Open mesh and laparoscopic total extraperitoneal inguinal hernia repair under spinal and general anesthesia

Abstract

IntroductionMesh placement is the main standard in repair of inguinal hernia, and laparoscopic repair is the standard of care via spinal, epidural, or combined anesthesia. Here, we compared open and laparoscopic total extraperitoneal (TEP) repairs under general (GA) and spinal anesthesia (SA).MethodsInguinal hernia patients (n=440) were analyzed retrospectively. There were four groups: Group 1 was TEP under GA (TEP-GA) (n=111); Group 2 was open mesh repair (OM) under SA (n=116) (OM-SA); Group 3 was open mesh repair under GA (n=117) (OM-GA); Group four was TEP under SA (n=96) (TEP-SA). The age, body mass index, duration of operation, hospital stay, postoperative Visual Analog Scale scores, recurrence, postoperative pain, urinary retention, headache, and patient satisfaction were all recorded.ResultsThere was no significant difference in terms of hypotension, vomiting, seroma and scrotal edema, recurrence, and wound infection incidence between the groups. However, the operation duration, hospital stay period, headache, urinary retention, postoperative Visual Analog Scale scores, chronic pain, and patient satisfaction showed significant differences between groups.ConclusionLaparoscopic TEP hernia repair is a safe and effective method along with its advantages of shorter hospital stay, less recurrence, less postoperative pain, higher patient satisfaction, and similar postoperative complication rates. SA has the disadvantage of higher incidence of headache and urinary retention compared to GA.

The Outcome Comparison of two Groups of total Extraperitoneal and Mesh Repair of Inguinal Hernia

“…A same study done by Schwab, wound infection rate of 4%. 19 Another study presented by Sunamak et al, the wound infection rate was 4 (3.6%) in TEP group and 8 (6.9%) in mesh repair which is comparable with our study 18 .…”

“…In a same study of Heikkinen, 2(4%) patients group A and in group B 2% patients had true recurrence at 6 months while the 2% patients had false recurrence at 1 month 17 . In a same study done by Sunamak showed that 3(2.7%) recurrence in TEP group and 3(3.1%) in mesh repair group 18 .…”

Small-Dose Ropivacaine Hydrochloride with Fentanyl versus Large-Dose of Ropivacaine Hydrochloride for Cesarean Section

“…9 Although traditional spinal anesthesia has the advantages of quick onset of anesthesia and reliable clinical implementation effects, it also has the disadvantages that the anesthesia plane is not easy to control and has a great influence on maternal hemodynamics. 10,11 Separate epidural anesthesia is difficult to be used as an anesthesia for cesarean section because of slow onset of anesthesia, insufficient block, and for other reasons. Therefore, the combination of the above two anesthesia methods, namely combined spinal-epidural analgesia, has received increasing attention in recent years.…”

Comparison of spinal anesthesia and general anesthesia in inguinal hernia repair in adult: a systematic review and meta-analysis

“…Six RCTs and five cohort studies were included [3,[8][9][10][11][12][13][14][15][16][17]. A total of 2593 patients were recruited into this analysis.…”

“…And all the RCTs analyzed were judged to have low or unclear risk of incomplete outcome data, selective outcome reporting and other potential source of bias. On the other hand, four cohort studies satisfied all criteria and scored 9 stars [10,12,14]. Only one cohort study scored 8 stars owing to inadequacy of follow up [9].…”