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Laparoscopic hernioplasty by Eyeglass-Shaped Mesh in 54 patients with bilateral inguinal hernia
Talebpour M,Yagoobi A,Zargar M
Tehran University Medical Journal , 2007,
Abstract: 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.
Laparoscopic Hernioplasty Using Omega-3 Coating Mesh  [PDF]
Masahiko Kawaguchi, Norihiko Ishikawa, Youji Nishida, Hideki Moriyama, Masahiro Kaneki, Go Watanabe
Surgical Science (SS) , 2012, DOI: 10.4236/ss.2012.38077
Abstract: Background: Laparoscopic hernioplasty has gained popularity with significant advances in prostheses. Omega-3 coating mesh (C-Qur) is a prosthesis that can be used in the abdominal cavity, and the coating prevents adhesion of the mesh to the viscera. We planned a prospective observational study of laparoscopic hernioplasty using C-Qur. Methods: C-Qur was used in laparoscopic hernioplasty over the course of 1 year. We considered laparoscopic approaches as our primary treatment method for abdominal wall hernias. Although only a single incision was made for the majority of the laparoscopic hernioplasties, additional incisions were made when severe adhesions were encountered. For incisional or ventral hernias, a lateral lower incision was made. For inguinal hernias, an umbilical incision was made. Sex, age, diagnosis, number of incisions, additional incisions, morbidity, and follow-up period were evaluated. Results: Twenty-four patients who underwent surgery between May 2010 and April 2011 were included in this study. The median follow-up period was 14 months. The most common early complications included wound pain and edema; however, there were no persistent complications.
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 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.
Laparoscopic Observations in Acquired Inguinal Hernia before and after Robotic-Assisted Laparoscopic Prostatectomy  [PDF]
Masahiko Kawaguchi, Yoshifumi Kadono, Masanari Shimada, Hideki Moriyama, Norihiko Ishikawa, Go Watanabe
Surgical Science (SS) , 2014, DOI: 10.4236/ss.2014.54030
Abstract: Background: The mechanism of the development of acquired inguinal hernia, especially indirect inguinal hernia, is not well known. Although anatomical studies have been performed to explain development of inguinal hernia, they have mainly involved autopsy or temporal findings at the time of hernioplasty. To elucidate the pattern of development of acquired inguinal hernia, we studied the occurrence of inguinal hernia after robotic-assisted laparoscopic prostatectomy (RALP). Methods: From March 2009 to November 2011, RALP for prostatic cancer was performed on 60 patients in our institute. The RALP was performed by one urologist using the da Vinci Surgical System. The postsurgical development of inguinal hernia was diagnosed based on patients’ symptoms. Seven patients were treated with laparoscopic hernioplasty, and one underwent mesh-plug repair. Using video recordings, the laparoscopic findings during RALP and laparoscopic hernioplasty were compared among all patients. Results: Seven of 59 patients (11.9%) developed an inguinal hernia. One patient had a pre-existing pantaloon inguinal hernia at the time of RALP. Eleven inguinal lesions in the seven patients who underwent laparoscopic hernioplasty were reviewed, and all were indirect inguinal hernias. Conclusion: A main factor in the development of inguinal hernia after RALP could be a combination of outer-side intact layers and inner-side hard scar of the inguinal ring, which seems like “out swing door”.
Hernioplastia laparoscópica totalmente extraperitoneal com tela 3-D sem fixa o: técnica de Dulucq Laparoscopic totally extraperitoneal hernioplasty with nonfixation of three-dimensional mesh: Dulucq's technique
Alberto Meyer,Jean-louis Dulucq,Ahmad Mahajna
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2013,
Abstract: INTRODU O: A repara o da hérnia inguinal tem sido área controversa na prática cirúrgica, desde que desde que ela foi concebida. O fato de que inúmeros procedimentos diferentes est o em uso reflete a complexidade de hérnia inguinal e seu reparo. OBJETIVO: Descrever a técnica de Dulucq e as modifica es do uso da tela 3-D na corre o de hérnia inguinal laparoscópica totalmente extraperitoneal. MéTODOS: A técnica da corre o da hérnia laparoscópica totalmente extraperitoneal é detalhada no texto. CONCLUS O: Corre o laparoscópica totalmente extraperitoneal é preferível à corre o de hérnias transabdominais pré-peritoneais porque o perit nio n o é violado. A dissec o deve ser sempre realizada nos mesmos passos, sem utilizar cautério monopolar e o paciente em leve posi o de Trendelemburg. Com estas recomenda es, a hernioplastia laparoscópica totalmente extraperitoneal é factível com poucas complica es intra-abdominais. INTRODUCTION: The inguinal hernia repair has been a controversial area in the surgical practice ever since it has been conceived. The fact that numerous different procedures are in use reflects the complexity of inguinal hernia and its repair. AIM: The purposes of this study were to describe Dulucq's technique and the modifications of using 3-D mesh in laparoscopic totally extraperitoneal inguinal hernia repair. METHODS: Surgical technique of laparoscopic totally extraperitoneal hernia repair is detailed on the text. CONCLUSION: Laparoscopic totally extraperitoneal is preferred over transabdominal preperitoneal hernia as the peritoneum is not violated. The dissection must always be done with the same stages, without monopolar diathermy and the patient in a slight Trendelenburg position. Following these recommendations, the laparoscopic totally extraperitoneal hernioplasty is feasible with fewer intra-abdominal complications.
Single-incision laparoscopic intraperitoneal onlay mesh hernioplasty for anterior abdominal wall hernia: A safe and feasible approach  [cached]
Roy Prabal,De Anushtup
Journal of Minimal Access Surgery , 2011,
Abstract: Background: Single-incision laparoscopic surgery is being increasingly performed in experienced laparoscopic centres. The primary aim is at improving the cosmetic outcome of surgery without compromising the safety of the operation. The challenge of this surgery lies in limited range of movement of the instruments due to proximity of working ports and limited triangulation. Methods: We describe our first four consecutive cases of single-incision laparoscopic intraperitoneal onlay mesh hernioplasty for anterior abdominal wall hernia repair during a period of June to July 2009. Operative time, hospital stay and postoperative pain were assessed, and follow up was done for 3 months. Results: Three patients were discharged on first postoperative day and one on second postoperative day without any complications. Conclusions: Based on our experience, we believe that the procedure is feasible without additional risk. Cosmetic benefit is clear; however, beyond that the actual outcome with respect to patient recovery, postoperative pain and long-term complications needs to be evaluated and compared to standard laparoscopic intraperitoneal onlay mesh hernioplasty.
Effective rectus sheath canal: does it affect total extraperitoneal approach for inguinal mesh hernioplasty?  [cached]
Maulana Mohammad Ansari
Journal of Experimental and Integrative Medicine , 2013, DOI: 10.5455/jeim.071212.br.012
Abstract: Objectives: This study aimed to compare the effects of the 1st port placement at two different levels below umbilicus during the total extraperitoneal (TEP) laparoscopic repair of inguinal hernia and to check the hypothesis that shorter effective rectus sheath canal would facilitate the TEP procedure. Methods: Eighteen adult males underwent TEP repair for uncomplicated primary inguinal hernia in one year. First (optical) port was placed 1 cm and 2.5 cm below the umblicus in the two groups (I and II, respectively). Effective rectus sheath canal (ERSC) was measured. Primary outcome measures (endoscopic vision, ease of the procedure and operating time) were compared between the two groups. Results: ERSC (mean ± SD) was found 3.24 ± 0.41 and 2.08 ± 0.27 cm in group I (n = 7) and group II (n = 11), respectively (P < 0.05). Endoscopic vision was found significantly better in group II compared to group I; visual analogue score (VAS) 8.82 ± 0.41 vs 4.57 ± 0.45, respectively (P < 0.05). Procedure was found significantly easier in group II compared to group I (VAS 8.91 ± 0.44 vs 5.5 ± 0.65; P < 0.05). Operating time was found significantly lower in group II compared to group I (1.83 ± 0.3 vs 2.71 ± 0.42 h; P < 0.05). Conclusions: Shorter effective rectus sheath canal of ≤ 2 cm greatly facilitates the TEP hernioplasty in terms of endoscopic vision, ease of the procedure and operating time, and is highly recommended, especially for the beginners. [J Exp Integr Med 2013; 3(1): 73-76]
Laparoscopic Extraperitoneal Inguinal Hernia Repair Using a Novel Mesh with Self-Fixating Properties  [PDF]
Jose Erbella, Alexander Erbella
Surgical Science (SS) , 2013, DOI: 10.4236/ss.2013.46056

Laparoscopic totally extraperitoneal (TEP) hernia repair is a well-accepted technique for inguinal hernia repair. Different types of mesh and fixation methods have been described. Recently, a novel, self-fixating mesh has been introduced and used successfully in open inguinal hernia repairs. We report the first initial experience using this mesh for TEP repairs.

Laparoscopic Inguinal Hernia Repair with Closure of Hernial Defect and Central Mesh Fixation Using Glubran 2  [PDF]
Ahmed E. Lasheen, Adel M. Tolba, Hany Mohamed, Hatem Mohammed, Nadia A. Smaeil
Surgical Science (SS) , 2013, DOI: 10.4236/ss.2013.412107

Background: Laparoscopic tension-free repair of inguinal hernia was presented in 1990s, promising less pain and short recovery period, but carrying the risk mesh bulging and migration. Objective: We have presented our technique in which central zone of mesh is fixed only after closure of hernial defect. Patients and Methods: This study included 27 males patients (14 indirect inguinal hernias, 9 direct inguinal hernias, 4 both direct and indirect inguinal hernias on the same side). These cases are undergoing tension-free mesh repair after closure of hernial defect, and the mesh is fixed only at its central zone using Gulbran 2, between April 2011 and March 2013. The follow-up period ranged from 6 to 30 months. The intra and postoperative complications were recorded. Results: Mean hospital stay was 1 day. The age of this group of patients ranged from 23 to 63 years (mean, 47 years). The operative time ranged from 30 to 100 minutes (mean, 45 minutes). The intraoperative complications were in form of mild bleeding in 7 patients (25.9%) during hernial sac dissection. Postoperative complications were mild inguinal pain in 4 patients (14.8%) for three weeks. Mild hydrocele in 3 patients (11%) was recorded. No recurrence or bulging at hernia site was noticed during the period of follow-up. Conclusion: Laparoscopic inguinal hernia repair with central mesh fixation after closure of hernial defect is effective, easy and free of complications.

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