Comparison of slit mesh versus nonslit mesh in laparoscopic extraperitoneal hernia repair

Dogan, Yildirim; Dönmez, Turgut; Ozcevik, Halim; Çakır, Mikail; Demiryas, Süleyman; Akturk, Okan Murat

doi:10.5114/wiitm.2018.77258

Cited by 4 publications

(17 citation statements)

References 27 publications

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“…We are aware that our study groups are relatively small and our results need confirmation in larger cohorts, but we did not observe any marked unfavorable effect of implant fixation or benefits from the use of the Parietex Pro-Grip self-fixing mesh. Our observations regarding the ProGrip self-fixing mesh are not confirmed in the studies of other authors, who demonstrated its beneficial treatment effect mostly reflected in the reduction of post-operative pain, faster return to normal physical activity or lack of hernia recurrence [11,22,23,30,31]. Most of the studies have shown that non-fixation hernia repair is generally more cost-effective than repair with mesh fixation.…”

Section: Discussioncontrasting

confidence: 80%

Totally extraperitoneal inguinal hernia repair with or without fixation leads to similar results. Outcome of randomized prospective trial

Pielaciński

Puła

Wróblewski

et al. 2020

wiitm

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A b s t r a c tIntroduction: The use of implants in inguinal hernia repair has reduced its recurrence rate. However, postoperative groin pain still remains an unresolved problem. There are suggestions that in totally extraperitoneal inguinal hernia repair (TEP-IHR) two of the likely factors responsible for pain are use of fixation and the type of fixation used. Aim: To evaluate the impact of mesh fixation on the incidence of postoperative pain, restriction of physical activities, hernia recurrence risk, return to normal activities and demand for analgesics in patients after unilateral TEP-IHR. Material and methods: Unilateral TEP-IHR was performed in 139 male patients randomized to three groups: self-gripping mesh (SG), lightweight mesh (L) and lightweight mesh with fixation (LF). Full study-inclusion criteria were met by 110 patients; 43, 18 and 49 in groups SG, L and LF respectively. Follow-up occurred on the 1 st , 2 nd , and 7 th day and 3, 6, 12 months postoperatively. The numeric rating scale (NRS) was used to assess pain and the EuraHS-QoL (European Registry for Abdominal Wall Hernias Quality of Life Score) questionnaire to compare quality of life (QoL) prior to surgery and one year later. Results: No statistically significant differences were observed between study groups with regard to the incidence rate and intensity of acute post-operative pain, chronic pain, analgesic demand, return to normal activity, hernia recurrence rate and post-operative QoL. Conclusions: Lack of fixation in TEP-IHR does not increase the risk of hernia recurrence, and its presence does not significantly worsen the treatment results; especially it does not increase the incidence of chronic pain.

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Section: Discussioncontrasting

confidence: 80%

Totally extraperitoneal inguinal hernia repair with or without fixation leads to similar results. Outcome of randomized prospective trial

Pielaciński

Puła

Wróblewski

et al. 2020

wiitm

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“…When the chronic pain was investigated at the 3 rd month, the SM group had a significantly higher pain level than that of the NSM group (p = 0.004). When the hernia diameter was larger than 5 cm, there was no significant difference between the groups in the early postoperative period of pain [24].…”

Section: Discussionmentioning

confidence: 81%

Infiltration of bupivacaine into the preperitoneal space and trocar incisions of patients undergoing laparoscopic totally extraperitoneal repair of unilateral inguinal hernia: a prospective randomized controlled observational study

Çolak¹,

Akkus²,

Gürbulak³

et al. 2020

wiitm

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Introduction: Although laparoscopic repair of inguinal hernia is associated with reduced postoperative pain, it is not entirely painless. In addition to reducing the need for analgesic medication, postoperative complications, and hospitalization, postoperative pain control enables early return to normal activity. Aim: To evaluate the efficacy of bupivacaine instilled into the pre-peritoneal space and trocar incisions of patients undergoing laparoscopic totally extraperitoneal (TEP) repair of inguinal hernia. Material and methods: Bupivacaine was instilled into the pre-peritoneal space and trocar incisions of the patients in group I (n = 23), whereas it was infiltrated only into the trocar incisions of the patients in group II (n = 21). No local anesthetic was administered to the patients in group III (n = 21). Postoperative pain was assessed using the Visual Analog Scale (VAS) at 4 and 24 h, and the dosage of analgesic medication was noted. Results: No significant difference regarding age, gender, body mass index, ASA class, history of abdominal surgery, or smoking was noted between the three groups (p > 0.05). VAS score at 4 h was significantly higher in group III than in groups I and II (p < 0.05). The dosage of analgesic medication was significantly higher in group III than in groups I and II (p < 0.05), with no significant difference between groups I and II (p > 0.05). Conclusions: Infiltration of long-acting local anesthetic into the pre-peritoneal space and trocar incisions of patients undergoing laparoscopic TEP repair of inguinal hernia reduces the need for analgesic medication by reducing early postoperative pain.

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“…1). Four retrospective cohort studies and one prospective, all single centre studies 3,4,5,6,7 (Table 1).…”

Section: Literature Searchmentioning

confidence: 99%

“…All included studies were assessed for methodological quality using the Newcastle-Ottawa Scale (NOS). Four studies were given score of seven (3,(5)(6)(7). One Study was given score of eight (4) (Table 2).…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

“…The authors used TEP or TAPP technique depending on the local practice and surgeon's preference. Two of the authors included both approaches in their institution, 3,4 two only TEP 5,6 and one TAPP only. 7 Of the two authors 3,4 who started with TEP approach, 16/722 (2.2%) of their patients were converted to TAPP but none gave any explanation for this.…”

Section: Tapp Versus Tep Techniquementioning

confidence: 99%

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Laparoscopic mesh placement during inguinal hernia repair: a meta‐analysis of two methods of repair

Demetriou

Ahmad

Robinson

2022

ANZ Journal of Surgery

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BackgroundThere are several modifications in the technique for the placement of mesh during laparoscopic inguinal hernia repair. One of these is a slit on the mesh to surround the cord structures which proponents of it suggest that it decreases the recurrence rate due to better anchoring of the mesh and lower risk of displacement. There is only low‐level evidence in current literature examining the two methods. The present study aimed to provide stronger evidence in establishing whether the slit mesh technique is superior to the non‐slit mesh technique.MethodsThe reporting of this systematic review was guided by the standards of the preferred reporting items for systematic review and meta‐analysis statement and registered with PROSPERO (ID: CRD42022300629). Eligible studies had to compare the two methods of mesh placement slit Vs nonslit in laparoscopic Inguinal hernia repair and also report on at least one outcome. The outcomes were expressed in odd ratios with their 95% confidence intervals. Where significant heterogeneity existed a random effects model was used otherwise a fixed effects model was used.ResultsFive studies met the criteria for inclusion in quantitative analysis. Overall, there were 10 (1.5%) recurrences in the slit group compared to 12 (2.5%) in the non‐slit group OR 0.62, 95% CI (0.27–1.41). There was no difference in the incidence of post‐operative bleeding (OR 1.21, 95%CI 0.4–3.66), seroma formation (OR1.5, 95% CI 0.81–2.76), or post‐operative neuralgia (OR 0.98, 95%CI 0.11–8.92) between the two groups.ConclusionThere was no difference between the two methods.

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Comparison of slit mesh versus nonslit mesh in laparoscopic extraperitoneal hernia repair

Cited by 4 publications

References 27 publications

Totally extraperitoneal inguinal hernia repair with or without fixation leads to similar results. Outcome of randomized prospective trial

Totally extraperitoneal inguinal hernia repair with or without fixation leads to similar results. Outcome of randomized prospective trial

Infiltration of bupivacaine into the preperitoneal space and trocar incisions of patients undergoing laparoscopic totally extraperitoneal repair of unilateral inguinal hernia: a prospective randomized controlled observational study

Laparoscopic mesh placement during inguinal hernia repair: a meta‐analysis of two methods of repair

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