of operation, antibiotics, perioperative complications, and later, the early and late postoperative complications, infection, recurrence rates and return to normal daily activity, verbal pain scales in terms of time and postoperative pain were evaluated. Added to this form of long-term pain ones. The presence of wound infection was assessed by the presence of purulent discharge from the incision. Visual analog scale pain status of the patients was measured. Results: 587 patients underwent repair of primary inguinal hernia mesh plug. One of the patients, 439 (74% of them have adapted follow-ups. Patients%u2019 ages ranged from 18-86. Was calculated as the mean of 47±18:07. Follow-up period of the patients was found to be a minimum of 3 months, maximum 55 months. Found an average of 28.2±13.4 months. Mean duration of surgery was 35.07±4.00 min (min:22mn-max:52mn, respectively. When complication rates of patients with recurrence in 2 patients (0.5%, hematoma development (1.4% in 6 patients, the development of infection in 11 patients (2.5% and long-term groin pain in 4 patients (0.9% appeared. Discussion: In our experience, the plug-mesh repair of primary inguinal hernia repair safe, effective low recurrence and complication rates can be used.

  3. Clinical effect analysis of twenty-four cases with laparoscopic hiatal hernia repair%补片修补食管裂孔疝24例疗效分析

    Institute of Scientific and Technical Information of China (English)

    阿依都·阿不都热依木; 张辅江; 朱学鹏; 姜伟; 郭文江; 克力木; 张成

    2015-01-01

    Objective To investigate the superiority and applicability of patch repair in hiatal hernia surgery. Methods A retrospective analysis from April 2009 to January 2015 in Bazhou People′s Hospital was performed,24 cases were hiatal hernia, the patients underwent patch repair for hiatal hernia, Nissen fundoplication was in 12 cases, Toupet fundoplication in eight cases, Dor fundoplication in four cases. Results 24 patients were operated successfully completely, the operation time were 60 to 200 minutes, average were 120 minutes, blood loss were 20 to 100 ml, mean postoperative hospital stay were 6. 1 days, started to feed in 2 days after operation, drainage tubes were pulled out within 2 days after operation. Followed-up 7 to 46 months,subcutaneous and mediastinal emphysema was 1 case,4 cases were with Nissen fundoplication,swallowed hard in one year after the operation, after one year relieved. Conclusion Patch repair for hiatal hernia surgery is safe, reliable, with shorter operative time, less wound, less short-term relapse,less postoperative complications. For hiatal hernia,patch repair is a safe,effective treatment.%目的:探讨补片修补食管裂孔疝术的应用经验。方法回顾性分析2009年4月至2015年1月,新疆巴州人民医院收治的24例食管裂孔疝患者的临床资料,患者均行补片修补食管裂孔疝,其中Nissen胃底折叠术12例,Toupet胃底折叠术8例,Dor胃底折叠术4例。结果24例患者手术均顺利完成,手术时间60~200 min,平均120 min,失血量20~100 ml,术后平均住院6.1 d,术后2 d内进食,引流管在术后2 d内拔出。随访7~46个月,术后皮下纵隔气肿1例,其中4例行Nissen胃底折叠术,术后1年内有明显吞咽因难,1年后吞咽困难症状逐渐缓解。结论补片修补食管裂孔疝术具有安全可靠、手术时间短、创伤小、短期复发少、术后并发症少等优点。对于食管裂孔疝,补片修补食管裂孔疝术是一种安全、有效的治疗方法。

  4. LAPROSCOPIC REPAIR OF UMBLICAL HERNIA BY EXTRACORPOREAL KNOTTING - AN INNOVATIVE SUCCESSFUL NON MESH TECHNIQUE: LOW RECURRENCE RATES ON LONG TERM FOLLOW UP

    Directory of Open Access Journals (Sweden)

    Dhamotharan

    2015-11-01

    Full Text Available : BACKGROUND: This study evaluates the feasibility of laparoscopic transfascial suture and extracorporeal knotting repair of umbilical hernias. METHODS: From August 2005 to August 2015, 45 patients underwent laparoscopic umbilical suture repair. The repair was performed with the Carter-Thomason suture passer and cobbler’s needle. RESULTS: Of the 45, 36 patients with more than 1-year follow-up were included in the study. The mean diameter of the umbilical hernia defect was 1.30 cm (range, 0.5 to 2. At a mean follow-up of 34 months (range, 12 to 60, there were only 1 recurrence (2.77% which happened in patients with hernia defects larger than 1.5 cm in diameter. Apart from 2 wound infections, no other complications occurred. CONCLUSION: Laparoscopic suture repair of umbilical hernias with the suture passer method is effective and durable. The cobblers needle proved a simple and cosmetically acceptable device with which to close the umbilical hernia defect extracorporeally.This technique can be done simultaneously during other laproscopic procedures such as laproscopic cholecystectomy,laproscopic appendicectomy where mesh placement is not feasible in view of contamination.We tried this new innovative method and proved successful on long term followup

  5. Laparoscopic Repair for Perforated Duodenal Ulcer

    Directory of Open Access Journals (Sweden)

    A. Cotirleţ

    2015-01-01

    Full Text Available Perforated peptic ulcer (PPU, despite antiulcer medication and Helicobacter eradication, is still the most common indication for emergency gastric surgery associated with high morbidity and mortality. Perforated peptic ulcer is a common abdominal disease that is treated by surgery. The development of laparoscopic surgery has changed the way to treat such abdominal surgical emergencies but there is no consensus on whether the benefits of laparoscopic closure of perforated peptic ulcer outweigh the disadvantages such as prolonged surgery time and greater expense. However we can say that laparoscopic repair is a viable and safe surgical option for patients with perforated peptic ulcer disease and should be considered with the necessary expertise available.

  6. [Azoospermia and a history of inguinal hernia repair in adult].

    Science.gov (United States)

    Khodari, M; Ouzzane, A; Marcelli, F; Yakoubi, R; Mitchell, V; Zerbib, P; Rigot, J-M

    2015-10-01

    Inguinal hernia repair is one of the most performed surgeries in the world. It is recognized that any surgery of the pelvic floor may represent a risk factor of male infertility. Retrospective study of patients with azoospermia and a history of adult inguinal hernia repair surgery and referred to our center between January 1990 and January 2011 for infertility. Among 69 azoospermia patients with history of adult inguinal hernia repair surgery, 60 patients underwent surgical extraction of sperm that was successful in 75% (45/60). Positive extraction rate decreases in the subgroup of patients with risk factors for infertility (61.4%) as well as in the group with bilateral inguinal hernia (67.9%). There was no statistically significant difference in the positive rate of sperm retrieval according to surgical technique or according to the use of polypropylene mesh (P>0.05). The obstruction of the vas deferens due to an inguinal hernia repair was a potential iatrogenic cause of male infertility that was rare and underestimated. The influence of using a polypropylene mesh was not clearly demonstrated. The management of these patients is based on prevention in order to identify patients with risk factors of infertility in order to propose a presurgery cryopreservation of sperm. 5. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  7. 腹腔镜脐内侧韧带移植修补术治疗小儿腹股沟疝的体会%Experience of laparoscopic transplantation of medial umbilical ligament for repair of inguinal hernia in children

    Institute of Scientific and Technical Information of China (English)

    阿布都赛米·阿布都热依木; 阿孜古丽; 玉苏甫; 李水学; 克力木

    2012-01-01

    Objective: The objective of this study was lo explore the application value of using the medial umbilical ligament as a reinforcing flap to cover the internal ring during laparoscopic hemiorrhaphy in children with indirect inguinal hernia. Methods: From Jan. 2011 to Jan. 2012, this procedure was carried out in 46 consecutive children with indirect hernia. Results: The operation of all 46 cases were performed successfully,and the average operative time was 15 min. There were no intraoperative complications such as bleeding, injury to vas deferens or retroperitoneal haematoma. No case had recurrence during follow-up of 3-12 months. Conclusions;This operative procedure has advantages of minimal damage,simple and easy manipulation,quick postoperative recovery,high cure rate,without pain or recurrence. It is acceptable and worthy of clinical application.%目的:探讨腹腔镜脐内侧韧带移植修补术治疗小儿腹股沟疝的应用价值.方法:2011年1月至2012年1月为46例腹股沟斜疝患儿行单孔腹腔镜脐内侧韧带移植修补术.结果:46例手术均获成功,手术时间平均15 min;术中无出血、输精管损伤、腹膜后血肿等并发症发生.术后随访3~12个月,无一例复发.结论:腹腔镜脐内侧韧带移植修补术具有患儿创伤小、手术简便、康复快、治愈率高等优点,一般术后无痛苦及复发,易于被接受,值得推广应用.

  8. Hiatal and paraesophageal hernia repair in pediatric patients.

    Science.gov (United States)

    Garvey, Erin M; Ostlie, Daniel J

    2017-04-01

    Hiatal and paraesophageal hernia (HH/PEH) can be congenital, resulting from embryologic abnormalities/genetic predisposition, or acquired, most commonly after gastroesophageal surgery such as fundoplication. Minimizing circumferential esophageal dissection at the time of Nissen fundoplication has been shown to decrease the risk of acquired HH/PEH from 36.5% to 12.2%. Gastrointestinal, respiratory, and constitutional symptoms, including anemia and failure to thrive, are common with high rates of associated gastroesophageal reflux. Chest x-ray is often abnormal and upper GI confirms the diagnosis. Treatment is surgical with the goal of reducing the hernia contents, excising the hernia sac, closing the crura, and performing an antireflux procedure. The laparoscopic approach is safe and effective. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Toxic shock syndrome following inguinal hernia repair: a rare condition

    Directory of Open Access Journals (Sweden)

    Rohit Prasad Yadav

    2014-01-01

    Full Text Available A 25-year-old man developed fulminant multisystem failure 28 hours after elective repair of an inguinal hernia. Toxic shock syndrome (TSS was diagnosed. The patient recovered fully with supportive care in ICU, antibiotics, and IV human immunoglobin . To the best of our knowledge, only one case of TSS following inguinal hernia repair have ever been previously published. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 57-59 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9689

  10. Components separation technique combined with a double-mesh repair for large midline incisional hernia repair

    NARCIS (Netherlands)

    M. Bröker (Mirelle); E. Verdaasdonk (Emiel); T.M. Karsten (Thomas)

    2011-01-01

    textabstractBackground The surgical treatment of large midline incisional hernias remains a challenge. The aim of this report is to present the results of a new technique for large midline incisional hernia repair which combines the components- separation technique with a double-prostheticmesh repai

  11. Cholecystoenteric Fistule and Laparoscopic Repair

    Directory of Open Access Journals (Sweden)

    Temel Bulut

    2014-03-01

    Full Text Available Gallbladder stones are an endemic disease of hepatobiliary system.Whereas, cholecystoenteric fistules which develop by depending on gallbladder stone are rarely seen complications. A diagnosis is usually established during an operation. As is seen in our case too, in view of acute-stoned cholecystitis, laparoscopy has been carried out and a diagnosis of cholecystoduodenal fistule has been established during laparoscopy. Our case to whom laparoscopic duodenography and cholecystectomy has been applied is a rarely seen disease in literature. So, we aimed at sharing this information.

  12. 氩离子凝固术联合腹腔镜食管裂孔疝修补术加胃底折叠术治疗食管裂孔疝合并Barrett食管的疗效观察%Clinical study of argon plasma coagulation combined with laparoscopic hiatal hernia repair and fundoplication in the treatment of hiatal hernia with Barrett esophagus

    Institute of Scientific and Technical Information of China (English)

    张成; 克力木; 李义亮; 苏福增; 李慧灵; 王志; 李赞林; 艾克拜尔; 阿扎提

    2015-01-01

    Objective To investigate the clinical efficacy of argon plasma coagulation (APC) combined with laparoscopic hiatal hernia repair and fundoplication in the treatment of hiatal hernia associated with Barrett esophagus.Methods A total of 61 cases of hiatal hernias with Barrett esophagus from June 2010 to January 2014 in the Department of Minimal Invasive Surgery, Hernia and Abdominal wall Surgery, People's Hospital of Xinjiang Uyhur Autonomous Region were prospectively enrolled and were randomly allocated into two groups by computer system.Twenty-nine patients received esomeprazole 40 mg/d after APC treatment for 8 weeks (APC with medicine group).Thirty-two patients underwent laparoscopic hiatal hernia repair and Nissen fundoplication after APC treatment (APC with surgery group).All the patients were reviewed by gastroscope and pathologic examination at half a year and one year after operation respectively.Differences of disease improvement and recurrence between the two groups were evaluated.Results In APC with medicine group, the Barrett's esophagus was relieved after one or two times of APC treatment, however, gastroscope and pathology revealed recurrence of Barrett's esophagus in 7 cases at half a year, and cumulative 16 cases of recurrences were detected after one year follow-up (16/29, 55.2%).In APC with surgery group, only one patient had recurrent Barrett's esophagus at half a year, and a total of two at one year follow-up by gastroscope examination(2/32, 6.3%).Significantly low recurrence rate of Barrett's esophagus was observed in APC with surgery group compared to APC with medicine group(P<0.01).Furthermore, recurrent hiatal hernia was detected in only one case in APC with surgery group.No esophageal cancer was found in both groups during follow-up.Conclusion APC combined with laparoscopic hiatal hernia repair and fundoplication is an ideal method for patients with hiatal hernia and Barrett's esophagus.%目的 探讨氩离子凝固术(APC)联合腹

  13. Umbilical hernia in cirrhotic patients: outcome of elective repair.

    Science.gov (United States)

    Lasheen, Adel; Naser, Hatem M; Abohassan, Ahmed

    2013-12-01

    Cirrhotic patients with umbilical hernia have an increased likelihood of complications following repair. The aim of this study was to assess the outcomes of elective umbilical hernia repair in cirrhotic patients. Fifty patients having uncomplicated umbilical hernia with a cirrhotic liver were studied prospectively. These patients divided into three groups' according to Child-Turcotte-Pugh (CTP) classification. After management of coagulopathy, correction of hypoalbuminaemia and electrolytes imbalance, and control of ascites, all patients underwent elective hernia repair under regional anesthesia. A comparison was made between the three groups as regard the size of the defect in the linea Alba, operative time, postoperative morbidity and mortality, length of hospital stay, time of return to daily life and postoperative changes in liver function tests (LFTs) in relation to the regional anesthesia applied. hernioplasty was done under spinal anesthesia in 13 patients (26%), under epidural anesthesia in 10 patients (20%), under intercostal nerve block in 7 patients (14%), and under local anesthesia in 20 patients (40%). There was an increased safety (less changes in LFTs) in cases done under local anesthesia and intercostal nerve block. The overall complications rate was 30%. There was an increased complications rate towards the decompensated cases. The differences in the mean length of hospital stay and mean time of return to daily life are statistically significant between the three groups. Umbilical hernia recurrence rate was 2% and no mortality was reported in the study groups.

  14. Long term recurrence, pain and patient satisfaction afterventral hernia mesh repair

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    AIM To compare long term outcomes of laparoscopicand open ventral hernia mesh repair with respect torecurrence, pain and satisfaction.METHODS: We conducted a single-centre follow-upstudy of 194 consecutive patients after laparoscopicand open ventral hernia mesh repair between March2000 and June 2010. Of these, 27 patients (13.9%)died and 12 (6.2%) failed to attend their follow-upappointment. One hundred and fifty-three (78.9%)patients attended for follow-up and two patients (1.0%)were interviewed by telephone. Of those who attendedthe follow-up appointment, 82 (52.9%) patients hadreceived laparoscopic ventral hernia mesh repair(LVHR) while 73 (47.1%) patients had undergoneopen ventral hernia mesh repair (OVHR), including 11conversions. The follow-up study included analysesof medical records, clinical interviews, examination ofhernia recurrence and assessment of pain using a 100mm visual analogue scale (VAS) ruler anchored by word descriptors. Overall patient satisfaction was alsodetermined. Patients with signs of recurrence wereexamined by magnetic resonanceimaging or computedtomography scan.RESULTS: Median time from hernia mesh repair tofollow-up was 48 and 52 mo after LVHR and OVHRrespectively. Overall recurrence rates were 17.1%after LVHR and 23.3% after OVHR. Recurrence afterLVHR was associated with higher body mass index.Smoking was associated with recurrence after OVHR.Chronic pain (VAS 〉 30 mm) was reported by 23.5%in the laparoscopic cohort and by 27.8% in the opensurgery cohort. Recurrence and late complications werepredictors of chronic pain after LVHR. Smoking wasassociated with chronic pain after OVHR. Sixty pointfive percent were satisfied with the outcome after LVHRand 49.3% after OVHR. Predictors for satisfaction wereabsence of chronic pain and recurrence. Old age andshort time to follow-up also predicted satisfaction afterLVHR.CONCLUSION: LVHR and OVHR give similar long termresults for recurrence, pain

  15. Chemotherapy-induced enterocutaneous fistula after perineal hernia repair using a biological mesh: a case report

    Directory of Open Access Journals (Sweden)

    Eriksen MH

    2014-01-01

    Full Text Available MH Eriksen, O Bulut Department of Surgical Gastroenterology, Hvidovre University Hospital, University of Copenhagen, Copenhagen, Denmark Abstract: This is the first reported case of an enterocutaneous fistula as a late complication to reconstruction of the pelvic floor with a Permacol™ mesh after a perineal hernia. A 70-year-old man had a reconstruction of the pelvic floor with a biological mesh because of a perineal hernia after laparoscopic abdominoperineal resection. Nine months after the perineal hernia operation, the patient had multiple metastases in both lungs and liver. The patient underwent chemotherapy, including bevacizumab, irinotecan, calcium folinate, and fluorouracil. Six weeks into chemotherapy, the patient developed signs of sepsis and complained of pain from the right buttock. Ultrasound examination revealed an abscess, which was drained, guided by ultrasound. A computed tomography scan showed a subcutaneous abscess cavity located in the right buttock with communication to the small bowel. Operative findings confirmed a perineal fistula from the distal ileum to perineum. A resection of the small bowel with primary anastomosis was performed. The postoperative course was complicated by fluid and electrolyte disturbances, but the patient was stabilized and finally discharged to a hospice for terminal care after 28 days of hospital stay. It seems that hernia repairs with biological meshes have lower erosion and infection rates compared with synthetic meshes, and so far, evidence suggests that biological grafts are safe and effective in the treatment of pelvic floor reconstruction. There have been no reports of enteric fistulas after pelvic reconstruction with biological meshes. However, the development of intestinal fistulas after chemotherapy with bevacizumab has been described in the literature. Our case report supports this association between bevacizumab and fistula formation among rectal cancer patients, as symptoms of a

  16. Incisional hernia recurrence following 'vest-over-pants' or vertical mayo repair of primary hernias of the midline

    NARCIS (Netherlands)

    R.W. Luijendijk; M.H.M. Lemmen (M. H M); W.C.J. Hop (Wim); J.C.J. Wereldsma

    1997-01-01

    textabstractA series of 68 primary midline incisional hernias with a vertical Mayo repair was evaluated retrospectively. Patients without documented hernia recurrence following this repair were invited for physical examination. Life- table methods were used for statistical analysis. The 1-, 3-, 5-,

  17. A novel reconstruction method for giant incisional hernia: Hybrid laparoscopic technique

    Directory of Open Access Journals (Sweden)

    G Ozturk

    2015-01-01

    Full Text Available Background and Objectives: Laparoscopic reconstruction of ventral hernia is a popular technique today. Patients with large defects have various difficulties of laparoscopic approach. In this study, we aimed to present a new reconstruction technique that combines laparoscopic and open approach in giant incisional hernias. Materials and Methods: Between January 2006 and August 2012, 28 patients who were operated consequently for incisional hernia with defect size over 10 cm included in this study and separated into two groups. Group 1 (n = 12 identifies patients operated with standard laparoscopic approach, whereas group 2 (n = 16 labels laparoscopic technique combined with open approach. Patients were evaluated in terms of age, gender, body mass index (BMI, mean operation time, length of hospital stay, surgical site infection (SSI and recurrence rate. Results: There are 12 patients in group 1 and 16 patients in group 2. Mean length of hospital stay and SSI rates are similar in both groups. Postoperative seroma formation was observed in six patients for group 1 and in only 1 patient for group 2. Group 1 had 1 patient who suffered from recurrence where group 2 had no recurrence. Discussion: Laparoscopic technique combined with open approach may safely be used as an alternative method for reconstruction of giant incisional hernias.

  18. WSES guidelines for emergency repair of complicated abdominal wall hernias

    NARCIS (Netherlands)

    M. Sartelli (Massimo); F. Coccolini (Federico); G.H. van Ramshorst (Gabrielle); G. Campanelli (Giampiero); V. Mandala; L. Ansaloni (Luca); E.E. Moore (Ernest); A. Peitzman (Andrew); G.C. Velmahos (George ); F.A. Moore (Fredrick); A. Leppaniemi (Ari); C.C. Burlew (Clay); W.L. Biffl (Walter); K. Koike (Kaoru); Y. Kluger (Yoram); G.P. Fraga (Gustavo); C.A. Ordonez (Carlos); S. Di Saverio (Salomone); F. Agresta; B. Sakakushev (Boris); I. Gerych (Igor); I. Wani (Imtiaz); M.D. Kelly (Michael ); C.A. Gomes (Carlos); M.P. Faro Jr (Mario); K. Taviloglu (Korhan); Z. Demetrashvili (Zaza); J.G. Lee (Jeong ); N. Vettoretto (Nereo); G. Guercioni (Gianluca); C. Tranà (Cristian); Y. Cui (Yijun); K.Y.Y. Kok (Kenneth); W.M. Ghnnam (Wagih); A.E.S. Abbas (Ashraf El-Sayed); N. Sato (Norio); S. Marwah (Sanjay); M. Rangarajan (Muthukumaran); O. Ben-Ishay (Offir); A.R.K. Adesunkanmi (Abdul Rashid); H.A. Segovia Lohse (Helmut); J. Kenig (Jakub); V. Mandalà (Vincenzo); A. Patrizi (Andrea); R. Scibé (Rodolfo); F. Catena (Fausto)

    2013-01-01

    textabstractEmergency repair of complicated abdominal hernias is associated with poor prognosis and a high rate of post-operative complications. A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013, during the 2nd Congress of the World Society of Emergenc

  19. Reliable and valid assessment of Lichtenstein hernia repair skills

    DEFF Research Database (Denmark)

    Carlsen, Charlotte Green; Lindorff-Larsen, K; Funch-Jensen, P

    2013-01-01

    PURPOSE: Lichtenstein hernia repair is a common surgical procedure and one of the first procedures performed by a surgical trainee. However, formal assessment tools developed for this procedure are few and sparsely validated. The aim of this study was to determine the reliability and validity...

  20. Concomitant sublay mesh repair of umbilical hernia and abdominoplasty

    OpenAIRE

    2012-01-01

    Concomitant mesh repair of large umbilical hernias and abdominoplasty pose a serious risk of devascularizing the umbilical stalk. A technique of placing mesh in a sublay manner, deep to the fascial defect, for an umbilical herniorrhaphy to avoid damage to the deep umbilical perforators during an abdominoplasty is described.

  1. Ultrasound-guided nerve block for inguinal hernia repair

    DEFF Research Database (Denmark)

    Bærentzen, Finn; Maschmann, Christian; Jensen, Kenneth;

    2012-01-01

    Open inguinal hernia repair in adults is considered a minor surgical procedure but can be associated with significant pain. We aimed to evaluate acute postoperative pain management in male adults randomized to receive an ultrasound-guided ilioinguinal and iliohypogastric nerve block administered...

  2. WSES guidelines for emergency repair of complicated abdominal wall hernias

    NARCIS (Netherlands)

    M. Sartelli (Massimo); F. Coccolini (Federico); G.H. van Ramshorst (Gabrielle); G. Campanelli (Giampiero); V. Mandala; L. Ansaloni (Luca); E.E. Moore (Ernest); A. Peitzman (Andrew); G.C. Velmahos (George ); F.A. Moore (Fredrick); A. Leppaniemi (Ari); C.C. Burlew (Clay); W.L. Biffl (Walter); K. Koike (Kaoru); Y. Kluger (Yoram); G.P. Fraga (Gustavo); C.A. Ordonez (Carlos); S. Di Saverio (Salomone); F. Agresta; B. Sakakushev (Boris); I. Gerych (Igor); I. Wani (Imtiaz); M.D. Kelly (Michael ); C.A. Gomes (Carlos); M.P. Faro Jr (Mario); K. Taviloglu (Korhan); Z. Demetrashvili (Zaza); J.G. Lee (Jeong ); N. Vettoretto (Nereo); G. Guercioni (Gianluca); C. Tranà (Cristian); Y. Cui (Yijun); K.Y.Y. Kok (Kenneth); W.M. Ghnnam (Wagih); A.E.S. Abbas (Ashraf El-Sayed); N. Sato (Norio); S. Marwah (Sanjay); M. Rangarajan (Muthukumaran); O. Ben-Ishay (Offir); A.R.K. Adesunkanmi (Abdul Rashid); H.A. Segovia Lohse (Helmut); J. Kenig (Jakub); V. Mandalà (Vincenzo); A. Patrizi (Andrea); R. Scibé (Rodolfo); F. Catena (Fausto)

    2013-01-01

    textabstractEmergency repair of complicated abdominal hernias is associated with poor prognosis and a high rate of post-operative complications. A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013, during the 2nd Congress of the World Society of Emergenc

  3. Unsuspected femoral hernia in patients with a preoperative diagnosis of recurrent inguinal hernia

    DEFF Research Database (Denmark)

    Henriksen, N A; Thorup, J; Jorgensen, L N

    2012-01-01

    Small femoral hernias may be difficult to diagnose by physical examination and are sometimes identified unexpectedly by laparoscopy. The aim of this study was to examine the incidence of unsuspected femoral hernia discovered during laparoscopic inguinal hernia repair in two well-defined patient...

  4. Littre hernia: surgical anatomy, embryology, and technique of repair.

    Science.gov (United States)

    Skandalakis, Panagiotis N; Zoras, Odyseas; Skandalakis, John E; Mirilas, Petros

    2006-03-01

    Littre hernia is the protrusion of a Meckel diverticulum through a potential abdominal opening. Alexis de Littre (1700) reported ileal diverticula and attributed them to traction. August Gottlieb Richter (1785) defined them as preformed, and Johann Friedrich Meckel (1809) postulated their embryologic origin. Sir Frederic Treves (1897) distinguished between Littre and Richter hernia (partial enterocele). Embryologically, Meckel diverticulum is the persistent intestinal part of the omphaloenteric duct through which the midgut communicates with the umbilical vesicle until the fifth week. It is found at the antimesenteric border of the ileum, usually located 30 to 90 cm from the ileocecal valve, measuring 3 to 6 cm in length and 2 cm in diameter. Usual sites of Littre hernia are: inguinal (50%), umbilical (20%), and femoral (20%). Meckel diverticulum may be accompanied in the sac by the ileal loop to which it is attached; rarely, it may undergo incarceration or strangulation, necrosis, and perforation. In children, it is mostly found in umbilical hernias, and the diverticulum is more prone to adhere to the sac. Repair of Littre hernia consists of resection of the diverticulum and herniorraphy; in perforated cases, care must be taken to not contaminate the hernia field.

  5. 腹腔镜食管裂孔疝修补术并胃底折叠术对患者生存质量的影响%Impact of laparoscopic hiatal hernia repair and fundoplication on patient quality of life

    Institute of Scientific and Technical Information of China (English)

    周旭坤; 王昆; 李平; 江涛; 刘顺顺; 罗毅

    2012-01-01

    Objective: To explore laparoscopic hiatal hernia repair and fundoplication effect on the quality of life for patients. Methods: Gastrointestinal Lebens qualities index (GLQI) prospectively was measured for 29 cases of laparoscopic hiatal hernia repair and fundoplication patients before and after 2 weeks, 1 month,3 months,6 months,quality of life values,clinical analysis was made. Results :Preoperative patients GLQI index (83. 62 ± 13. 14) was significantly lower than the normal population 121-125 points. After 2 weeks, the patient GLQI index ( 86. 76 ± 10. 16) , somewhat higher than before surgery, but the difference was not significant ( P > 0. 05) ,mental,psychological areas were significantly improved compared with the preoperative data(P<0. 05). Surgery after 1 month,3 months,the index patient GLQI index (106. 83 ± 8. 40) , (113. 35 ± 8. 54) were significantly higher compared with preoperative and postoperative 2 weeks data(P<0. 05). Six months later,the patient GLQI index (121.45 ±5.96)was close to or reached normal levels. Conclusions:Laparoscopic hiatal hernia repair and fundoplication can improve postoperative quality of life,which could be close to or reach normal levels.%目的:探讨腹腔镜食管裂孔疝修补术并胃底折叠术对患者生存质量的影响.方法:采用消化病生存质量指数(gastrointestinal Lebens qualities index,GLQI)前瞻性地测定29例患者行腹腔镜食管裂孔疝修补术和胃底折叠术前,术后2周、1个月、3个月、6个月的生存质量值,并进行临床分析.结果:术前患者GLQI指数平均(83.62±13.14),明显低于正常人群(121 ~125分);术后2周平均(86.76±10.16),较术前有所升高,差异无统计学意义(P>0.05),但患者精神、心理较术前改善(P<0.05);术后1个月、3个月平均为(106.83±8.40)及(113.35±8.54),较术前及术后2周明显升高,差异有统计学意义(P<0.05);术后6个月平均(121.45±5.96),接近或达到正常水平.结论:

  6. Tailored Approach in Inguinal Hernia Repair – Decision Tree Based on the Guidelines

    OpenAIRE

    2014-01-01

    The endoscopic procedures TEP and TAPP and the open techniques Lichtenstein, Plug and Patch, and PHS currently represent the gold standard in inguinal hernia repair recommended in the guidelines of the European Hernia Society, the International Endohernia Society, and the European Association of Endoscopic Surgery. Eighty-two percent of experienced hernia surgeons use the “tailored approach,” the differentiated use of the several inguinal hernia repair techniques depending on the findings of ...

  7. An Unusual Trocar Site Hernia after Prostatectomy

    Directory of Open Access Journals (Sweden)

    Ryan K. Schmocker

    2016-01-01

    Full Text Available Trocar site hernias are rare complications after laparoscopic surgery but most commonly occur at larger trocar sites placed at the umbilicus. With increased utilization of the laparoscopic approach the incidence of trocar site hernia is increasing. We report a case of a trocar site hernia following an otherwise uncomplicated robotic prostatectomy at a 12 mm right lower quadrant port. The vermiform appendix was incarcerated within the trocar site hernia. Subsequent appendectomy and primary repair of the hernia were performed without complication.

  8. De Garengeot's hernia: diagnosis and surgical management of a rare type of femoral hernia.

    Science.gov (United States)

    Ramsingh, Jason; Ali, Ahmad; Cameron, Caroline; Al-Ani, Ahmed; Hodnett, Robert; Chorushyj, Catriona

    2014-02-12

    De Garengeot's hernia is quite rare and is a femoral hernia that contains a vermiform appendix and can present as a painful, tender swelling or an asymptomatic lump. We present the case of a 70-year-old patient who presented to our surgical unit after being referred for diagnostic imaging of an asymptomatic groin lump which was found to be a De Garengeot's hernia. She had an open repair of her femoral hernia and laparoscopic appendicectomy. Her post-operative stay was uneventful. De Garengeot's hernia is rare; however, imaging is usually required to make a diagnosis preoperatively. Management is usually surgical with simultaneous repair of the femoral hernia and appendicectomy.

  9. Results of AlloDerm use in abdominal hernia repair.

    Science.gov (United States)

    Misra, S; Raj, P K; Tarr, S M; Treat, R C

    2008-06-01

    AlloDerm (decellularized human cadaveric dermis) is increasingly being used for tissue reconstruction and hernia repairs. This article presents the results of AlloDerm use in treating abdominal wall hernias by analyzing all patients who underwent repair with AlloDerm at our institution. A series of 70 consecutive patients starting in October 2003 with abdominal wall hernia repair using AlloDerm was studied. This study began as a retrospective chart review, which included subsequent postoperative follow-up. SPSS version 11.5 was used for statistical analysis, and parametric tests were conducted. Various technical variables (type of AlloDerm placement, mesh-suture technique, suture type) and nontechnical variables (steroids use, obesity, smoking status, diabetes, prior surgeries, number of comorbidities) were evaluated. Of 70 study patients, 31 were men and 39 were women, with a mean age of 58 (range 25-88) years. Fifty-six patients (80%) had no complications, whereas 14 (20%) suffered one or more complications. Of those patients with complications, there was one rejection, two infections, and 14 hernia recurrences. The overall complication rate was 24%. Of patients with hernia recurrences, one had the initial repair with AlloDerm implant of 1.8-mm thickness (ultrathick). The 14 patients with recurrences include three who had a prior AlloDerm repair with ultrathick implant. Two of these three patients reported abdominal wall protrusion, and one had a recurrence between two pieces of AlloDerm used in the initial repair. Of these 14 patients, nine had subsequent repair of their recurrence with synthetic mesh, and four had subsequent repair with AlloDerm with satisfactory outcomes; one patient was yet to have a repair at the time of this paper. Recurrence rates with ultrathick and thick AlloDerm were 23% and 6%, respectively. None of the patients who were on steroid therapy had complications. Mesh-suture technique had no effect on recurrence. Type of placement was

  10. Laparoscopic repair of high rectovaginal fistula: Is it technically feasible?

    Directory of Open Access Journals (Sweden)

    Parthasarathi Ramakrishnan

    2005-10-01

    Full Text Available Abstract Background Rectovaginal fistula (RVF is an epithelium-lined communication between the rectum and vagina. Most RVFs are acquired, the most common cause being obstetric trauma. Most of the high RVFs are repaired by conventional open surgery. Laparoscopic repair of RVF is rare and so far only one report is available in the literature. Methods We present a case of high RVF repaired by laparoscopy. 56-year-old female who had a high RVF following laparoscopic assisted vaginal hysterectomy was successfully operated laparoscopically. Here we describe the operative technique and briefly review the literature. Results The postoperative period of the patient was uneventful and after a follow up of 6 months no recurrence was found. Conclusion Laparoscopic repair of high RVF is feasible in selected patients but would require proper identification of tissue planes and good laparoscopic suturing technique.

  11. Location of recurrent groin hernias at TEP after Lichtenstein repair: a study based on the Swedish Hernia Register.

    Science.gov (United States)

    Bringman, S; Holmberg, H; Österberg, J

    2016-06-01

    To investigate which type of hernia that has the highest risk of a recurrence after a primary Lichtenstein repair. Male patients operated on with a Lichtenstein repair for a primary direct or indirect inguinal hernia and with a TEP for a later recurrence, with both operations recorded in the Swedish Hernia Register (SHR), were included in the study. The study period was 1994-2014. Under the study period, 130,037 male patients with a primary indirect or direct inguinal hernia were operated on with a Lichtenstein repair. A second operation in the SHR was registered in 2236 of these patients (reoperation rate 1.7 %). TEP was the chosen operation in 737 in this latter cohort. The most likely location for a recurrence was the same as the primary location. If the recurrences change location from the primary place, we recognized that direct hernias had a RR of 1.51 to having a recurrent indirect hernia compared to having a direct recurrence after an indirect primary hernia repair. Recurrent hernias after Lichtenstein are more common on the same location as the primary one, compared to changing the location.

  12. Management of Patients with Hernia or Incisional Hernia Undergoing Surgery for Morbid Obesity

    Directory of Open Access Journals (Sweden)

    Ramon Vilallonga

    2011-01-01

    Full Text Available Morbidly obese patients (MOPs are predisposed to developing abdominal wall hernias with the potential complication of small bowel obstruction and other morbidity. We report our experience in treating morbidly obese patients. Hernia prophylaxis has been attempted as a means of decreasing the incisional hernia risk associated with weight loss surgery. The controversy regarding the optimal time and method of repair of abdominal wall hernias in patients undergoing open or laparoscopic gastric bypass is discussed with emphasis placed on either a simultaneous repair or splits of the omentum, and of leaving a plug in the hernia defect, to allow time to perform a delayed repair.

  13. Surgical management of chronic pain after inguinal hernia repair

    DEFF Research Database (Denmark)

    Aasvang, E; Kehlet, H

    2005-01-01

    BACKGROUND: Chronic pain after inguinal hernia repair is an adverse outcome that affects about 12 per cent of patients. Principles of treatment have not been defined. This review examines neurectomy and mesh or staple removal as possible treatments. METHOD: A literature search was carried out using...... the Medline and Ovid databases. Keywords were 'pain; chronic', 'herniorrhaphy; inguinal', 'neurectomy' and similar words. Article references were cross-checked for additional references. Articles were reviewed for data on surgical treatment of chronic pain after hernia repair. RESULTS: Neurectomy...... of the ilioinguinal, iliohypogastric, genitofemoral or lateral femoral cutaneous nerve was described in 14 papers. Overall, a favourable outcome was reported. However, the methodological quality was poor in all studies in respect of preoperative diagnostic criteria and treatment, intraoperative success in identifying...

  14. Leiomyoma mimicking an incarcerated inguinal hernia: A rare complication of laparoscopic hysterectomy

    Directory of Open Access Journals (Sweden)

    Carlos Apestegui

    2011-01-01

    Full Text Available A 52-year-old, obese, female patient was referred for a right inguinal mass, which appeared seven months after a laparoscopic hysterectomy, which was performed because of myomatosis. Despite several examinations, including ultrasound, computed tomography (CT-Scan, positron emission tomography (PET-CT, and ultrasound-guided biopsy, the diagnosis remained unclear until surgical exploration, which disclosed a well-encapsulated solid tumour corresponding to a fibrotic leiomyoma. Spilling of leiomyoma cells is a rare and unusual complication of laparoscopic surgery. Tumour development in the inguinal canal after laparoscopic gynaecological surgery should be kept in mind in the differential diagnosis of inguinal hernia and other uncommon pathologies.

  15. A systematic review of laparoscopic port site hernias in gastrointestinal surgery.

    LENUS (Irish Health Repository)

    Owens, M

    2011-08-01

    Port site hernia is an important yet under-recognised complication of laparoscopic surgery, which carries a high risk of strangulation due to the small size of the defect involved. The purpose of this study was to examine the incidence, classification, and pathogenesis of this complication, and to evaluate strategies to prevent and treat it.

  16. Clinical experience with laparoscopic inguinal hernia 45 cases%腹腔镜治疗腹股沟疝45例的临床体会

    Institute of Scientific and Technical Information of China (English)

    王景学

    2015-01-01

    ObjectiveTo explore the feasibility and superiority of laparoscopic inguinal hernia repair.Methods Retrospective analysis of the clinical data of 45 cases of laparoscopic repair of inguinal hernia.ResultsIn this group of patients in the combined anesthesia or general anesthesia laparoscopic treatment of children, 12 underwent high ligation. Adult for transabdominal preperitoneal repair in 28 cases, total extraperitoneal repair in 5 cases, including 2 cases with chronic cholecystitis cholecystectomy, 3 cases with chronic appendicitis, appendectomy, 3 cases of inguinal and scrotal hematoma after operation, 1 cases of recurrence of hernia.Conclusion Laparoscopic treatment with less trauma, less complications and lower recurrence rate advantages of recurrent hernia, inguinal hernia, especially bilateral hernia, abdominal cavity associated with other diseases underwent the combined operation has greater advantage.%目的:探讨腹腔镜行腹股沟疝修补术的可行性及优越性。方法回顾分析45例腹股沟疝行腹腔镜修补术患者的临床资料。结果本组患者在联合阻滞或全麻下行腹腔镜治疗,儿童12例行高位结扎术。成人行经腹腹膜前