Causes of recurrence in laparoscopic inguinal hernia repair

Siddaiah‐Subramanya, Manjunath; Ashrafi, Darius; Memon, Breda; Memon, Muhammed Ashraf

doi:10.1007/s10029-018-1817-x

Cited by 66 publications

(42 citation statements)

References 93 publications

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“…Recurrences after inguinal hernia repairs can occur even up to 50 years later [2]. In recent administrative data and registry analyses it was revealed that the proportion of recurrent repairs in the total collective of inguinal hernia repairs among men was 11.3-14.3% [3][4][5][6][7] and in women 7.0-7.4% [4,8]. By contrast, in systematic reviews and meta-analyses the recurrence rates were still far lower (1.2-3%) than those cited above since the included studies had a maximum follow-up time of 6 years [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

What is the outcome of re-recurrent vs recurrent inguinal hernia repairs? An analysis of 16,206 patients from the Herniamed Registry

Köckerling

Krüger

Gagarkin³

et al. 2020

Hernia

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Introduction The proportion of recurrent repairs in the total collective of inguinal hernia repairs among men is 11.3-14.3% and among women 7.0-7.4%. The rate of re-recurrences is reported to be 2.9-9.2%. To date, no case series has been published on second and ≥ third recurrences and their treatment outcomes. Only case reports are available. Materials and methods In an analysis of data from the Herniamed Registry the perioperative and 1-year follow-up outcomes of 16,206 distinct patients who had undergone first recurrent (n = 14,172; 87.4%), second recurrent (n = 1,583; 9.8%) or ≥ third recurrent (n = 451; 2.8%) inguinal hernia repair between September 1, 2009 and July 1, 2017 were compared. Results The intraoperative complication rate for all recurrent repairs was between 1-2%. In the postoperative complications a continuous increase was observed (first recurrence: 3.97% vs second recurrence: 5.75% vs ≥ third recurrence 8.65%; p < 0.001). That applied equally to the complication-related reoperation rates (first recurrence: 1.50% vs second recurrence: 2.21% vs ≥ third recurrence 2.66; p = 0.020). Likewise, the re-recurrence rate rose significantly (first recurrence: 1.95% vs second recurrence: 2.72% vs ≥ third recurrence 3.77; p = 0.005). Similarly, the rate of pain requiring treatment rose highly significantly with an increasing number of recurrences (first recurrence: 5.21% vs second recurrence: 6.70% vs ≥ third recurrence 10.86; p = < 0.001). Conclusion The repair of re-recurrences in inguinal hernia is associated with increasingly more unfavorable outcomes. For the first recurrence the guidelines should definitely be noted. For a second and ≥ third recurrence diagnostic laparoscopy may help to select the best possible surgical technique.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Section: Introductionmentioning

confidence: 99%

What is the outcome of re-recurrent vs recurrent inguinal hernia repairs? An analysis of 16,206 patients from the Herniamed Registry

Köckerling

Krüger

Gagarkin³

et al. 2020

Hernia

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“…Numerous surgical procedures are available to treat groin hernias. [27][28][29][30][31] The technique selection depends on the surgeons' expertise and preference, patient-and herniarelated characteristics, and local resources available. 1,2 The international guidelines for management of groin hernias (HerniaSurge Group) suggest that laparoscopic repair is an optimal technique that is associated with faster recovery time, lower chronic pain, lower risk, and are costeffective.…”

Section: Discussionmentioning

confidence: 99%

“…As compared to TAPP, TEP has the advantage of not entering the peritoneal cavity and therefore reducing abdominal viscera lesions, especially in patients with intra-abdominal adherence. 15,26,29 However, some surgeons avoid or contraindicate the TEP and even the TAPP approach in patients with previous lower abdominal operations because of the difficulty to dissect the preperitoneal space and prevent intra-abdominal organ injuries. 13,15 Intra-abdominal adherence and abdominal wall fibrosis secondary to prior abdominal operations increase operative time, conversion to open surgery, complication rate, and hospital stay and costs in patients subjects to either open or laparoscopic abdominal operations.…”

Section: Discussionmentioning

confidence: 99%

Groin Hernia in Females Routinely Treated by Totally Extraperitoneal Laparoscopic Approach

Coelho

Hosni

Moreira

et al. 2021

JSLS

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Background and Objectives: There is a dearth of studies on laparoscopic treatment of female groin hernia. Our study assessed the outcome of groin hernia repair in females employing the totally extraperitoneal laparoscopic (TEP) access.Methods: Data of all females who were subjected to laparoscopic groin herniorrhaphy, from August 1998 to February 2020 were retrospectively obtained. Groin hernia repair was routinely started with TEP access.Results: A total of 2,399 patients who underwent laparoscopic groin herniorrhaphy, 254 (10.6%), were females. Most females (n = 191; 75.2%) had single hernia and the remaining (n = 63; 24.8%) had bilateral hernias, making a total of 317 hernias operated. Indirect inguinal hernia was the most common hernia type (72.5%), followed by femoral hernia (17.4%) and direct hernia (10.1%). Prior lower abdominal operations were recorded in 97 (38.2%) patients. Conversion to a laparoscopic transabdominal preperitoneal procedure was performed due to technical difficulties to dissect the preperitoneal space in 17 patients (6.7%) and to open procedure in only one patient (0.4%) with incarcerated femoral hernia in whom an incidental perforation of the small bowel occurred. Intra-and postoperative complications occurred in 12 (4.7%) and 15 (5.9%) patients, respectively. There was no mortality. Most patients (n = 221; 87%) were discharged on the same day of the operation. Hernia recurrence was diagnosed in 6 patients (2.4%). Conclusion:It is concluded that females with groin hernia may be successfully treated with totally extraperitoneal laparoscopic access, with low conversion and complication rates.

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“…A study suggests that single incision laparoscopic surgery has a higher incidence of port-site hernia when compared to conventional laparoscopy. 54 Studies have also shown a higher incidence of port-site hernia in cases of single incision robotic procedures. 55 With the multitude of port entry and closure techniques, it will be an uphill task for the surgeon to familiarize with all the techniques.…”

Section: Whether To Close or Notmentioning

confidence: 99%

Laparoscopic Port Closure Techniques and Incidence of Port-site Hernias: A Review and Recommendations

Arifuzaman¹,

Samreen²

2018

World Journal of Laparoscopic Surgery With DVD

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Minimally invasive surgeries have dawned a new era in surgical practice, cosmesis and safety. These have been heralded as one of the best surgical methods to treat a multitude of surgical disorders. Though the term minimally invasive seems attractive, in the real sense of the word, these surgeries are minimal access surgeries and do require incisions for trocars. The wounds must be closed appropriately to prevent the incidence of port-site hernia. Though rare, port-site hernias can cause considerable morbidity. Most of these are seen in the midline, particularly around the umbilicus, but there are reports of herniation at laterally placed ports. The accepted surgical practice is to close the fascial layers at all midline laparoscopic ports. There is a multitude of ways in which the ports can be closed. This article aims to review the various port closure techniques practiced by different surgeons and institutions to and reflect upon the pathophysiology of port-site hernia and recommendations to minimize them. Systematic research of the literature was performed using PubMed, Cochrane database, Google scholar and ClinicalKey. Different port-site closure techniques are described and analyzed. Though not one technique has been found to be superior to the other, all of them have their pros and cons. All of them produce similar results, and it is upon the discretion of the surgeon to accept any one of these methods. The authors have also tried to provide recommendations to minimize the incidence of port-site hernias.

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Causes of recurrence in laparoscopic inguinal hernia repair

Cited by 66 publications

References 93 publications

What is the outcome of re-recurrent vs recurrent inguinal hernia repairs? An analysis of 16,206 patients from the Herniamed Registry

What is the outcome of re-recurrent vs recurrent inguinal hernia repairs? An analysis of 16,206 patients from the Herniamed Registry

Groin Hernia in Females Routinely Treated by Totally Extraperitoneal Laparoscopic Approach

Laparoscopic Port Closure Techniques and Incidence of Port-site Hernias: A Review and Recommendations

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