Outcomes of slit mesh in laparoscopic totally extraperitoneal inguinal hernia repair: Does it affect recurrence?

Chia, C. K.; Su, Jun; Hoe, Yingmin; Shelat, Vishal G; Junnarkar, Sameer P; Low, Jee Keem; Woon, Winston

doi:10.1111/ases.12224

Cited by 9 publications

(18 citation statements)

References 10 publications

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“…Laparoscopic TEP is the principally used procedure of laparoscopic hernia repair. The size and type of mesh, the fixation method, and the surgical technique affect the recurrence rates [ 11 ]. Fitzgibbons et al described the reasons for recurrence as follows: the inexperience of the surgeon, inadequate dissection, insufficient mesh size, ineffective coverage of mesh of the hernia defect, failure in fixation, and hematoma formation [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of slit mesh versus nonslit mesh in laparoscopic extraperitoneal hernia repair.

Dogan

Dönmez²,

Ozcevik³

et al. 2018

Videosurgery and Other Miniinvasive Techniques

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IntroductionEndoscopic hernia repair integrates the advantages of tension-free preperitoneal mesh support of the groin with the advantages of minimally invasive surgery procedures.AimTo compare outcomes between slit mesh (SM) and nonslit mesh (NSM) placement in laparoscopic totally extraperitoneal (TEP) inguinal hernia repair.Material and methodsThis is a retrospective study of 353 patients who underwent TEP inguinal hernia repair between January 2010 and December 2011. One hundred forty-nine and 154 hernias were operated on in the SM and NSM groups, respectively. Postoperative complications, recurrence, early postoperative pain, and chronic pain levels were evaluated.ResultsIn a total of 303 patients, hernia repair was performed as 395 direct and indirect hernias. Nonslit mesh was converted from TEP to transabdominal preperitoneal patch plasty (TAPP) in 4 patients in the group and 6 patients in the slit mesh group. The average operation time of the SM group was significantly higher than that of the NSM group (p < 0.001). In the evaluation of early postoperative pain, VAS levels of the NSM group were statistically significantly lower than those of the SR group in all evaluations (p = 0.001). The pain rate of the SM group after 3 months of chronic pain was significantly higher than that of the NSM group (p = 0.004). There was no difference in recurrence rate, 6th month chronic pain, wound infection or wound hematoma.ConclusionsThe use of SM and NSM in TEP operations is not different in terms of recurrence and complications. However, the use of NSM gives better results in terms of early postoperative pain and chronic pain.

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Section: Discussionmentioning

confidence: 99%

“…However, there are conflicting reports about the rates of recurrence when using slit (SM) and nonslit mesh (NSM) [ 9 ]. Also, testicular pain is reported to be higher in TEP operations with SM compared with NSM operations [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of slit mesh versus nonslit mesh in laparoscopic extraperitoneal hernia repair.

Dogan

Dönmez²,

Ozcevik³

et al. 2018

Videosurgery and Other Miniinvasive Techniques

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“…1). Four retrospective cohort studies and one prospective, all single centre studies 3,4,5,6,7 (Table 1).…”

Section: Literature Searchmentioning

confidence: 99%

“…All included studies were assessed for methodological quality using the Newcastle-Ottawa Scale (NOS). Four studies were given score of seven (3,(5)(6)(7). One Study was given score of eight (4) (Table 2).…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

Laparoscopic mesh placement during inguinal hernia repair: a meta‐analysis of two methods of repair

Demetriou

Ahmad

Robinson

2022

ANZ Journal of Surgery

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BackgroundThere are several modifications in the technique for the placement of mesh during laparoscopic inguinal hernia repair. One of these is a slit on the mesh to surround the cord structures which proponents of it suggest that it decreases the recurrence rate due to better anchoring of the mesh and lower risk of displacement. There is only low‐level evidence in current literature examining the two methods. The present study aimed to provide stronger evidence in establishing whether the slit mesh technique is superior to the non‐slit mesh technique.MethodsThe reporting of this systematic review was guided by the standards of the preferred reporting items for systematic review and meta‐analysis statement and registered with PROSPERO (ID: CRD42022300629). Eligible studies had to compare the two methods of mesh placement slit Vs nonslit in laparoscopic Inguinal hernia repair and also report on at least one outcome. The outcomes were expressed in odd ratios with their 95% confidence intervals. Where significant heterogeneity existed a random effects model was used otherwise a fixed effects model was used.ResultsFive studies met the criteria for inclusion in quantitative analysis. Overall, there were 10 (1.5%) recurrences in the slit group compared to 12 (2.5%) in the non‐slit group OR 0.62, 95% CI (0.27–1.41). There was no difference in the incidence of post‐operative bleeding (OR 1.21, 95%CI 0.4–3.66), seroma formation (OR1.5, 95% CI 0.81–2.76), or post‐operative neuralgia (OR 0.98, 95%CI 0.11–8.92) between the two groups.ConclusionThere was no difference between the two methods.

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“…No evidence exists on spermatic cord injury nor a reduction in the recurrence rate due to the slit procedure has been published [ 5 – 11 ]. To date, only nine studies have compared the results of slit vs. no-slit mesh techniques, six during a TEP [ 5 , 6 , 12 – 15 ] and three others during a TAPP [ 10 , 11 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Lack of advantages of slit mesh placement during laparoscopic transabdominal preperitoneal inguinal hernia repair (TAPP): a single centre, case matched study

Bracale

Andreuccetti

Sodo³

et al. 2018

BMC Surg

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BackgroundDuring laparoscopic trans-abdominal pre-peritoneal hernia repair (TAPP) the positioning of the mesh around the spermatic cord could provide an additional anchoring point and ensure better defect closure, thereby preventing mesh movement and recurrence. The primary aim of our retrospective study was to determine if, during a TAPP procedure, an advantageous difference for mesh placement exists between the slit and the non-slit techniques in terms of recurrence rate. Secondary aims were intra and post-operative complications and the time required to return to normal activity.MethodsFrom January 2010 to December 2015, data from patients who had undergone TAPPs at our Institution were prospectively collected. We performed a retrospective case control matched study of two homogenous (BMI, Age, type of hernia) groups of 100 patients who underwent respectively TAPP with no slit mesh placement (Group NS) and slit mesh placement (Group S). Statistical analysis was carried out using a SPSS 20. To compare continuous variables, an independent sample T-test was performed. A Chi-square test was employed for categorical data.ResultsNo differences were found between the slit and non-slit groups in terms of biometric features and intra and post-operative outcomes were found to be similar in both groups as well. In particular, at mean follow-up of 57.34 ± 10.56 months for Group NS and 55.66 ± 8.61 months for Group S months only one recurrence per group was found.ConclusionOur study failed to prove a superiority of the slit mesh technique over the no-slit mesh technique during TAPP. However, in light of its not being a randomized study, a subsequent, well-designed RCT would be desirable in order to better determine if the Slit mesh technique could prove to be advantageous enough to justify its routine use during the TAPP procedure.

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Outcomes of slit mesh in laparoscopic totally extraperitoneal inguinal hernia repair: Does it affect recurrence?

Abstract: No significant differences in outcomes were found between slit and non-slit mesh placement. Both have low complication rates, low recurrence rates, and high satisfaction levels.

Cited by 9 publications

References 10 publications

Comparison of slit mesh versus nonslit mesh in laparoscopic extraperitoneal hernia repair.

Comparison of slit mesh versus nonslit mesh in laparoscopic extraperitoneal hernia repair.

Laparoscopic mesh placement during inguinal hernia repair: a meta‐analysis of two methods of repair

Lack of advantages of slit mesh placement during laparoscopic transabdominal preperitoneal inguinal hernia repair (TAPP): a single centre, case matched study

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