Correção de hérnia laparoscópica: tela sem fixação é viável?

Meyer, Alberto; Dulucq, Jean-Louis; Mahajna, Ahmad

doi:10.1590/s0102-67202013000100006

Cited by 15 publications

(10 citation statements)

References 28 publications

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“…Despite the laparoscopic technique still being little used worldwide (corresponding to just 16% in Denmark 14 and less than 5% in Brazil 9 ), many studies indicate it as a viable and effective method for repair of inguinal hernias. www.nature.com/scientificreports/ With regard to incarceration and strangulation, the discussion is contradictory 4,6 , without widespread consensus and conclusions, even in guidelines 15 . Previous studies 16 aimed to investigate the effectiveness of this approach in the repair of incarcerated/strangulated hernias by analyzing complication rate, recurrence, postoperative mortality and time to hospital discharge, but not from the perspective of the difficulty for trained surgeons in elective procedures.…”

Section: Discussionmentioning

confidence: 99%

“…The laparoscopic approach has been proved to be a feasible method for non-complicated hernias, with a low rate of clinical postoperative complications 5 , low length of postoperative hospital stay and less discomfort during recover when compared to open surgery. However, there is no significant difference in recurrence rates between the two approaches 6 . Due to the greater cost and technical difficulty 8 , the laparoscopic approach is the less common of the two, being used in the minority of procedures for hernia repair around the world 7 .…”

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confidence: 85%

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Treating incarcerated inguinal hernias with TEP is a viable option for experienced surgeons

Medeiros

Carvalho

Pipek

et al. 2020

Sci Rep

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Despite inguinal hernias being a common problem in public health, there is still scarce information about the epidemiology of the complications, especially incarceration, and their influence on the laparoscopic surgical methods considering the role of the learning process of the surgeon. Compare laparoscopic totally extraperitoneal (TEP) approach in the repair of incarcerated and non-incarcerated inguinal hernias from the perspective of technical difficulty for trained surgeons. We obtained data about sex, age, location and type of hernia, surgery duration, ASA score, postoperative complications, previous surgeries and BMI. Groups were descriptively analyzed and statistically compared to verify how similar the samples were. 265 (90.1%) patients had non-incarcerated hernias and 29 (9.9%) incarcerated. We observed that there was no significant difference in the pattern of location (right, left or bilateral), sex, ASA, previous or complications between the two groups. Unilateral incarcerated hernias had longer operative times compared to non-incarcerated. No difference was found between bilateral hernias. We didn´t find significant epidemiological differences between incarcerated and non-incarcerated hernias. In our experience, with the limitation of a single-surgeon series, laparoscopic hernia repair achieved satisfactory results in terms of feasibility (especially for bilateral hernias) and safety.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 85%

Treating incarcerated inguinal hernias with TEP is a viable option for experienced surgeons

Medeiros

Carvalho

Pipek

et al. 2020

Sci Rep

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“…The study was conducted by senior expert surgeons using the TEP technique. 5 , 6 The contraindications for the TEP technique in this study were as follows: the choice of the patient, patients aged <18 years, pregnant women, high–surgical risk patients (American Society of Anesthesiologists status 3 or 4), obesity (BMI >35 kg/m 2 ), strangulated hernias, patients receiving anticoagulant treatment, large inguinal-scrotal hernias, and previous surgery in the preperitoneal space (radical prostatectomy, relapse after laparoscopic hernia repair).…”

Section: Methodsmentioning

confidence: 99%

Laparoscopic Hernia: Umbilical-Pubis Length Versus Technical Difficulty

Meyer

Kassir

Atger³

2014

JSLS

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Laparoscopic hernia repair is more difficult than open hernia repair. The totally extraperitoneal procedure with 3 trocars on the midline is more comfortable for the surgeon. We studied the impact of the length between the umbilicus and the pubis on the totally extraperitoneal procedure (95 hernias operated on in 70 patients). This length did not influence the totally extraperitoneal procedure in this study.Background:The laparoscopic repair of hernias is considered to be difficult especially for the totally extra-peritoneal technique (TEP) due to a limited working space and different appreciation of the usual anatomical landmarks seen through an anterior approach. The aim of our study has been to answer a question: does the umbilical-pubic distance, which influences the size of the mesh, affect the TEP technique used in the treatment of inguinal hernias?Methods:From January 2001 to May 2011, the umbilical-pubic (UP) distance was measured with a sterile ruler graduated in centimeters in all patients who underwent a symptomatic inguinal hernia by the TEP technique in two hernia surgery centers. The sex, age, BMI, hernia type, UP distance, operation time, hospital stay and complications were prospectively examined based on the medical records.Results:Seventy patients underwent 95 inguinal hernia repairs by the TEP technique. The umbilical-pubic distance average was 14 cm (10 to 22) and a 25 kg/m2 (16–30) average concerning the body mass index (BMI). Seventy percent of patients were treated on an outpatient basis. The postoperative course was very simple. There was no recurrence of hernia within this early postoperative period.Conclusion:The umbilical-pubic distance had no influence on the production of TEP with 3 trocars on the midline in this study.

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“…As for fixation, the use of staples has been widely debated in recent years, since they can induce damage to sensitive nerves and lead to neuropathy. In the case of TEP, studies show no clinical advantages with fixing the mesh, and it can be dispensed in up to 95% of cases, being recommended for exceptional cases 16,17 . The persistence of pain after a few months warrants systemic pharmacological interventions.…”

Section: Etiologymentioning

confidence: 99%

Inguinodynia: review of predisposing factors and management

Barbosa

Oliveira

DE-Melo-Delgado

et al. 2020

Rev. Col. Bras. Cir.

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Herniorrhaphy is one of the most common surgical procedures, with an estimated 20 million operations performed annually worldwide. One of the common complications associated with this procedure is inguinodynia, defined as pain beyond three months after inguinal hernia surgery. In this review, we have addressed the main aspects of this complication with current articles, published in the last five years. Inguinodynia has a multifactorial nature and studies have shown that its development is related to the surgical technique and intrinsic factors of the patient that imply greater predisposition to this phenomenon. In this regard, it has been discussed which surgical techniques imply a lower incidence of this complication. Many studies have focused on understanding intrinsic features of each patient, both in physical and cognitive aspects, and how the approach of these factors can favor a better post-surgical recovery. The treatment of this condition is still challenging, and there are no established universal guidelines. We believe that due to its multifactorial nature, the treatment is hampered due to the individuality inguinodynia presentations.

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Correção de hérnia laparoscópica: tela sem fixação é viável?

Abstract: Total extraperitoneal hernioplasty is a very effective and safe procedure in the hands of experienced surgeons with specific training. It is an interesting option in bilateral and recurrent hernia as it obtains satisfactory results in terms of postoperative pain and morbidity.

Cited by 15 publications

References 28 publications

Treating incarcerated inguinal hernias with TEP is a viable option for experienced surgeons

Treating incarcerated inguinal hernias with TEP is a viable option for experienced surgeons

Laparoscopic Hernia: Umbilical-Pubis Length Versus Technical Difficulty

Inguinodynia: review of predisposing factors and management

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