Association of Mesh and Fixation Options with Reoperation Risk after Laparoscopic Groin Hernia Surgery: A Swedish Hernia Registry Study of 25,190 Totally Extraperitoneal and Transabdominal Preperitoneal Repairs

Novik, Bengt; Sandblom, Gabriel; Ansorge, Christoph; Thorell, Anders

doi:10.1097/xcs.0000000000000060

Cited by 18 publications

(9 citation statements)

References 60 publications

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“…With the widespread application of minimally invasive laparoscopic techniques, laparoscopic TEP has become the preferred surgical method for treating inguinal hernias. Compared with traditional laparotomy, TEP is characterized by smaller surgical incisions, less pain, faster postoperative recovery, and a lower complication rate, which conforms to the high medical needs of modern patients 7 .…”

Section: Discussionmentioning

confidence: 99%

Therapeutic efficacy of programmed spatial anatomy of the myopectineal orifice in total extraperitoneal hernioplasty: a retrospective study

Zhuang

et al. 2023

Sci Rep

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This study aimed to investigate the therapeutic efficacy of programmed spatial anatomy of myopectineal orifice technique in laparoscopic total extraperitoneal hernioplasty (TEP) surgery. A total of 121 adult male patients with unilateral inguinal hernias who underwent TEP in the Department of General Surgery, Wujin Hospital, affiliated with Jiangsu University, from January 2019 to December 2020 were selected. Patients were divided into the procedural (63 cases) and traditional groups (58 cases) according to the surgical methods adopted. The procedural group underwent programmed spatial anatomy of the myopectineal orifice combined with TEP, and the traditional group underwent traditional TEP. The perioperative evaluation indicators and postoperative complications were observed and compared between the two groups. Compared with the traditional group, the time of handling hernia, the intraoperative operation time, intraoperative blood loss, postoperative ambulation time, and postoperative hospital stay in the procedural group were significantly reduced (P < 0.05). The incidence of postoperative complications such as sensory nerve abnormalities and chronic pain was significantly decreased (P < 0.05), and the total incidence of complications in the procedural group was significantly lower than that in the traditional group (P < 0.05). While there was no significant difference in postoperative incision infection (P > 0.05). The programmed spatial anatomy of the myopectineal orifice can significantly improve the treatment outcome of TEP, significantly improve the patients' intraoperative and postoperative indicators, and reduce the incidence of postoperative complications. It is worthy of being promoted among young physicians and basic hospitals.

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Section: Discussionmentioning

confidence: 99%

Therapeutic efficacy of programmed spatial anatomy of the myopectineal orifice in total extraperitoneal hernioplasty: a retrospective study

Zhuang

et al. 2023

Sci Rep

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“…Barcelona). Standard polypropylene mesh (≥ 50 g/m 2 ) decreases the risk of recurrence and is the most cost-effective alternative compared to lightweight mesh (< 50 g/m 2 ) [ 27 ]. We initially used a vascular catheter to apply the glue as described by Kukleta [ 26 ].…”

Section: Methodsmentioning

confidence: 99%

The transition from open to laparoscopic surgery for bilateral inguinal hernia repair: how we did it

Hidalgo

Bachero

Hoyuela

et al. 2022

Langenbecks Arch Surg

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Purpose To describe the transition process from open repair (OR) to laparoscopic repair (LR) of bilateral inguinal hernia in a small basic general hospital Methods We describe the technical details and training strategy used to facilitate the transition to systematic LR of bilateral inguinal hernia. We conducted a retrospective analysis of prospectively collected data from all patients undergoing bilateral inguinal hernia repair between January 2017 and December 2020. We analysed the evolution of LR and compared the surgical outcomes: complications, acute pain (24 h), chronic pain (> 3 months), and recurrence (1 year) of the patients operated on by OR and LR. Results We performed 132 bilateral inguinal hernia repairs, 55 (41.7%) ORs, and 77 (58.3%) LRs. A significant difference was observed in the choice of LR over time (2017: 9%, 2018: 32%, 2019: 75%, 2020: 91%, p < 0.001). The mean operative time was shorter in the OR group than in the LR group (56 min vs. 108 min, p < 0.001). However, the operative time of the LR decreased over the years. No significant differences were observed in complications or recurrence. LR was associated with lower acute postoperative pain at 24 h (2.2 vs. 3.1 points, p = 0.021) and lower chronic groin pain than OR (1.3% vs. 12.7%, p = 0.009). Conclusion A structured and systematized training process made the transition from OR to LR of bilateral inguinal hernias feasible and safe in a small basic general hospital. This transition did not increase complications or recurrence. Additionally, LR was associated with a decrease in postoperative pain and chronic groin pain.

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“…In PP HWM or LWM, neither mechanical nor glue fixation improves the outcome of laparoscopic IHR. In HWM non fixation and LWM, fibrin glue fixation has been recommended [82]. There remains no superiority in terms of mesh fixation; the choice of fixation remains with the surgeon's expertise and the patient's preference [83].…”

Section: Mesh Fixationmentioning

confidence: 99%

A Narrative Review on Polypropylene Mesh Complications in Inguinal Hernia Repair - is Titanized Mesh an Option?

2022

J Surg

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Introduction: Since the introduction of mesh in Inguinal Hernia Repair (IHR) the recurrence rate was lowered. Instead, postoperative pain which may be related to mesh side effects e.g. fibrosis, foreign body reaction, erosion and migration, and infection, has been recognized as the relevant outcome factor. The long-term effects of mesh and composite mesh need to be analyzed.Methods: Pubmed, google scholar search using the search terms: polypropylene mesh, titanized mesh, TiMesh ® ; about polypropylene mesh the following terms: adhesion, erosion, infection, shrinkage, migration, seroma, degradation, pain; biocompatibility, foreign body reaction. Also, a bibliography of relevant articles and product-related information was searched.Results: Mesh properties are determined by tensile strength, pore size, weight, reactivity and biocompatibility, elasticity, constitution, and shrinkage. PolyPropylene Mesh (PP) is associated with actual and long-term complications more than expected. These complications are associated with mesh structure-lightweight meshes showed fewer risks for complication as infection, pain, mesh migration, foreign body response, erosion, adhesion, shrinkage, pain, seroma, and recurrence. TiMesh ® showed an advantage in in-vitro and animal studies which were supported by clinical studies. There is a shorter convalescence, and lesser foreign material sensitivity with comparable results in complications (Chronic pain, infection, recurrence). Conclusion:Polypropylene mesh has been successful in inguinal hernia repair for decades. However, in recent years complications of PP became evident in scientific reports and the public. Complications seem to be related to the material and structure of the mesh but also to the surgeon's expertise and patient's characteristics. It became evident that more complications appear long-term. The true rate of complications could be higher. There are a few clinical reports on titanium-coated mesh (TiMesh) in TAPP and TEP inguinal hernia repair. Experience with TiMesh in laparoscopic procedures long-term and open IHR are missing. Especially about the long-term effects of coating PP with titanium we need to have a better understanding of the interaction of soft tissue and mesh. There are promising results of pure titanium mesh for inguinal hernia repair which need to be confirmed in further controlled clinical studies.

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Association of Mesh and Fixation Options with Reoperation Risk after Laparoscopic Groin Hernia Surgery: A Swedish Hernia Registry Study of 25,190 Totally Extraperitoneal and Transabdominal Preperitoneal Repairs

Cited by 18 publications

References 60 publications

Therapeutic efficacy of programmed spatial anatomy of the myopectineal orifice in total extraperitoneal hernioplasty: a retrospective study

Therapeutic efficacy of programmed spatial anatomy of the myopectineal orifice in total extraperitoneal hernioplasty: a retrospective study

The transition from open to laparoscopic surgery for bilateral inguinal hernia repair: how we did it

A Narrative Review on Polypropylene Mesh Complications in Inguinal Hernia Repair - is Titanized Mesh an Option?

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