Perioperative outcomes of laparoscopic total extraperitoneal inguinal hernia repair

Zaborowski, Alexandra; Farrell, Eric; Moynihan, Alice; Stafford, Anthony T.; Hoti, Emir; Maguire, Donal; Winter, Desmond C.

doi:10.21037/ales.2018.03.08

Cited by 2 publications

(7 citation statements)

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“…The majority of seromas resolved with conservative management with aspiration. Zaborowski 22 et al reported Seroma formation as the most common postoperative complication in their study in 4.2% of patients. In a number of studies Seroma following laparoscopic inguinal hernia repairs is reported as 3.6-7.2%.…”

Section: Resultsmentioning

confidence: 82%

“…Post operative hospital stay showed hematoma in 5 (5%) patients, seroma in 12 (12%) patients, foreign body sensation in 4 (4%) patients detail given in Table- 16,17 In our study regarding the type of hernia 68% of patients had indirect inguinal hernia while 32% of patients had direct inguinal hernia as compared to a study by Gatabi et al 18 in which 23.3% of patients in their study had direct where as 69.2% of patients had indirect hernia. In a study by zaborowski et al 22 out of the 403 patients operated 85% had unilateral inguinal hernias with 64.5% of patients having indirect, 27% of patients having direct hernias. 0.5% of patients in the study were reported as having femoral and 8% as pantaloon hernias.…”

Section: Resultsmentioning

confidence: 95%

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Evaluation of early post-operative pain and seroma formation in transabdominal pre-peritoneal (TAPP) repair of groin hernias with light weight mesh placement.

Qazi

Jan

Zeb

et al. 2020

TPMJ

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Objectives: To share our experience with laparoscopic surgery using TAPP technique, for groin hernias using light weight parietene mesh, to find out early post operative pain and foreign body sensation as complications. Study Design: Cross sectional study. Setting: Department of Surgery Khyber Teaching Hospital Peshawar. Period: January 2018 till August 2018. Material & Methods: A sample of 100 patients was recruited into study. All patients underwent standard transabdominal preperitonial repair with light weight Mesh. Data was collected by predesigned Performa and analyzed with SPSS 21. Results: Out of 100 patients 98% were male, 2% female, mean age was 43.2± 5.3years (minimum 17years and maximum 64years). Regarding frequency of type of hernia data showed 68% patients had indirect inguinal hernia while 32% patients had direct inguinal hernia. 65% patients had right sided inguinal hernia, 26% left sided while 9% had bilateral inguinal hernia. Post operative hospital stay showed hematoma in 5% patients, seroma in 12% patients, wound infection in 8% of patients while foreign body sensation in 4% patients. Conclusion: Most of the patients presented were of middle age. Indirect inguinal hernia was more frequent than direct inguinal hernia. Common complications apart from pain were seroma formation, hematoma, wound infection and foreign body sensation.

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Section: Resultsmentioning

confidence: 82%

Section: Resultsmentioning

confidence: 95%

Evaluation of early post-operative pain and seroma formation in transabdominal pre-peritoneal (TAPP) repair of groin hernias with light weight mesh placement.

Qazi

Jan

Zeb

et al. 2020

TPMJ

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“…It is now widely accepted that LIHR is a safe and effective procedure that provides a valid alternative to open techniques. 2,4,5,9,13 Published literature demonstrates reduced postoperative pain, a shorter hospital stay, a more prompt return to normal activity, less wound complications and better cosmetic outcomes for LIHR when compared to traditional open surgery. 4,13,14 These advantages come with evidence that recurrence rates do not suffer with a minimallyinvasive approach.…”

Section: Discussionmentioning

confidence: 99%

“…9,18 For these reasons, TEP repair for IH has been routinely offered in our service since 2007. 2 Despite the support of international guidelines, uptake of LIHR has been slow, and an unfortunate side effect of this hesitancy is that, not only are patients currently unable to uniformly benefit from the advantages of LIHR, but this may also continue to be the case in the future, as current trainee surgeons fail to acquire the necessary skillset from mentors to offer this approach to their patient population. 10 The incorporation of LIHR into surgical training programmes is currently limited.…”

Section: Discussionmentioning

confidence: 99%

“…1 Over the past few decades, there has been a paradigm shift in operative approaches, evolving from open suture-based techniques such as the Shouldice or Bassini repair, to the standard tension-free Lichtenstein mesh repair and more recently to laparoscopic approaches. 2 While the Lichtenstein repair remains a popular choice for surgeons due to its status as a technique with low recurrence rates that is easy to reproduce and teach, it is not without limitations. 3 These include potential wound complications such as haematoma or seroma, slow recovery due to incision size and location, and chronic groin pain which may result from a variety of mechanisms, including nerve impingement, suboptimal mesh placement or spermatic cord injury.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic totally extraperitoneal hernia repair performed by surgical trainees: overcoming the learning curve

Hannan

Duggan

Harding

et al. 2021

ANZ Journal of Surgery

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Background: Surgical trainees struggle to obtain experience in laparoscopic inguinal hernia repair (LIHR) due to a perceived steep learning curve. The purpose of this study was to compare outcomes in totally extraperitoneal (TEP) repair performed by surgical consultants and trainees under supervision as part of a standardised training regimen to assess the safety of residency training in this technique. Methods: A retrospective review of patients managed by TEP repair by either a consultant or a supervised trainee was performed. Demographic, perioperative and postoperative data were collected and compared. All trainees underwent a standardised approach to teaching TEP repair. Results: Trainees performed 133 procedures and consultants performed 121 procedures. Estimated blood loss was minimal in both cohorts. A significant difference was noted in mean operating time between consultants and trainees (33 vs. 50 min). However, it was also observed that the trainee mean operating time reduced significantly with experience (from 61 to 42 min). No statistically significant difference was demonstrated in postoperative complications, recurrence rate or length of stay. All trainees achieved the ability to complete a laparoscopic TEP repair under unscrubbed consultant supervision during a 1-year placement. Conclusion:With senior supervision and in the presence of a structured training regimen, trainees can safely and effectively perform LIHR, progressing to performing the procedure under unscrubbed consultant supervision. This is valuable information that can serve to inform the structure and direction of surgical training programmes as the ability to offer LIHR is increasingly becoming an expectation of consultant surgeons.

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Perioperative outcomes of laparoscopic total extraperitoneal inguinal hernia repair

Cited by 2 publications

References 0 publications

Evaluation of early post-operative pain and seroma formation in transabdominal pre-peritoneal (TAPP) repair of groin hernias with light weight mesh placement.

Evaluation of early post-operative pain and seroma formation in transabdominal pre-peritoneal (TAPP) repair of groin hernias with light weight mesh placement.

Laparoscopic totally extraperitoneal hernia repair performed by surgical trainees: overcoming the learning curve

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