An analysis of results in a single-blinded, prospective randomized controlled trial comparing non-fixating versus self-fixating mesh for laparoscopic inguinal hernia repair

Denham, Merritt; Johnson, Brandon; Leong, Michelle; Kuchta, Kristine; Conaty, Eliza A.; Ujiki, Michael; Denham, Woody; Butt, Zeeshan; Carbray, Jo Ann; Gitelis, Matthew E.; Linn, John G.

doi:10.1007/s00464-018-6555-8

Cited by 12 publications

(7 citation statements)

References 22 publications

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“…Common perioperative complication rates in inguinal hernia procedures are low, Stavert et al reported, in 780 laparoscopic inguinal hernia repairs, a complication rate of 0.13–1.67% being seroma (1.41%), hematoma (1.41%) and surgical site infection (SSI) (0.13%) the most frequently found 31 . Results similar to those were found in our study with a slightly higher presence of seroma but no presence of SSI (Seroma 2.1%, hematoma 1.45% and SSI 0%) 21 , 32 , 33 . In terms of SSI, adding clean contaminated procedure to hernia inguinal repair still remains controversial due to believed aggregated risk, nevertheless, as Quezada et al described in 21 patients who underwent concomitant laparoscopic hernia repair and cholecystectomy, we found lower incidence of SSI 34 .…”

Section: Discussionsupporting

confidence: 91%

“…Recurrence rate, as one of the milestones in hernia surgery follow up, was low (0.7%), equivalent to other self-fixation mesh experience rate (< 1%) reported by Stavert et al Furthermore, recurrence rate found is lower compared to other studies matching different surgical techniques (open, TAPP, TEP) and fixation methods (Invasive, non-invasive, not fixation) with reported rates that may vary between 1 to 15% 4 , 21 , 27 , 30 , 32 , 33 , 39 – 42 . As reported in literature analysis of a non-invasive fixation (self-fixation mesh) technique in our population showed low morbidity preoperatively and in the late follow up 16 , 22 .…”

Section: Discussionsupporting

confidence: 59%

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Outcomes of 207 totally extraperitoneal hernia repairs using self-fixation mesh

Girón

Hernández

Linares

et al. 2021

Sci Rep

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Inguinal hernia (IH) repair is one of the most common procedures in general surgery around the world. Minimizing postoperative acute and chronic pain without increasing recurrence has been a critical point, giving place to different strategies like self-fixation mesh. The current study aimed to describe a group of patients who underwent IH repair by Totally Extraperitoneal (TEP) technique with self-gripping mesh at a fourth level hospital between 2012 and 2019. Retrospective review of a prospectively collected database including patients who underwent laparoscopic TEP approach with self-fixation mesh for IH repair. Follow up data was obtained at 12, 24, 36, 48, and 60 months post surgical intervention. 207 hernia repairs were performed in 142 patients, with a total of 66 patients with bilateral IH. 10.6% required hospitalization due to either concomitant procedure performed or cardiovascular comorbidities, with a mean hospital stay of 1.6 days. Median and late follow up was up to 5 years. 88.9% of patients complete a year, 86% two years, and 36.7% with a 5 year follow-up. IH repair using the TEP technique and self-fixation mesh showed to be an excellent approach, demonstrating satisfactory results in follow up and complications.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 59%

Outcomes of 207 totally extraperitoneal hernia repairs using self-fixation mesh

Girón

Hernández

Linares

et al. 2021

Sci Rep

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“…A recent randomized trial of 270 patients compared self‐fixating with control mesh‐reinforcement . The study demonstrated reduced early post‐operative pain in the control group, with no difference at 3 weeks or 1 year and no recurrences.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic totally extra‐peritoneal groin hernia repair with self‐gripping polyester mesh: a series of 780 repairs

Stavert

Chan

Ozmen

et al. 2019

ANZ Journal of Surgery

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Background: Laparoscopic groin hernia repair is an increasingly common procedure with benefits of reduced post-operative pain and infection. Post-operative chronic pain remains an ongoing concern in about 10% of patients. Parietex ProGrip™, a polyester self-gripping mesh, has a theoretical benefit of avoiding tacks for mesh-fixation. This case series reflects our long-term experience of this technique. Methods: We conducted a retrospective case series from November 2011 to December 2017. Patients were identified through an operative Medicare Benefits Schedule item number search. Clinical documentation was reviewed with length of stay, mesh infection, chronic pain, recurrence and re-operation as primary data points. Results: A total of 514 patients underwent 780 laparoscopic inguinal hernia repairs with self-gripping polyester mesh during this period. There were 53 female (10.3%) and 461 male patients (89.7%). Unilateral hernia repair was performed in 248 patients (48.2%) and bilateral repair in 266 patients (51.8%). Almost all repairs (779, 99.8%) were primary hernias. There were no mesh infections. Four recurrences were noted (0.51%) and three of these subsequently underwent open redo-hernia repairs (0.38%). Post-operative follow-up was up to 4.4 years. Conclusions: Our series of laparoscopic groin hernia repair with self-gripping mesh demonstrate this is a safe and reliable mesh and effective technique with low recurrence rates.

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“…Additionally, inguinal hernia repair using mesh is the preferred method when the prevention of recurrence is the primary goal. However, mesh implantation is associated with increased complications for patients, particularly postoperative pain, for this reason, some patients request non-mesh hernia repair [26][27][28]. In our study, we found adding subcutaneous bupivacaine infiltration to the analgesic regimen attenuates the postoperative pain even in the presence of mesh repair.…”

Section: Discussionmentioning

confidence: 56%

Comparison of the Analgesic Effect of Subcutaneous Bupivacaine Infiltration and Intravenous Diclofenac vs. Intravenous Diclofenac Monotherapy After Inguinal Hernioplasty: A Retrospective Study

Alijla¹,

Amran²

2022

Cureus

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BackgroundPostoperative pain is a significant problem encountered by patients after a surgical intervention, and there is a crucial need for effective postoperative pain control. The studies have shown that multimodal analgesia and wound infiltration are effective ways to reduce this pain and have a substantial role in the reduction of postoperative medications requirement. This study aimed to evaluate the effect of subcutaneous infiltration of bupivacaine hydrochloride and intravenous (IV) diclofenac as postoperative pain relief in adults undergoing inguinal hernia repair. MethodsA single-center retrospective study included 104 patients aged 18-65 undergoing unilateral inguinal herniorrhaphy at the selected hospital. The patients were in two groups of 52 each. Group A received a 75 mg dose of IV diclofenac plus a subcutaneous injection of 10 mL of bupivacaine hydrochloride (HCl) 0.5% while Group B only received the IV diclofenac without the bupivacaine injection. The postoperative pain was assessed at one, two, three, six, and 12 hrs after the operation using the visual analog scale (VAS), which exhibited a range of pain from zero (no pain) to 10 (extreme pain). ResultsOf a total of 104 patients, 92% of patients were male. The patients' mean age was 36 ± 11 years, and the mean body mass index (BMI) was 22 ±3 kg/m 2 . American Society of Anesthesiologists physical class I was similar in both groups (90.4% versus 84.6%). Patients in Group A had significantly lower VAS pain scores at one, two, three, six, and 12 hrs after the operation and a longer emergence time than Group B (all p-values were < 0.001). Subcutaneous bupivacaine infiltration and IV diclofenac were also found to be an effective analgesic technique in open hernia repair with mesh (p-value < 0.001 for all). ConclusionSubcutaneous injection of bupivacaine combined with IV diclofenac provides superior analgesia to monotherapy intravenous diclofenac after inguinal hernia repair.

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An analysis of results in a single-blinded, prospective randomized controlled trial comparing non-fixating versus self-fixating mesh for laparoscopic inguinal hernia repair

Cited by 12 publications

References 22 publications

Outcomes of 207 totally extraperitoneal hernia repairs using self-fixation mesh

Outcomes of 207 totally extraperitoneal hernia repairs using self-fixation mesh

Laparoscopic totally extra‐peritoneal groin hernia repair with self‐gripping polyester mesh: a series of 780 repairs

Comparison of the Analgesic Effect of Subcutaneous Bupivacaine Infiltration and Intravenous Diclofenac vs. Intravenous Diclofenac Monotherapy After Inguinal Hernioplasty: A Retrospective Study

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