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Laparoscopic Transabdominal Preperitoneal Mesh Hernioplasty: A Medical College Experience  [PDF]
Mushtaq Chalkoo, Mujahid Ahmad Mir, Hilal Makhdoomi
Surgical Science (SS) , 2016, DOI: 10.4236/ss.2016.72015
Abstract: Objectives: To determine the feasibility and patient’s outcome of laparoscopic transabdominal preperitoneal mesh hernioplasty for inguinal hernias. Patients and Methods: This study was carried out from March 2011 to April 2014. A total of 130 patients underwent laparoscopic transabdominal preperitoneal mesh hernioplasty (TAPP) for uncomplicated inguinal hernia. Of this, 10 patients presenting with bilateral inguinal hernias were operated in the single sitting. A 15 cm × 12 cm polypropylene mesh was used in all cases. Operative morbidity, postoperative pain, seroma formation, evidence of superficial infection, chronic groin pain and hernia recurrence were noted. The majority of the patients were discharged within 24 hours and follow-up was done at 1 week, 1 month, and 6 months. Results: 130 patients presenting with uncomplicated inguinal hernias were operated over a period of three years in the department of surgery, Govt. Medical College Srinagar. The mean age of the patients was 39.18 years (range: 18 - 70 years). The median duration of operation was 48.5 minutes (range: 18 - 120 minutes). None of the procedure was converted to open inguinal hernia repair. Postoperative pain was observed in 9.23% of the cases and was easily controlled by oral analgesics. Six patients (4.62%) developed seroma, out of which one required aspiration while others settled conservatively. Two patients (1.54%) developed wound infection and one patient (0.77%) had recurrence. None of the patients developed scrotal hematoma or neuralgia. Return to normal activity after TAPP repair was found to be after a median of 16.1 days. Conclusion: Transabdominal preperitoneal repair for inguinal hernia using proline mesh may be a safe and effective procedure with low morbidity, early return to normal activity and with a very low recurrence after six months follow-up.
LAPAROSCOPIC TRANSABDOMINAL PRE-PERITONEAL (TAPP) FOR BILATERAL INGUINAL HERNIA
R. Moldovanu,G. Pavy
Jurnalul de Chirurgie , 2010,
Abstract: The laparoscopic approach is not still the world wide accepted for the treatment of inguinal hernias. However, in the last years, this approach tends to become the gold standard procedure for the one day surgery of groin hernias. We present the laparoscopic TransAbdominal PrePeritoneal approach (TAPP) in a case of a large bilateral, direct type inguinal hernia. The surgical technique is described and different key points are discussed. Conclusions: TAPP is a feasible method for the treatment of bilateral hernia. The laparoscopic exploration allows the intra operative diagnosis of other associated hernias. The anatomic landmarks are easily recognizable and the learning curve could be shortened. The postoperative recovery is rapid and the patient can quicker return to his normal activity; in this way, the day surgery could be considered.
Laparoscopic appendicectomy for suspected mesh-induced appendicitis after laparoscopic transabdominal preperitoneal polypropylene mesh inguinal herniorraphy  [cached]
Jennings Jason,Ng Philip
Journal of Minimal Access Surgery , 2010,
Abstract: Laparoscopic inguinal herniorraphy via a transabdominal preperitoneal (TAPP) approach using Polypropylene Mesh (Mesh) and staples is an accepted technique. Mesh induces a localised inflammatory response that may extend to, and involve, adjacent abdominal and pelvic viscera such as the appendix. We present an interesting case of suspected Mesh-induced appendicitis treated successfully with laparoscopic appendicectomy, without Mesh removal, in an elderly gentleman who presented with symptoms and signs of acute appendicitis 18 months after laparoscopic inguinal hernia repair. Possible mechanisms for Mesh-induced appendicitis are briefly discussed.
Single-incision trans-abdominal preperitoneal mesh hernioplasty  [cached]
Roy Prabal,De Anushtup
Journal of Minimal Access Surgery , 2011,
Abstract: Single-incision laparoscopy is being used to carry out a wide variety of laparoscopic operations since its introduction in 2007. Various case reports and studies have demonstrated the safety and feasibility of single-incision laparoscopic transabdominal preperitoneal (TAPP) and totally extra-peritoneal mesh hernioplasty. However, till date, its apparent advantages have been mainly cosmetic and related to patient satisfaction. We have been performing single-incision laparoscopic TAPP mesh hernioplasty since June 2009 using conventional laparoscopic instruments. Here, we describe our technique that is aimed at standardising the method.
A New Alternative Technique for Preperitoneal Inguinal Hernia Repair: Using Groin Innominate Fascial Island Flap  [PDF]
Feyzi Kurt, Musa Abe?
Surgical Science (SS) , 2012, DOI: 10.4236/ss.2012.37071
Abstract: Aim: Despite the fact that reported low recurrence rates and improvement results, optimal surgical technique for in-guinal hernia repair was not found and recurrence was not eliminated. We used firstly groin innominate fascial island flap to reinforce the weak inguinal tissue for the repair. Methods: From the February 2010 to December 2010, 15 patients (13 male and 2 female) with inguinal hernia underwent repair with using island groin innominate fascial flap. The follow-up period ranged from 8 to 12 months (mean, 10 months). Results: Seroma developed in one case. Others had not any complications. Conclusion: Because of our technique avoids from the complications and drawbacks of the prosthetic mesh, autograft and abdominal wall flaps, we think that the groin deep fascial flap can be a good alternative to prosthetic meshes for reconstruction of inguinal hernia repair.
Appendiceal pus in a hernia sac simulating strangulated femoral hernia: a case report
Tien-Fa Hsiao, Yenn-Hwei Chou
International Journal of General Medicine , 2011, DOI: http://dx.doi.org/10.2147/IJGM.S16413
Abstract: ppendiceal pus in a hernia sac simulating strangulated femoral hernia: a case report Case report (2897) Total Article Views Authors: Tien-Fa Hsiao, Yenn-Hwei Chou Published Date March 2011 Volume 2011:4 Pages 235 - 237 DOI: http://dx.doi.org/10.2147/IJGM.S16413 Tien-Fa Hsiao, Yenn-Hwei Chou Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan Abstract: Acute appendicitis involving the hernia sac is infrequent but well-documented in medical literature. In most instances, it occurs within the right inguinal (Amyand’s hernia) or right femoral hernia (de Garengeot hernia). The diagnosis is always mistaken for incarcerated groin hernia. During surgery, the appendix itself, either perforated or strangulated, is most commonly encountered within the hernia sac. In very rare occasions, only appendiceal pus is found in the hernia sac. In this paper, we report the case of a 90-year-old woman with acute appendicitis and a tender mass in the right groin. Typical findings of acute appendicitis by computed tomography (CT) and incarcerated femoral hernia with groin cellulitis misled us into preoperative diagnosis of strangulated femoral hernia. Acute phlegmonous inflammation of the incarcerated femoral hernia sac containing pus only and acute suppurative appendicitis were found intraoperatively. This case presents a rare complication of acute appendicitis and the first report of CT-documented appendiceal pus-contained femoral hernia. Knowledge of this rare condition is helpful in establishing preoperative diagnosis and patient management decisions.
Anterior Lichtenstein Repair versus Posterior Preperitoneal Repair Techniques for Recurrent Inguinal Hernia  [cached]
Ali Güner,Kadri Güler,Süleyman Bozkurt,Mehmet Altan Kaya
Erciyes Medical Journal , 2009,
Abstract: Purpose: Recurrent inguinal hernia presents a significant clinical problem with high recurrence and complication rates. However, a gold standart technique for the repair of recurrent hernia has not been established. The aim of this study was to evaluate the efficiency of two different techniques for repairing recurrent groin hernia.Material and methods: This was a prospective randomized study of 70 consecutive patients with recurrent inguinal hernia. 34 patients were managed by preperitoneal mesh graft, 36 patients were managed by Lichtenstein mesh hernioplasty. Early and late results of both techniques were compared.Results: Despite there was no statistically significant difference for early complications and re-recurrence, the group of preperitoneal repair had shorter average operation time and lower pain scores. There were one recurrence in preperitoneal group and three recurrences in Lichtenstein group with a follow-up period ranging from 12 to 48 months.Conclusion: As a result this study, it was concluded that the preperitoneal mesh repair is a safe and efficient method with its lower pain score and shorter operation time for the repairing of recurrent inguinal hernia.
Strangulated Femoral Hernia Turned to Be Peritoneal Cyst  [PDF]
Dionysios Dellaportas,George Polymeneas,Christina Dastamani,Evi Kairi-Vasilatou,Ioannis Papaconstantinou
Case Reports in Surgery , 2012, DOI: 10.1155/2012/528780
Abstract: Introduction. A peritoneal inclusion cyst is a very rare mesenteric cyst of mesothelial origin usually asymptomatic. A rare case of an 82-year-old white Caucasian female with a femoral hernia containing a large peritoneal inclusion cyst, mimicking strangulated hernia, is presented herein. Case Presentation. The patient was admitted to our hospital suffering from a palpable groin mass on the right, which became painful and caused great discomfort for the last hours. Physical examination revealed a tender and tense, irreducible groin mass. An inguinal operative approach was selected and the mass was found protruding through the femoral ring. After careful dissection it turned out to be a large unilocular cyst, containing serous fluid, probably originating from the peritoneum. McVay procedure was used to reapproximate the femoral ring. Histologic examination showed a peritoneal inclusion cyst. Discussion. Peritoneal inclusion cysts are usually asymptomatic but occasionally present with various, nonspecific symptoms according to their size. Our case highlights that high index of clinical suspicion and careful exploration during repair of a hernia is mandatory in order to reach the correct diagnosis about hernia’s contents. 1. Introduction A peritoneal inclusion cyst is a very rare mesenteric cyst of mesothelial origin occurring in the peritoneal cavity, mostly affecting women in the reproductive age. Unilocular peritoneal inclusion cysts are usually asymptomatic, but occasionally present with various, nonspecific symptoms, which makes correct preoperative diagnosis difficult [1]. They may be attached or lie free in the peritoneal cavity, and occasionally they may involve the round ligament simulating an inguinal hernia. Femoral hernias comprise 6–17% of abdominal wall hernias and usually contain abdominal viscera [2]. We present a rare case of an 82-year-old white female with a femoral hernia containing a large peritoneal inclusion cyst, mimicking strangulated hernia. 2. Case Presentation An 82-year-old white Caucasian female was admitted to our hospital suffering from a palpable groin mass on the right, which appeared two days ago, but for the last hours before admission it became painful and caused great discomfort. The mass was tender and tense on physical examination measuring at least 8?cm on diameter, and it was not reducible. The initial differential diagnosis was either a strangulated femoral or groin hernia. She had no history of other hernias and her laboratory findings were within normal range. Also no history of previous surgery, endometriosis,
Strangulated Femoral Hernia Turned to Be Peritoneal Cyst
Dionysios Dellaportas,George Polymeneas,Christina Dastamani,Evi Kairi-Vasilatou,Ioannis Papaconstantinou
Case Reports in Surgery , 2012, DOI: 10.1155/2012/528780
Abstract: Introduction. A peritoneal inclusion cyst is a very rare mesenteric cyst of mesothelial origin usually asymptomatic. A rare case of an 82-year-old white Caucasian female with a femoral hernia containing a large peritoneal inclusion cyst, mimicking strangulated hernia, is presented herein. Case Presentation. The patient was admitted to our hospital suffering from a palpable groin mass on the right, which became painful and caused great discomfort for the last hours. Physical examination revealed a tender and tense, irreducible groin mass. An inguinal operative approach was selected and the mass was found protruding through the femoral ring. After careful dissection it turned out to be a large unilocular cyst, containing serous fluid, probably originating from the peritoneum. McVay procedure was used to reapproximate the femoral ring. Histologic examination showed a peritoneal inclusion cyst. Discussion. Peritoneal inclusion cysts are usually asymptomatic but occasionally present with various, nonspecific symptoms according to their size. Our case highlights that high index of clinical suspicion and careful exploration during repair of a hernia is mandatory in order to reach the correct diagnosis about hernia’s contents.
Transumbilical single-incision laparoscopic inguinal hernia repair – feasibility study on anatomical specimens  [cached]
Andreas Kirschniak,Thomas Shiozawa,Markus Küper,Frank A. Granderath
Videosurgery and Other Miniinvasive Techniques , 2010,
Abstract: Laparoscopic inguinal hernia has replaced open surgery in recent years. For transabdominal preperitoneal mesh placement,3 incisions have to be made to prepare the inguinal region, place the mesh and adapt the peritoneum witha suture. We describe the feasibility of a single incision transumbilical hernia repair. For this, we operated on3 anatomical specimens (2 male, 1 female), which had been conserved using alcohol-glycerol fixation. A subumbilical1.5 cm incision was performed, and three 5 mm trocars were inserted. The preparation and procedure steps conformedto conventional laparoscopic transabdominal preperitoneal hernia repair (TAPP). In the right port we used a 5 mm30 degree laparoscope, for preparation a grasper and scissors with optional flexure. Mean procedure time was 45.5 min(35-55 min, ±7 min). The left and right inguinal region was prepared. Adaptation in handling and ergonomics needsfamiliarization.
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