Postoperative Outcomes and Patient's Satisfaction after Hybrid TIPP with UHS and TEP Repair for Inguinal Hernias: A Single-Centre Retrospective Comparative Study

Abstract

Generalităţi: Cura herniilor inghinale prin procedeele transabdominal preperitoneal (TAPP) şi total extraperitoneal (TEP) sunt recunoscute pentru scăderea riscului de durere cronică postoperatorie şi cu rate de recidivă acceptabile. Totuşi procedeele hibrid/combinate încă sunt o opţiune semnificativă în rândul chirurgilor. Scopul este de a compara tehnicile hibrid TIPP (hTIPP) folosind sistemul Ultrapro Hernia ® (UHS) şi TEP privind rezultatele şi satisfacţia pacienţilor şi de a analiza siguranţa şi eficienţa celor două procedee. Materiale şi Metode: Nouăzeci de pacienţi care au fost operaţi între anii 2013-2017 pentru hernie inghinală prin procedeele hTIPP sau TEP la spitalul Naas General Hospital, Irlanda au fost incluşi într-o bază de date şi analizaţi într-un studiu retrospectiv. Rezultate: Internarea postoperatorie neplanificată a fost comparabilă între cele două grupuri (3 pacienţi pentru hTIPP şi 3 pacienţi pentru TEP). Nu a fost nicio diferenţă statistică între complicaţiile imediat şi tardiv postoperatorii. Rata de recidivă a fost nulă în grupul hTIPP comparativ cu TEP unde a existat o recidivă. Pe baza chestionarului PROM şi scalei Likert, nu există diferenţe statistic semnificative privind satisfacţia pacienţilor între hTIPP şi TEP.Concluzii: Nu există diferenţă statistic semnificativă privind rata de complicaţii şi satisfacţia pacienţilor între hTIPP şi TEP. hTIPP este un procedeu sigur şi o alternativă validă. AbstractBackground: Transabdominal Preperitoneal (TAPP) and Totally Extraperitoneal (TEP) inguinal hernia repairs are largely acclaimed for their lower risk of chronic postoperative pain and acceptable recurrence rates. However, hybrid/combined open procedures are still a reliable option among surgeons. Our aim is to compare the outcomes and patients' satisfaction of hybrid TIPP (hTIPP) procedure using the Ultrapro Hernia System® with laparoscopic pre-peritoneal mesh repair approaches (TEP) to assess its safety and effectiveness. Patients and Methods: The study design is a single center, retrospective comparative study on 90 patients who had hTIPP and TEP inguinal hernia repair in the NAAS General Hospital, over a four-year period (2013-2017). Results: Unplanned postoperative hospital admission was comparable both groups, the figures were 3 patients for hTIPP and 3 patients for TEP. There was no statistically significant difference in the immediate, early and late postoperative pain and complications in both groups. The recurrence rate was nil in hTIPP group compared to one recurrent case in TEP. There is no statistical difference in the five outcomes of the PROM questionnaire and satisfaction rate between hTIPP and TEP. Conclusions: There is no significant difference between hTIPP and TEP in terms of postoperative outcomes and patient satisfaction. hTIPP approach is a safe and feasible alternative to TEP.

Assessment of feasibility and safety of cyanoacrylate glue versus absorbable tacks for inguinal hernia mesh fixation. A prospective comparative study.

“…Traditionally, studies have compared different repair techniques in the light of surgical complications such as wound infection, chronic pain and recurrence, but it is now accepted and recommended that functional outcomes, patient satisfaction and quality of life are considered when adopting new approaches [ 33 , 34 ]. Herein we used the previously reported PROMs [ 17 ], which are split into five main questions with regards to pain, mobility, self-care at home, daily activities and satisfaction. Each question is scored with 1, 2 or 3 points based on the answer given, summing up to a maximum grade of 15.…”

“…All procedures were day cases, performed under general anaesthesia, by using a laparoscopic TAPP as previously reported [ 17 ]. The mesh fixation method was either using LB or AT based on the patient preference and intraoperative, pre-fixation, surgeon preference.…”