Bilateral Laparoscopic Totally Extraperitoneal Repair Without Mesh Fixation

Dehal, Ahmed; Woodward, Brandon; Johna, Samir; Yamanishi, F.J.

doi:10.4293/jsls.2014.00297

Cited by 12 publications

(9 citation statements)

References 30 publications

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“…7 In a study conducted on Bilateral Laparoscopic Totally Extraperitoneal Repair Without Mesh Fixation among 343 patients, the duration of hospital stay after surgery was few hours for 99% of the patients where as 1% was discharged by 24 hours. 11 Our study could not observe any recurrence of hernia as duration was slightly higher than one year which is short enough for any recurrence. In yet another prospective controlled, randomized study conducted in Egypt with an aim to compare mesh fixation versus non fixation regarding postoperative pain and recurrence rates among 60 patients with inguinal hernias.…”

Section: : Comparison Of Average Pain Scores (By Vas Score) In Differcontrasting

confidence: 54%

To compare advantage of non-fixation versus fixation of mesh in Laparoscopic totally Extra Peritoneal (TEP) repair of inguinal hernias

Gangopadhyay

Ghosh

2018

Asian J Med Sci

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Background: Mesh fixation during laparoscopic totally extra peritoneal repair is thought to be necessary to prevent recurrence of infections and post-operative complications. However, mesh fixation might increase the postoperative complications and chronic pain. This study was to describe the experience of a single surgeon at R.G. Kar Medical College and Hospital performing this operation. This study evaluates the outcomes of laparoscopic hernioplasty performed with and without mesh fixation at our institution.Aims and Objective: To compare advantage of non-fixation versus fixation of mesh in laparoscopic Totally Extra peritoneal (TEP) repair of inguinal hernias. This study was conducted for analysis of outcome with respect to pain, operative time, intra and postoperative complication, days of hospital stay, recurrence regarding the procedure between fixation and non-fixation of mesh in totally extra peritoneal repair of inguinal hernia.Materials and Methods: The study was conducted in the Department of Surgery, R.G.Kar Medical College and Hospital from January 2011 to April 2012. All patients admitted in General surgical unit presenting with uncomplicated unilateral inguinal hernias were included. A total of 60 patients were included in the study, of which 30 patients underwent TEP repair without fixation of mesh and for remaining 30 patients the mesh was fixed using metallic tacks.Results: Difference in average pain score at 24 hrs, 72 hrs, 1 month and 6 months was significant statistically (p =0.003, p = 0.003, p< 0.001 and p=0.001 respectively) when compared in both groups. There was no recurrence in the study period in either of the groups. The duration of operative time and days of hospital stay was higher in fixation group and was statistically significant.Conclusion: Mesh fixation appears to be disadvantageous in TEP repair of inguinal hernias compared to non- fixation of mesh as it is associated with higher operative time, higher postoperative complication and an increased likelihood of developing chronic groin pain. The omission of mesh fixation did not increase the risk of early hernia recurrence.Asian Journal of Medical Sciences Vol.9(4) 2018 35-40

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Section: : Comparison Of Average Pain Scores (By Vas Score) In Differcontrasting

confidence: 54%

To compare advantage of non-fixation versus fixation of mesh in Laparoscopic totally Extra Peritoneal (TEP) repair of inguinal hernias

Gangopadhyay

Ghosh

2018

Asian J Med Sci

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“…Furthermore, laparoscopic inguinal hernia repair has detectable hematoma rates of 1.5 to 3.6 percent. 21, 22 Similarly, the terms bleeding and hematoma are often used interchangeably. This may be especially useful when considering small surgical procedures such as Mohs defect reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Ibuprofen May Not Increase Bleeding Risk in Plastic Surgery: A Systematic Review and Meta-Analysis

Kelley

Bennett

Chung

et al. 2016

Plastic &Amp; Reconstructive Surgery

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Background Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are common medications with multiple useful effects including pain relief and reduction of inflammation. However, surgeons commonly hold all NSAIDs peri-operatively because of bleeding concerns. However, not all NSAIDs irreversibly block platelet function. We hypothesized that the use of ibuprofen would have no effect on postoperative bleeding in plastic surgery patients. Methods A literature review was performed using Medline (PubMed), EMBASE, and the Cochrane Collaboration Library for primary research articles on ibuprofen and bleeding. Inclusion criteria were primary journal articles examining treatment of acute postoperative based on any modality. Data related to pain assessment, postoperative recovery, and complications were extracted. Bias assessment and meta-analysis were performed. Results A total of 881 publications were reviewed. Four primary randomized controlled trials were selected for full analysis. Articles were of high quality by bias assessment. No significant difference was noted regarding bleeding events (p = 0.32) and pain control was noted to be equivalent. Conclusion Ibuprofen is a useful medication in the setting of surgery with multiple beneficial effects. This meta-analysis represents a small set of high quality studies that suggests ibuprofen provides equivalent pain control to narcotics. Importantly, ibuprofen was not associated with an increased risk of bleeding. Further large studies will be necessary to elucidate this issue further, but ibuprofen is a safe postoperative analgesic in patients undergoing common plastic surgery soft tissue procedures.

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“…Dehal et al challenged the idea of non-fixation after reviewing 343 patients who had undergone bilateral total extraperitoneal repair without fixation and observing a higher recurrence rate than in the literature. 10 Mesh fixation is currently performed in many centers worldwide, with ongoing research being carried out to evaluate the effectiveness and risks of evolving fixation devices. 11 Suture fixation requires simple reusable instruments and minimizes foreign body introduction.…”

Section: Discussionmentioning

confidence: 99%

Transfascial suture fixation technique in laparoscopic repair of inguinal hernia

Chan

2019

Asian J Endoscop Surgery

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Introduction This study presents the initial results of a transfascial suture mesh fixation technique. This method was devised to reduce operative costs and foreign body‐associated risks while embracing the benefits of fixation in laparoscopic inguinal hernia repair. Materials and Surgical Technique Patients undergoing laparoscopic inguinal hernia repair with transfascial suture fixation (TRANSFIX) in our center between March 2017 and March 2018 were retrospectively reviewed. The procedure is orchestrated by a reusable fascial closure device sequentially puncturing the fascia vertically through the inferior port site and guiding a polypropylene thread through the mesh. The thread is retrieved from the extraperitoneal plane with the device, creating an extracorporeal suture loop to embed a surgical knot at the subcutaneous layer of the port site. Discussion In its first year after introduction, 16 TRANSFIX were performed. All patients were men (mean age, 62.6 years). Thirteen hernias (81.3%) were first occurrence, and three (18.8%) were recurrent. Twelve (75.0%) were direct hernias, and three (18.8%) were indirect hernias; one patient presented with concurrent direct and indirect hernia. Median operating time was 41.5 minutes for unilateral repair and 73.0 minutes for bilateral. Median blood loss was 5 mL. One patient had a seroma after unilateral indirect hernia repair. After a median follow‐up of 15.5 months (range, 9‐21 months), no patient had chronic pain, wound infection, hematoma, or recurrence. Instrumental cost reduction per operation was between $150 and $300. TRANSFIX appears to be a safe and economical mesh fixation method.

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Bilateral Laparoscopic Totally Extraperitoneal Repair Without Mesh Fixation

Cited by 12 publications

References 30 publications

To compare advantage of non-fixation versus fixation of mesh in Laparoscopic totally Extra Peritoneal (TEP) repair of inguinal hernias

To compare advantage of non-fixation versus fixation of mesh in Laparoscopic totally Extra Peritoneal (TEP) repair of inguinal hernias

Ibuprofen May Not Increase Bleeding Risk in Plastic Surgery: A Systematic Review and Meta-Analysis

Transfascial suture fixation technique in laparoscopic repair of inguinal hernia

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