Comparison of Conventional Anterior Surgery and Laparoscopic Surgery for Inguinal-Hernia Repair

Liem, Mike S L; Graaf, Y. van der; Steensel, C. J. Van; Boelhouwer, Roelof U.; Clevers, G. J.; Meijer, W. S.; Stassen, Laurents P. S.; Vente, J. P.; Weidema, W. F.; Schrijvers, A. J. P.; Vroonhoven, T. J. M. V. Van

doi:10.1056/nejm199705293362201

Cited by 468 publications

(117 citation statements)

References 21 publications

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“…It can be performed conventionally (open surgery) or in a minimally invasive way. Worldwide studies show that laparoscopic procedures are associated with less postoperative pain (1-4), with less analgesia consumption by the patient (13). Our study confirms these results: patients after laparoscopic TAPP repair had lower postoperative pain scores, required fewer analgesics, and the duration of the pain was shorter compared with open surgery.…”

Section: Discussionsupporting

confidence: 81%

“…Intraoperative complications belong from chosen surgery technique and can be -bladder injury, bowel injury, vascular injury, injury to Vas Deferens, etc (4). The main postoperative complications can be seroma/hematoma formation, neuralgias, mesh infection, wound infection, testicular pain and swelling, recurrence (4,13). Nine of 64 patients in our study had postoperative complications: 5 of them (7.81%) had wound infection.…”

Section: Discussionmentioning

confidence: 91%

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Laparoscopic Versus Open Repair of Inguinal Hernia

et al. 2017

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SummaryBackground and objective. Inguinal hernia repair is one of the most common general surgery procedures. Laparoscopic repair is technically more demanding, though it has been shown to be superior in terms of pain and discomfort, however, there is no apparent difference in recurrence between laparoscopic and open mesh methods of hernia repair. Over the years we see a relatively slow increase of laparoscopic procedures and even scepticism of the patients; thus we decided to test the hypothesis that more demanding and costly laparoscopic surgery has little benefits over the open procedure. The aim of our study was to compare postoperative pain, short-and long-term outcomes after laparoscopic hernia repair and conventional open hernia repair. Results. Laparoscopic procedure was significantly more often performed for the patients, who were younger, had shorter history of disease. The mean operative time for laparoscopic inguinal hernia repair was significantly longer than for open repair (p=0.02). The pain score for laparoscopic surgery was significantly lower according to VAS on day 1, 2, 3 (overall p≤ 0.002). The patients in the laparoscopic group required significantly lower doses of narcotic analgesics on the third postoperative day; the doses of nonsteroidal anti-inflammatory drugs were also significantly lower on the second and third postoperative day in this group. The postoperative hospital stay was shorter after laparoscopic repair (p=0.01). Sixty-four patients (71.11%) completed follow-up at one year after the operation. Nine (14.06%) of them had postoperative complications and eight of them were after open hernia repair. Two patients (3.1%) were re-operated (both patients were treated by Lichtenstein hernioplasty): one for inguinal hernia recurrence, another for testicular necrosis. Conclusions. The patients from laparoscopic group had significantly shorter postoperative pain duration (p=0.019), returned to daily activity slightly earlier and had better satisfaction with the operation comparing with the patients who undergone open surgery (p=0.915, p=0.893), but the duration of the sick leave (time off from work) was similar in both hernia repair group (p=0.260). Data shows that laparoscopic hernia repair has advantages in terms of post-operative pain intensity and duration, as well as risk of complications and patient satisfaction.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 91%

Laparoscopic Versus Open Repair of Inguinal Hernia

et al. 2017

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“…This technique has proven to be comprehensively superior to traditional laparotomy in terms of esthetics, recovery, and complications. 7 The patient receives an enhanced cosmetic outcome because only one incision, often in the umbilicus, is used. Both recovery times and complication rates are significantly decreased because of the reduced number of wounds, which theoretically decreases postoperative wound pain, infection, bleeding, and adhesion formation.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Reoperations After Laparoscopic Adjustable Gastric Banding

Chiapaikeo

Schultheis

Protyniak

et al. 2014

JSLS

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Background and Objectives:Increased interest in laparoendoscopic single-site surgery has instigated research into trials of novel techniques. The procedure we propose may potentially improve patient satisfaction and cosmetic results while diminishing the incidence of trocar-site herniation. We report our initial experience with laparoendoscopic single-site totally extraperitoneal herniorrhaphy for postoperative incisional hernia to determine the procedure's feasibility and safety.Methods:Three patients with incisional hernias after gynecologic surgery underwent laparoendoscopic single-site totally extraperitoneal procedures. We evaluated the patients' preoperative and postoperative condition, as well as the details of their original surgery. We performed the procedure through a 2-cm umbilical incision followed by mesh insertion and transabdominal suture placement in all patients.Results:Laparoendoscopic single-site totally extraperitoneal herniorrhaphy was completed in 80 to 120 minutes. No intraoperative complications were encountered, and surgical blood loss was minimal. The duration of hospital stay ranged from 2 to 4 days. One patient had a postoperative wound infection. The patients have shown no sign of recurrence at 9 months' follow-up.Conclusion:Laparoendoscopic single-site totally extraperitoneal herniorrhaphy appears to be feasible and safe. It may be performed with readily available instruments, although further experience and practice are warranted for a more efficient repair. The procedure has similar advantages to a multiport laparoscopic totally extraperitoneal procedure but yields better cosmetic results. More studies are needed to assess the long-term benefits and complications of this procedure.

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“…Meanwhile, the indications for laparoscopic surgery have gradually expanded and the laparoscope has been applied to nearly every surgical speciality and procedure. Today the minimally invasive technique seems to be an alternative to a variety of open procedures such as gastric fundoplication, adrenalectomy or inguinal hernia repair [2, 3, 4, 5]. …”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Colorectal Surgery:A Five-Year Experience

Bruch

Schiedeck²,

Schwandner³

1999

Dig Surg

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Objective: The aim of this study was to assess the feasibility and outcome of 300 laparoscopic colorectal procedures performed within 5 years for both benign and malignant disorders. The specific purpose was to identify the impact of the learning curve on reducing morbidity and on improving the outcome of laparoscopic colorectal surgery. Patients and Methods: All cases were divided into 3 groups: the first 100, the second 100 and the third 100 procedures were analyzed. Statistical analysis was performed by Student’s t test and χ² test. Results: The laparoscopic procedure had to be converted to open surgery in 22 cases (mean conversion rate 7.3%). Thus, a total of 278 procedures could be performed laparoscopically. The mean major complication rate was 8.6%, minor complications occurred in 9.7%. The overall morbidity rate was 18.3%. In 44 cases, laparoscopic resections were performed for the cure of colorectal malignancy. The mean lymph node harvest was 12.8 nodes, no port-site recurrence was documented at a mean follow-up of 22 months. Analyzing our 5-year experience, the incidence of conversion showed a decline from 8.0% (1st and 2nd 100) to 6.0% in the last 100 procedures (p > 0.05). The major complication rate was significantly decreased from 15 to 6.0% (1st vs. 2nd 100) and was 5.0% in the 3rd group. The minor complication rate, overall morbidity rate and laparotomy rate have also been reduced (p > 0.05). The duration of surgery was shortened from 251.4 to 213.5 min (1st vs. 2nd 100, p < 0.05) and was 196.9 min in the last 100 procedures. Postoperative hospital stay was decreased from 16.3 to 14.3 days (1st 100 vs. 2nd 100, p > 0.05) and could be shortened to 11.2 days (2nd vs. 3rd 100, p < 0.05). Conclusion: With increasing experience, laparoscopic colorectal surgery can be performed with reduced morbidity and improved outcome. To evaluate the role of laparoscopic colorectal procedures, particularly for the cure of malignancy, prospective randomized trials are necessary.

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Comparison of Conventional Anterior Surgery and Laparoscopic Surgery for Inguinal-Hernia Repair

Abstract: Patients with inguinal hernias who undergo laparoscopic repair recover more rapidly and have fewer recurrences than those who undergo open surgical repair.

Cited by 468 publications

References 21 publications

Laparoscopic Versus Open Repair of Inguinal Hernia

Laparoscopic Versus Open Repair of Inguinal Hernia

Analysis of Reoperations After Laparoscopic Adjustable Gastric Banding

Laparoscopic Colorectal Surgery:A Five-Year Experience

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