Does peritoneal flap closure technique following transabdominal preperitoneal (TAPP) inguinal hernia repair make a difference in postoperative pain? A long-term quality of life comparison

Ross, Samuel W.; Groene, Steven A.; Prasad, T Krishna; Lincourt, Amy E.; Kercher, Kent W.; Augenstein, Vedra A.; Heniford, B. Todd

doi:10.1007/s00464-016-5258-2

Cited by 14 publications

(11 citation statements)

References 40 publications

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“…Ross et al [ 15 ] reported that suture closure of the peritoneum resulted in less early postoperative pain than tacked closure, and improved 2-wk postoperative activity compared with stapled and tacked closures. Subsequently, based on a larger sample size and a 2-yr follow-up, Ross et al [ 16 ] found that there were no significant differences between the tacked, sutured and stapled techniques. However, a prospective randomized study by Oguz et al [ 17 ] reported peritoneal closure using tacks increased short-term pain compared with suture closure.…”

Section: Discussionmentioning

confidence: 99%

Recurrent abdominal pain due to small bowel volvulus after transabdominal preperitoneal hernioplasty: A case report and review of literature

Man¹,

Li²,

Zhang³

et al. 2021

WJCC

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BACKGROUND Compared with open mesh repair, transabdominal preperitoneal (TAPP) hernioplasty results in less chronic postoperative inguinal pain and faster postoperative recovery. However, it may still lead to rare but serious complications. Here we report a case of intestinal volvulus with recurrent abdominal pain as the only clinical symptom, which occurred 3 mo after TAPP repair for bilateral inguinal hernia. CASE SUMMARY A 50-year-old male patient underwent laparoscopic TAPP for bilateral inguinal hernias. After the operation, he experienced recurring pain in his lower right abdomen around the surgical area, which was relieved after symptomatic treatment. Three months after the surgery, the abdominal pain became severe and was aggravated over time. The whirlpool sign of the mesentery was seen on contrast-enhanced computed tomography (CT). Laparoscopic exploration confirmed that a barb of the V-Loc™ suture penetrated the peritoneum, which caused the adhesion of the small intestinal wall to the site of peritoneal injury, forming intestinal volvulus. Since there was no closed-loop obstruction or intestinal ischemia, recurrent abdominal pain became the only clinical manifestation in this case. After laparoscopic lysis of adhesions and reduction of intestinal volvulus, the patient recovered and was discharged. CONCLUSION The possibility of intestinal volvulus should be considered in patients who experience recurrent abdominal pain following TAPP surgery during which barbed V-Loc sutures are used for closing the peritoneum. Contrast-enhanced CT and active laparoscopic exploration can confirm the diagnosis and prevent serious complications.

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Section: Discussionmentioning

confidence: 99%

Recurrent abdominal pain due to small bowel volvulus after transabdominal preperitoneal hernioplasty: A case report and review of literature

Man¹,

Li²,

Zhang³

et al. 2021

WJCC

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“…We just detailed the care that must be taken to fix the mesh with tacks, most commonly used method, and correlate with inverted Y and the five triangles. Atraumatic fixation of the mesh (glues or fibrin sealants and self-gripping meshes) has been advocated by many authors and be a good option to avoid complications specific related to tacks, especially chronic pain 18 , 19 , 20 . As well, it does not appear to be associated with an increased risk of recurrence and may be associated with a lower risk of chronic pain 20,21.…”

Section: Discussionmentioning

confidence: 99%

Systemization of Laparoscopic Inguinal Hernia Repair (Tapp) Based on a New Anatomical Concept: Inverted Y and Five Triangles

Furtado

Claus

Cavazzola

et al. 2019

ABCD, arq. bras. cir. dig.

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Background: Laparoscopic inguinal hernia repair has been shown to be superior than open repairs with faster return to daily activities and decrease in the occurrence of chronic pain. However, higher direct costs and mandatory use of general anesthesia are arguments against their use. In addition, increased complexity of surgery resulting from an anatomy that is unusual to general surgeons prevents the widespread adoption of laparoscopic approach. Aim:To propose a technical systematization for transabdominal laparoscopic repair (TAPP) of inguinal hernias based on anatomical concepts. Method:To offer a systematization of TAPP repair based on well defined anatomic landmarks, describing the concept of “inverted Y”, identification of five triangles and three zones of dissection, to achieve the “critical view of safety” for laparoscopic inguinal hernia repair. Results:Since this standardization was developed five years ago, many surgeons were trained following these precepts. Reproducibility is high, as far as, it´s rate of adoption among surgeons. Conclusion: The concept of the “inverted Y”, “Five triangles” and the dissection based in “Three Zones” establish an effective and reproducible standardization of the TAPP technique.

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“…The final controversy raised by our paper is how the peritoneum in TAPP should be approximated. Although there is one paper that suggests tacking the peritoneum is safe 1,11 , we feel that this technique is risky. Blind placement of penetrating fixation of the peritoneum, whether permanent or absorbable may unnecessarily injure the ilioinguinal and iliohypogastric nerves and therefore should be avoided.…”

Section: Updatementioning

confidence: 98%

Challenges to the 10 Golden Rules for a Safe Minimally Invasive Surgery (Mis) Inguinal Hernia Repair: Can We Improve?

Claus

Cavazolla

Furtado³

et al. 2021

ABCD, arq. bras. cir. dig.

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Background: Since publication of our paper “Ten Golden Rules for a Safe MIS Inguinal Hernia Repair” we have received many questions. As the authors, we feel it is important to address these topics as a follow-up to our paper. Aim: To discuss in more details the main points of controversy, review the rules and update de recommendations. Method: The questions and discussions came mainly over five rules, numbered 3, 5, 6, 7, 10. We analyzed all the comments about recommendations and update some technical principles. Results: Rule 3 - Removing normal fat plugs from the obturator canal is unnecessary and therefore is not recommended; Rule 5 - transection of the uterine round ligament (1 cm proximal to the deep ring) facilitates adequate dissection. When performed in this way it does not appear to be associated with complications; Rule 6 - transection of huge sacs are safer than over-dissection of the cord structures. Whether dissecting completely the sac or abandon the distal part it results in less postoperative seromas is an ongoing debate; Rule 7 - any retroperitoneal structure traversing the internal ring is or play a role like a hernia. Failing to identify and remove the lipoma will ultimately result in the patient experiencing a recurrence; Rule 10 - in TAPP peritoneum should preferably be closed with suture than tackes. Conclusion: 10 Golden Rules emphasize the most important surgical tips and technical steps that allow the safe performance of MIS repairs of inguinal hernias, regardless the technique.

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Does peritoneal flap closure technique following transabdominal preperitoneal (TAPP) inguinal hernia repair make a difference in postoperative pain? A long-term quality of life comparison

Abstract: Tacked, sutured, and stapled techniques for peritoneal flap closure following TAPP have no significant differences in operative outcomes, postoperative quality of life, or resolution of symptoms.

Cited by 14 publications

References 40 publications

Recurrent abdominal pain due to small bowel volvulus after transabdominal preperitoneal hernioplasty: A case report and review of literature

Recurrent abdominal pain due to small bowel volvulus after transabdominal preperitoneal hernioplasty: A case report and review of literature

Systemization of Laparoscopic Inguinal Hernia Repair (Tapp) Based on a New Anatomical Concept: Inverted Y and Five Triangles

Challenges to the 10 Golden Rules for a Safe Minimally Invasive Surgery (Mis) Inguinal Hernia Repair: Can We Improve?

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