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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.
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.
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 Transabdominal Preperitoneal Repair for Strangulated Groin Hernia  [PDF]
Po Ching Cathy Ng, George Pei Cheung Yang, Michael Ka Wah Li
International Journal of Clinical Medicine (IJCM) , 2013, DOI: 10.4236/ijcm.2013.46A007

Introduction: Single incision laparoscopic surgery (SILS) has become more popular for various surgical procedures including hernia surgery. Initial results of SILS in elective hernia repair were comparable to those of conventional laparoscopic approaches. However the use of SILS in emergency case has not been widely reported. This study aimed to evaluate the feasibility of the use of single incision laparoscopic transabdominal preperitoneal (TAPP) repair for patients presenting with strangulated groin hernia. Method: Emergency single incision laparoscopic TAPP repair were performed in our unit from June 2011 onwards for selected patients. Retrospectively data including the patient demographics, operative time, type of hernia, hospital stay, complications and recurrence rate were collected and analyzed. Result: There were a total of five patients in this series from June 2011 to June 2012. The median age was 62 years old with a male to female ratio of 4:1. Four patients had unilateral hernia (one femoral and three inguinal hernias) and one had bilateral hernia (unilaterally strangulated femoral hernia and bilaterally reducible indirect inguinal hernia). The median operative time was 75 minutes for patients with unilateral repair. None of the patients required bowel resection. The conversion rate to either conventional laparoscopic or open repair was zero. The median hospital stay was 2 days. No major complication or recurrence was detected. Conclusion: This series showed that single port laparoscopic TAPP repair for strangulated groin hernia is a feasible option with no major complication reported.

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 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.
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.
An Experience of Short-Term Results of Laparoscopic Inguinal Hernioplasty Using 3D Mesh in a Developing Country  [PDF]
Iqbal Saleem Mir, Alfer Ah Nafae, Aijaz Ahmed Malyar, Muntakhab Nafae, Yawar Watali, Mudasir Farooq, Shahnawaz Bashir Bhat, Sheikh Viqar
International Journal of Clinical Medicine (IJCM) , 2015, DOI: 10.4236/ijcm.2015.61010
Background: The experience of short term results of laparoscopic inguinal hernia repair using 3D mesh in a developing country is reviewed. Methods: From January 2012 to February 2014, 53 patients underwent laparoscopic inguinal hernioplasty. A retrospective case series of 53 consecutive patients undergoing TEP/TAPP by a single surgical team was followed prospectively with a focused physical examination and interview. 4 out of 53 patients had recurrent hernia following open repairs and 49 had primary hernias. Data collected included operative time, intraoperative bleeding, intraoperative difficulties, immediate postoperative pain, chronic groin pain, recurrence, sensory disturbance, activity or occupational limitation and personal satisfaction. Results: All the patients were male aged 32 to 75 years with a mean age of 53.5 years. Mean operative time was 37.4 minutes; intraoperative dissection, blood loss were less; and immediate postoperative pain was negligible as assessed by VAS. There was no mortality or major morbidity. Mean follow-up was 12 months (2 to 18 months). Follow-up was completed by interview and physical examination. Hernia was not found to recur during the follow up period. Chronic pain occurred in 2 patients (3.7%), which was mild in nature. Ninety-seven percent of patients were satisfied with their repair and would or had recommended TEP/TAPP to others using 3D Mesh. Conclusions: Short-term results of TEP/TAPP hernia repair using 3D mesh demonstrated to be an effective and safe procedure with low prevalence of chronic pain that is generally of a mild, infrequent nature. It was also concurred that there is decrease in operative time. Manipulation of mesh was significantly reduced. Intraoperative bleeding and use of post operative analgesia was reduced considerably. There was no recurrence, however the cost of the mesh increased the overall cost of the procedure acting as a limiting factor in a developing country.
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.
Polypropylene versus Polyester Mesh for Laparoscopic Inguinal Hernia Repair: Short-Term Results of a Comparative Study  [PDF]
Mike Ralf Langenbach, Stefan Sauerland
Surgical Science (SS) , 2013, DOI: 10.4236/ss.2013.41005

Background: Polypropylene meshes are commonly used in laparoscopic inguinal hernia repair, although they may cause complications. In this prospective study, a polyester mesh was compared to a polypropylene mesh. Methods: Transabdominal preperitoneal (TAPP) laparoscopic repair was performed in 160 consecutive male patients suffering from unilateral inguinal hernia. The first 80 cases received a polypropylene mesh (Parietene\"\", Covidien, France), and a polyester mesh (Parietex\"\", Covidien, France) was implanted in the second half of patients. Both groups were comparable with respect to clinical and demographic variables. Patients rated their pain using the visual analogue scale (VAS), and ultrasonography was performed on postoperative days 1 and 3 to measure seroma formation. Results: The duration of surgery and the length of stay were similar in both groups. Postoperative pain, measured on day 1 and 3, was significantly less in patients who had received a polyester mesh as compared to the polypropylene group. The size of local seroma was also significantly reduced in the polyester group. Complication rates were 10% in the polypropylene and 9% in the polyester group and included one early recurrence in each group. Conclusions: Polyester meshes may be useful in TAPP, as this mesh material produces less foreign body reaction with less seroma formation and lower pain levels than conventional polypropylene.

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