Evaluation of the effects of absorbable and nonabsorbable tacks on laparoscopic suprapubic hernia repair: A retrospective cohort study

Sıkar, Hasan Ediz; Çetin, Kenan; Eyvaz, Kemal; Gökçeimam, Mehmet; Kaptanoğlu, Levent; Küçük, Hasan Fehmi

doi:10.1016/j.ijsu.2019.01.018

Cited by 5 publications

(10 citation statements)

References 18 publications

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“…Therefore, the outcome following mesh removal and the technical details should be discussed regarding the laparoscopic repair. Laparoscopic ventral hernia repair provides a better outcome regarding operative time and postoperative infections [3][4][5][6]. Removal of the mesh could convert this simple procedure to a complex modality.…”

Section: Discussionmentioning

confidence: 99%

“…Recurrence following abdominal wall hernia repair remains a significant problem [1][2][3][4][5][6]. Failure of previous repair attempts could be the starting point of a vicious circle.…”

Section: Introductionmentioning

confidence: 99%

“…The high recurrence rate reported in the literature indicates the need for standardization regarding the repair methods. Laparoscopic repair allows a decreased recurrence rate and morbidity for incisional hernias [3][4][5][6]. Although numerous methods could be used for recurrent hernias, most of the patients have the previous repair with mesh either laparoscopic or open approach.…”

Section: Introductionmentioning

confidence: 99%

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The influence of mesh removal during laparoscopic repair of recurrent ventral hernias on the long-term outcome.

Sıkar

Çetin

2019

Videosurgery and Other Miniinvasive Techniques

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IntroductionRecurrent hernias can be treated by laparoscopy without the need for mesh removal. However, shrinkage of the mesh following recurrence affects most of the patients, and leaving a partially floating and rigid foreign body could be discussed.AimTo compare the outcomes of patients regarding the removal of previous mesh during laparoscopic repair of recurrent abdominal wall hernias.Material and methodsPatients who underwent laparoscopic repair for recurrent ventral hernias between August 2012 and March 2015 were included in the study. The patients with complete removal of the mesh were included in the MR group and the patients with partial removal or without removal of the previous mesh were included in the non-MR group. Patient characteristics and demographics, previous hernia repair, defect size, mesh size, operative time, mean hospital stay, complications, recurrences, numeric pain rating scale (NRS), early termination of analgesics and prolonged use of analgesics were compared.ResultsA total of 112 patients with a mean age of 53.2 and mean body mass index of 31.1 kg/m2 underwent laparoscopic repair. There were 47 patients in the MR group and 54 patients in the non-MR group. Operative time was shorter in the non-MR group (p < 0.05), whereas symptomatic seroma and NRS scores on postoperative day 10 and at the 6th week were higher in comparison with the MR group (p < 0.05).ConclusionsMesh removal during laparoscopic repair of recurrent ventral hernias has an association with the reduction of pain and symptomatic seroma. However, further prospective comparative studies are required to verify this view.

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Section: Discussionmentioning

confidence: 99%

“…Recurrence following abdominal wall hernia repair remains a significant problem [1][2][3][4][5][6]. Failure of previous repair attempts could be the starting point of a vicious circle.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The influence of mesh removal during laparoscopic repair of recurrent ventral hernias on the long-term outcome.

Sıkar

Çetin

2019

Videosurgery and Other Miniinvasive Techniques

Self Cite

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“…Here proximity to important anatomical structures including the urinary bladder and iliac vessels usually leads to inadequate mesh overlaps. Moreover, high abdominal wall pressure occurs in the erect position, thus, the repair technique is challenging with recurrences often following suprapubic hernia surgery (5,(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

“…Based on the European Hernia Society (EHS) classification, M5, L3 or partial M4 and L2 needing a free peritoneal flap during repair belong to the lower abdominal marginal hernia classification ( Figure 1 ) ( 3 , 4 ). Among these types, suprapubic hernias, which are located <3–4 cm on the pubic arch in the midline are most commonly seen ( 5 ). Additionally, incisional hernias occurring in these areas are also regarded as lower abdominal marginal hernias ( 1 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Non-closure of the Free Peritoneal Flap During Laparoscopic Hernia Repair of Lower Abdominal Marginal Hernia: A Retrospective Analysis

Xiang

et al. 2021

Front. Surg.

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Background: During lower abdominal marginal hernia repair, the peritoneal flap is routinely freed to facilitate mesh placement and closed to conclude the procedure. This procedure is generally called trans-abdominal partial extra-peritoneal (TAPE). However, the necessity of closing the free peritoneal flap is still controversial. This study aimed to investigate the safety and feasibility of leaving the free peritoneal flap in-situ.Methods: A retrospective review was conducted on 68 patients (16 male, 52 female) who underwent laparoscopic hernia repair between June 2014 and March 2021. Patients were diagnosed as the lower abdominal hernia and all required freeing the peritoneal flap during the operation. Patients were divided into 2 groups: one group was TAPE group with the closed free peritoneal flap, another group left the free peritoneal flap unclosed. Analyses were performed to compare both intraoperative parameters and postoperative complications.Results: There were no significant differences in demographic, comorbidity, hernia characteristics and ASA classification. The intra-operative bleeding volume, visceral injury, hospital stay, urinary retention, visual analog scale (VAS) score, dysuria, intestinal obstruction, surgical site infection, mesh infection, recurrence rate and hospital stay were similar among the two groups. Mean operative time of the flap closing procedure was higher than for patients with the free peritoneal flap left in-situ (p = 0.002). Comparisons of postoperative complications showed flap closure resulted in a higher incidence of seroma formation (p = 0.005).Conclusion: Providing a barrier-coated mesh is used during laparoscopic lower abdominal marginal hernia repair, it is safe to leave the free peritoneal flap in-situ and this approach may prevent the occurrence of seromas.

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The association of permanent versus absorbable fixation on developing chronic post-herniorrhaphy groin pain in patients undergoing laparoscopic inguinal hernia repair

Woo,

Ellis,

Maskal

et al. 2024

Surg Endosc

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Introduction Fixation of mesh during minimally invasive inguinal hernia repair is thought to contribute to chronic post-herniorrhaphy groin pain (CGP). In contrast to permanent tacks, absorbable tacks are hypothesized to minimize the likelihood of CGP. This study aimed to compare the rates of CGP after laparoscopic inguinal hernia repair between absorbable versus permanent fixation at maximum follow-up. Methods This is a post hoc analysis of a randomized controlled trial in patients undergoing laparoscopic inguinal hernia repair (NCT03835351). All patients were contacted at maximum follow-up after surgery to administer EuraHS quality of life (QoL) surveys. The pain and restriction of activity subdomains of the survey were utilized. The primary outcome was rate of CGP, as defined by a EuraHS QoL pain domain score ≥ 4 measured at ≥ 1 year postoperatively. The secondary outcomes were pain and restriction of activity domain scores and hernia recurrence at maximum follow-up. Results A total of 338 patients were contacted at a mean follow-up of 28 ± 11 months. 181 patients received permanent tacks and 157 patients received absorbable tacks during their repair. At maximum follow-up, the rates of CGP (27 [15%] vs 28 [18%], P = 0.47), average pain scores (1.78 ± 4.38 vs 2.32 ± 5.40, P = 0.22), restriction of activity scores (1.39 ± 4.32 vs 2.48 ± 7.45, P = 0.18), and the number of patients who reported an inguinal bulge (18 [9.9%] vs 15 [9.5%], P = 0.9) were similar between patients with permanent versus absorbable tacks. On multivariable analysis, there was no significant difference in the odds of CGP between the two groups (OR 1.23, 95% CI [0.60, 2.50]). Conclusion Mesh fixation with permanent tacks does not appear to increase the risk of CGP after laparoscopic inguinal hernia repair when compared to fixation with absorbable tacks. Prospective trials are needed to further evaluate this relationship.

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Evaluation of the effects of absorbable and nonabsorbable tacks on laparoscopic suprapubic hernia repair: A retrospective cohort study

Cited by 5 publications

References 18 publications

The influence of mesh removal during laparoscopic repair of recurrent ventral hernias on the long-term outcome.

The influence of mesh removal during laparoscopic repair of recurrent ventral hernias on the long-term outcome.

Non-closure of the Free Peritoneal Flap During Laparoscopic Hernia Repair of Lower Abdominal Marginal Hernia: A Retrospective Analysis

The association of permanent versus absorbable fixation on developing chronic post-herniorrhaphy groin pain in patients undergoing laparoscopic inguinal hernia repair

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