Rezidivleistenhernienreparation nach vorangegangener Netzimplantation

Schwab, Robert; Conze, Joachim; Willms, Arnulf; Klinge, U.; Becker, H. P.; Schumpelick, Volker

doi:10.1007/s00104-006-1158-7

Cited by 13 publications

(4 citation statements)

References 26 publications

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“…In preperitoneal repair group, the morphology of recurrence was a bit different from that in the other group as the internal ring and total posterior wall recurrence were equally seen. In other studies of same interest, The majority of recurrences were medial or suprapubic [11] and medial, lateral or combined [12]. …”

Section: Discussionmentioning

confidence: 99%

Open preperitoneal versus anterior approach for recurrent inguinal hernia: a randomized study

et al. 2012

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BackgroundInguinal herniorrhaphy remains one of the most common general surgical operations, with approximately 15% performed for recurrence. The repair of the resulting recurrent hernia is a daunting task because of already weakened tissues and obscured and distorted anatomy. The aim of this study is to compare the posterior preperitoneal versus anterior tension-free approach for repair of unilateral recurrent inguinal hernia regarding complications and early recurrence.Methods120 Patients in this study were divided randomly into 2 main groups; Group A patients were subjected to posterior preperitoneal approach and those of group B were subjected to conventional anterior tension-free repair. The primary end point was recurrence and the secondary end points were time off from work, postoperative pain, scrotal swelling and wound infections.ResultsThe mean hospital stay was 1.2 days and 4.7, the mean time to return work was 8.2 and 11.2 days and the mean time off from work was 9.4 and 15.9 days in group A and B respectively. The maximum follow-up period was 48 months and the minimum was 14 months with a mean value as 37.11 ± 5.14 months. Only 2 recurrences (3.3%) in group A and 4 cases (6.25%) in group B were seen. The final pain score per patient and the overall complication rate were higher in group B.ConclusionsThe open preperitoneal repair offers the advantages of low recurrence rate and allows covering all potential defects with one piece of mesh and is far superior to the anterior approach.Trial RegistrationACTRN12611000337976

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Section: Discussionmentioning

confidence: 99%

Open preperitoneal versus anterior approach for recurrent inguinal hernia: a randomized study

et al. 2012

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“…Inguinal hernia repair is one of the most frequently performed surgical procedures. In the USA alone, over 800.000 hernia repairs are performed every year [1] , [2] , [3] , [4] , [5] , [6] . By examining the literature, and drawing upon over 30 years of surgical experience, we began to question three key problems in inguinal hernia repair: 1) the complications consequent to invasive fixation, 2) the poor quality of tissue ingrowth induced by the mesh, and 3) the early mesh dislocation after implantation [7] , [8] , [9] .…”

Section: Introductionmentioning

confidence: 99%

Endoscopic and histological evaluations of a newly designed inguinal hernia mesh implant: Experimental studies on porcine animal model and human cadaver

Panaro

Matos-Azevedo

Fatás

et al. 2015

Annals of Medicine &Amp; Surgery

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PurposeConventional prostheses used for inguinal hernia repair are static and passive. This feasibility-study shows the features of a new 3D tension-free prosthesis in an experimental model.MethodsThis study was divided into two-phases: 1) aimed to test the physics intrinsic features and the anatomical adaptability of a new 3D designed mesh, and 2) aimed to evaluate the inflammatory reaction associated with different materials used. On phase-1 implantations were performed in pigs. During the first trial phase, the prostheses were also implanted on human cadavers. On phase-2, implantation was carried out on large swine. Follow-up was of 60-days, after which the animals were anaesthetized for laparoscopic assessment, and for sample collection of mesh implantation site for histological analysis.ResultsAll animals showed good 3D mesh tolerance, and the follow-up period was uneventful. The laparoscopy showed no inflammatory lesions on the internal surface of the peritoneum. Macroscopic observation of implantation site revealed some local fibrosis and reorganization of tissue, no signs of infection, and no changes on original implant positioning. Histological analysis on phase-1 showed in most sample segments the deferent duct maintaining its central position and surrounded by vascular and nervous structures. On phase-2 differences in inflammatory lesion score could be found between subjects.ConclusionsThis new 3D mesh can be placed appropriately and from this preliminary animal study no untoward complications were noted over a 60 day period.

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“…Todos os casos desta casuística ocorreram pela primeira premissa. ; por inguinotomia ou acesso anterior, pode ser fixada uma nova prótese parcial, total ou em forma de plug 22 . Alguns tipos de plug foram descritos, e ressalta-se o trabalho de Rutkow e Robbins 21 , que relataram 320 pacientes operados de hérnias recidivadas, resul-tantes de diferentes técnicas, utilizando plug em forma de guarda-chuva, apre-sentando re-recidiva em 6 casos (2%).…”

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Recidiva de hernioplastia inguinal à Lichtenstein: o emprego do plug de poliproplileno

Peres

Lavrada

Andreollo

2008

ABCD, arq. bras. cir. dig.

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Peres MAO, Lavrada JP, Andreollo NA. Recidiva de hernioplastia inguinal à Lichtenstein -O emprego de plug de poliproplileno. ABCD Arq Bras Cir Dig. 2008;21(2):65-8 RESUMO -Racional -A técnica de Lichtenstein continua sendo o padrão-ouro no tratamento das hérnias inguinais nas últimas duas décadas, por ser livre de tensão em linha de sutura e pela fixação rotineira da tela de poli-propilene, apresentando as menores taxas de recidiva já publicadas. O trata-mento cirúrgico da recidiva após hernioplastia à Lichtenstein é assunto contro-verso na literatura. Objetivo -Apresentar os resultados do emprego de prótese de polipropileno em forma de cone (plug) na correção desta recidiva. , em 1958, ao implantarem uma prótese ou tela de polipropileno no reparo das hérnias inguinais e incisionais 26,27 . Em 1974, Lichtenstein e Shore introduziram esta mesma prótese, agora em forma de rolha cilíndrica obliterando o defeito tecidual de hérnias crurais ou inguinais recidivadas, medi-ante abordagem simples 15 . A seguir, Shulman et al. 24 documentaram a eficácia e a baixa recidiva desta técnica em 1402 hérnias recidivadas.A primeira vez que foi utilizada na literatura o termo "hernioplastia isenta de tensão" ocorreu em 1986, por Lichtenstein et al. 16 . Descreveram com detalhes a técnica que utiliza a tela de polipropileno suturada sobre a fáscia transversal, que por si só representa o reparo real e que se aplica a todos os tipos de hérnias inguinais diretas ou indiretas. Esta técnica tem sido o padrão-ouro das hernioplastias inguinais nas duas últimas décadas, por inguinotomia 1,8,10,14 . Gilbert manteve o desenvolvimento da tela-rolha na evolução das técni-cas isentas de tensão. Confeccionava um pedaço plano de tela de polipropileno, que era pregueado até ficar com formato de cone e introduzido no defeito. Inicialmente descrevia a técnica sem suturas nas hérnias indiretas e posteriormente padronizou fixação com pontos nas hérnias diretas. Ressaltou a menor dissecção tecidual, menor complicação em cordão inguinal e nervos, com taxas de recidiva de 0,1% 8,11,12 . Entretanto, a técnica de Lichtenstein teve rápida aceitação e reprodução em todos os continentes, atingindo as menores taxas de recidiva até então registradas. As suas vantagens incluem tratamento bilateral no mesmo ato sem detrimento dos resultados tardios, a possibilidade de ser realizada em ambiente ambulatorial sob anestesia local e a recuperação das atividades laborativas sem esforços em menor tempo. Além disso, não restringe o paciente das suas diversas atividades com maiores esforços após um período de dez semanas. A minuciosa aplicação da técnica, como descrita com detalhes pelo autor, tem sido o alicerce dos melhores resultados tardios, com recorrências menores que 1% descritos na literatura 6,7,16,19 .

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Rezidivleistenhernienreparation nach vorangegangener Netzimplantation

Abstract: The surgical management of recurrent hernias after previous mesh repair is a particular challenge for surgeons. We introduce a therapeutic algorithm for recurrent hernia surgery after previous mesh implantation based on analysis of clinical practice.

Cited by 13 publications

References 26 publications

Open preperitoneal versus anterior approach for recurrent inguinal hernia: a randomized study

Open preperitoneal versus anterior approach for recurrent inguinal hernia: a randomized study

Endoscopic and histological evaluations of a newly designed inguinal hernia mesh implant: Experimental studies on porcine animal model and human cadaver

Recidiva de hernioplastia inguinal à Lichtenstein: o emprego do plug de poliproplileno

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