Does the use of monopolar energy as the preferred mode of dissection effectively reduce seroma formation in laparoscopic total extra peritoneal hernioplasty? A prospective double-blinded randomized control trial

Liu, J W; Chen, K J; Xu, Xinhui; Deng, Yang; Zhang, H; Chan, F.H.Y.; Kim, H J; Fan, Jicong

doi:10.1007/s10029-020-02136-3

Cited by 12 publications

(7 citation statements)

References 15 publications

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“…Although this method can somewhat reduce the amount of fluid that enters the scrotum from the preperitoneal space and reduce ultrasound seromas, it increases surgical cost and duration, and a large proportion of patients still develop ultrasound seromas. Some studies[ 5 17 18 ] found that preperitoneal drainage could significantly reduce post-operative seromas, but this is difficult to apply in clinical practice for the following reasons: (1) fluid exudation from the wound on the preperitoneal space is a continuous process that usually persists for 1 week, (2) inserting a drainage tube causes discomfort for patients and increases the potential risk of infection and lastly, (3) the process prevents patients from being discharged earlier.…”

Section: Discussionmentioning

confidence: 99%

A randomised controlled study on the effects of hernial sac stump fenestration on ultrasound seroma prevention in laparoscopic Type III inguinal hernia repair

Sun

et al. 2022

Journal of Minimal Access Surgery

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Background: The incidence of ultrasound seromas has significantly increased after large hernial sac surgery. Several methods are available for preventing ultrasound seromas, but the clinical results are poor. It has also been demonstrated that hernial sac stump fenestration during laparoscopic incisional hernia repair surgery can significantly decrease the incidence of ultrasound seromas. Materials and Methods: Ninety patients aged 18–75 years who were treated in our hospital for primary Type III indirect inguinal hernia from March 2017 to March 2018 were randomised to a preventive fenestration group and a control group. All patients underwent transabdominal preperitoneal repair. The number of ultrasound seromas in the inguinal regions and ultrasound seroma volume on day 6 and months 1 and 3 after surgery in the two groups were compared. The secondary outcomes included length of surgery, urinary retention, acute pain, chronic pain, length of hospitalisation, recurrence rate and other complications. Results: There were no significant differences in demographic characteristics. Ultrasound seroma incidence and ultrasound seroma volume on day 6 and months 1 and 3 after surgery were significantly lower in the preventive fenestration group than that in the control group. There were no significant differences in the length of hospitalisation or incidence of acute pain or urinary retention between the two groups. Conclusions: Hernial sac stump fenestration after hernial sac transection in inguinal hernia repair surgery is a simple method that can effectively reduce post-operative ultrasound seromas.

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Section: Discussionmentioning

confidence: 99%

A randomised controlled study on the effects of hernial sac stump fenestration on ultrasound seroma prevention in laparoscopic Type III inguinal hernia repair

Sun

et al. 2022

Journal of Minimal Access Surgery

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“…A previous study found that catheterization and drainage can effectively reduce the size and occurrence of seroma, [30] whereas another study suggested that drainage is not effective in reducing the occurrence of seroma. [22] In response to the studies with the opposite conclusions, we have included RCTs, cohort studies, and retrospective studies in recent years, which have advantages in terms of increasing sample size and credibility and decreasing errors.…”

Section: Discussionmentioning

confidence: 99%

Curative effect of different drainage methods on laparoscopic inguinal hernia repair: A meta-analysis

Zhong

et al. 2022

Medicine

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Background: Laparoscopic inguinal hernia repair has developed rapidly as an important surgical method for inguinal hernia repair; however, postoperative complications, especially postoperative seroma, are becoming an important factor hindering its development. Many studies have shown that placing a negative-pressure drainage tube in the preperitoneal space can effectively reduce postoperative seromas. Accordingly, this study aimed to compare differences in postoperative seroma between surgical procedures with drainage tubes (DRG) and those without drainage tubes (nonDRG). Methods: PubMed/Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases were searched from the establishment of the database to May 1, 2021. Odds ratio (OR), mean difference (MD), standardized mean difference (SMD), and 95% confidence interval (CI) were selected as the effect scale indices for the evaluation of the difference in seroma, operation time, hospital stay time, blood loss, and recovery time. All of these were compared using RevMan 5.3 Software. Results: Sixteen studies involving 4369 patients, 2856 in the DRG group and 1513 in the nonDRG group, were included. The incidence of seroma in the DRG group was lower than that in the nonDRG group (OR = 0.16, 95% CI: 0.07–0.35, P < .001). Additionally, the operation time (min) in the DRG group was longer than that in the nonDRG group (MD = 3.67, 95% CI: 2.18–5.17, P < .001). Nevertheless, no significant differences were found in hospital stay (days) (SMD = 0.22, 95% CI: −0.10–0.54, P = .17), blood loss (mL) (MD = 0.28, 95% CI: −0.14–0.69, P = .19), and recovery time (h) (SMD = 0.54, 95% CI: −0.60–1.69, P = .35) between the 2 groups. Conclusion: Despite the slightly prolonged operation time, negative pressure drainage in the preperitoneal space during laparoscopic inguinal hernia repair can significantly reduce the occurrence of postoperative seroma without increasing blood loss, recovery, and hospital stay.

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“…Moreover, in both studies, the Trendelenburg position led to reduced complications and increased patient satisfaction. Seroma, as the build-up of fluid at the surgical site, is a common complication of surgery typically occurring in the early postoperative period with an incidence rate of up to 37.9% (20).…”

Section: Discussionmentioning

confidence: 99%

Effect of the Trendelenburg position on the homeostasis during and post thyroidectomy

Khazaei¹,

Maleknejad²,

Firouzabadi³

et al. 2021

jsurgery

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Introduction: Thyroidectomy is one of the most common surgeries that can be accompanied by postoperative hematoma. The present study aimed to evaluate the impact of the Trendelenburg position on the homeostasis of the surgery site during and after thyroidectomy. Methods: This clinical trial was performed on 60 euthyroid patients in the age range of 18-70 years within 2019-2021. Patients were randomly assigned to the two groups of routine surgery and Trendelenburg using a table of random numbers. The primary outcome was the number of bleeding points immediately after the Trendelenburg position, and secondary outcomes included demographics, final pathology, postoperative hematoma, duration of operation, rate of fluid and seroma accumulation, and patient satisfaction. Data were analyzed in SPSS software (version 19) using Mann Whitney, Chi-square, and Fisher’s exact test. The significance level was set to 5%. Results: The mean age of the patients was 40±13 years, and the majority of them (n=48) were female. The mean number of bleeding points identified intraoperatively was significantly higher in the Trendelenburg group, as compared to that in the routine surgery group (8.7±3.8 vs 5.4±1.8; P<0.001). In the Trendelenburg group, the mean scores of intra-operative blood loss and duration of operation were obtained at 6.4±1.8 g and 118.0±32.0 min, respectively. Conclusion: As evidenced by the obtained results, the Trendelenburg position significantly increased the number of bleeding points in patients undergoing thyroidectomy; nonetheless, it had no effect on the amount of bleeding and operation duration.

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Does the use of monopolar energy as the preferred mode of dissection effectively reduce seroma formation in laparoscopic total extra peritoneal hernioplasty? A prospective double-blinded randomized control trial

Cited by 12 publications

References 15 publications

A randomised controlled study on the effects of hernial sac stump fenestration on ultrasound seroma prevention in laparoscopic Type III inguinal hernia repair

A randomised controlled study on the effects of hernial sac stump fenestration on ultrasound seroma prevention in laparoscopic Type III inguinal hernia repair

Curative effect of different drainage methods on laparoscopic inguinal hernia repair: A meta-analysis

Effect of the Trendelenburg position on the homeostasis during and post thyroidectomy

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