Endoscopic Extraperitoneal Inguinal Hernia Repair with Double Mesh: Indications, Technique, Complications, and Results

Glavan, Elizabet; Mijić, August; Bekavac-Bešlin, Miroslav; Franjić, Björn Dario; Jurišić, Darko

doi:10.1089/lap.2005.15.586

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…However, the last of these series was reported almost 20 years ago and since then there have been no new publications on the matter (Table 1). 9 One reason may be the controversy regarding postoperative chronic pain related to heavy polypropylene meshes (HM), since reports were published suggesting the use of light meshes (LM) to reduce the possibility of chronic postoperative pain. 10,11 The debate continued since then.…”

Section: Discussionmentioning

confidence: 99%

Double mesh in special cases of laparoscopic inguinal hernia repair: case series study

Weber-Sánchez,

Weber- Alvarez,

Martínez

et al. 2023

MOJS

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Recurrence of laparoscopic inguinal hernia repair decreases if the technique is systematized and the recommendations are followed. However, there are special cases in which the usual technique may require modifications to avoid it. The use of two polypropylene meshes has been suggested since the early years of laparoscopic hernia repair with good results. However, for almost two decades, there have been no reports in this regard. The objective of this work, is to describe our technique using double mesh, and report a series of complex cases in which this technique was used to reinforce the inguinal wall with good results comparing it with the techniques described in other series.

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Section: Discussionmentioning

confidence: 99%

Double mesh in special cases of laparoscopic inguinal hernia repair: case series study

Weber-Sánchez,

Weber- Alvarez,

Martínez

et al. 2023

MOJS

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“…These differences must be kept into consideration when comparing both studies. However, Glavan and his associates [36] reported the double mesh technique's superiority in preventing recurrence as that there were no recurrences in the double mesh group, with longer follow-up [range, 7 -97 months]. In contrast, 1.0% of patients treated with the standard one-mesh technique developed recurrences.…”

Section: Discussionmentioning

confidence: 99%

Comparison between Single Mesh and Double Mesh Placement in Huge Inguinal Hernia

Behiery¹,

Sayouh

Salem

2021

International Journal of Medical Arts

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Background: Recurrence after surgical treatment of inguinal hernia is still a challenge facing surgeons during their daily practice. Aim of the Work:The current trial aims to compare single and double mesh placement in huge inguinal hernia repair.Patients and Methods: 40 cases were involved in the study. They were classified into two equal groups according to the operative technique [A for single mesh and B for double mesh]. The study's candidates were examined and investigated thoroughly regarding their complaint, the presence of a clinically detectable hernia in the inguinal region, its size, characters, onset, duration, and associated symptoms. Then, all were examined clinically and prepared for surgical intervention after lab investigations. Results:The mean ages were 56 and 56.9 years for groups A and B. Both groups were comparable to body mass index, risk factors, type of hernia, hernia side, and intraoperative blood loss. There was a significant decrease in operative time in group A when compared to group B [54.50 ± 8.256 vs. 61.25 ± 6.664 minutes, respectively]. The overall rate of complications was lower in group B when compared to group A [30.0% vs. 50.0%, respectively]. Complications in group A were seroma [10.0%], wound infection [5.0%], scrotal edema [25.0%], and chronic pain [10.0%]; while in group B, seroma [10.0%], scrotal edema [5.0%], chronic pain [15.0%]. Recurrence was confined to group A, and reported to three patients [15.0%]. However, the difference was statistically nonsignificant. Conclusion: Double mesh technique is a safe and efficacious approach for managing huge inguinal hernia. It is associated with lower rate of recurrence than the single mesh approach with comparable operative time, complications, and outcomes.

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“…We used standard laparoscopic equipment, which proved to be somewhat technically demanding, mainly due to reduced triangulation and subsequent collision of instruments. However, dissection, reposition, double mesh placement, and fixation [9] were without complication. The drain was inserted through right 5-mm port.…”

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confidence: 96%

Single-incision laparoscopic surgery (SILS) for totally extraperitoneal (TEP) inguinal hernia repair: first case

et al. 2009

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To the Editors There has been an open debate in the most recent literature on possible progress in laparoscopic surgery, aiming mainly at benefits of minimization of surgical trauma and improvement of cosmesis. Natural-orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopic surgery (SILS) have emerged as approaches whose advantages and possible applications are being explored and tested currently.Operations eligible for NOTES approach are determined by the availability of entry point or hollow organ, availability of endoscopic instruments, and occasional necessity for hybrid or laparoscopic assistance. SILS on the other hand enables the application of a wide range of already existing instruments, implying less of a learning curve, lower costs, and lack of necessity for penetration through the hollow organ, which itself carries certain complications. The main point for reducing the number of incisions prevails: each incision risks morbidity of bleeding, incisional hernia, and organ damage, and decreases cosmesis.SILS was first described in 1998 in laparoscopic appendectomy [1] and cholecystectomy [2], but enthusiasm was limited until recently due to insufficient technical support. Revival was initiated by Hirano et al. in 2005 with its application in urology [3]. Return of SILS cholecystectomy and application in obesity surgery followed [4,5]. Technical approaches that enabled this revival were several adjacently placed trocars, special multilumen ports that allow simultaneous multiple instruments insertion [6], gelports [7], bent and articulating instruments, and adjustments in laparoscopes, which are all commercially available.Based on Cohrane 2005 systematic review [8] TAPP was associated with higher rates of port-site hernias and visceral injuries whilst there appear to be more conversions with TEP. Vascular injuries and deep/mesh infections were rare and there was no obvious difference between the groups. No studies reporting economic evidence were identified. Very limited data were available on learning effects, but these data suggest that operators become experienced at between 30 and 100 procedures. However, there were not enough data to support either one unanimously. Arguments discerning open and laparoscopic hernia repair are well known and we will not pursue them in this letter.We chose TEP, with the strongest argument of not entering the abdominal cavity and avoiding potential injury to intra-abdominal structures. Indications are bilateral and recurrent inguinal hernia and patient choice if dealing with primary hernia. We started performing TEP in 1996 and have so far performed more than 1,000 procedures without major complications. Until now we used three-port access as a standard approach and single or double mesh placement after adequate reposition and field preparation.In this technical modification-right primary indirect inguinal hernia TEP repair-we used a single vertical midline infraumbilical skin incision 2.5 cm long. Dissection of subcutaneous tissue to the anterior ...

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Endoscopic Extraperitoneal Inguinal Hernia Repair with Double Mesh: Indications, Technique, Complications, and Results

Cited by 5 publications

References 22 publications

Double mesh in special cases of laparoscopic inguinal hernia repair: case series study

Double mesh in special cases of laparoscopic inguinal hernia repair: case series study

Comparison between Single Mesh and Double Mesh Placement in Huge Inguinal Hernia

Single-incision laparoscopic surgery (SILS) for totally extraperitoneal (TEP) inguinal hernia repair: first case

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