Controlled multicenter trial of laparoscopic transabdominal preperitoneal hernioplasty vs Shouldice herniorrhaphy

Tschudi, J.; Wagner, Markus; Klaiber, C; Brugger, J.-J.; Frei, E.; Krähenbühl, L.; Inderbitzi, Rolf; Hüsler, Jürg; Schmitz, S-F Hsu

doi:10.1007/bf00189547

Cited by 59 publications

(11 citation statements)

References 2 publications

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“…21,22 In this study we found a similar trend with fewer patients complaining of chronic pain at 6 months, as compared with the numbers at the 6 th month of follow up. We found that in Group 'A' the incidence of pain at rest had decreased from 6 at one month to 0 at six months that of pain on coughing 5 times had decreased from 10 to 0 respectively at 1 and 6 months.…”

Section: Clinical Testing At 6 Monthssupporting

confidence: 79%

A clinical study of the incidence and disability caused by mesh neuralgia after inguinal mesh hernioplasty and the effects of prophylactic ilioinguinal neurectomy and its role in preventing chronic groin pain after inguinal hernioplasty

Sunkar¹,

Brashier²,

Bhagwat³

et al. 2018

Int Surg J

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Background: Residual neuralgia, called as Inguinodynia, is an important complication unique to groin hernia repair. The reported incidence ranges between 9-63%. The symptoms are potentially disabling. Symptoms are often more pronounced on axial twisting of body. Methods for prevention include identification and preservation of all nerves, Ilioinguinal Neurectomy and triple Neurectomy during surgery.Methods: One hundred patients underwent elective unilateral Lichtenstein’s tension free hernioplasty. 50 patients were subjected to elective ilioinguinal neurectomy. The remaining underwent standard Liechtenstein’s mesh hernioplasty, without ilioinguinal neurectomy. Randomization was achieved by allocating alternate patients to each group - prophylactic neurectomy, or nerve preservation. All patients, during each review were asked to fill out a Pain Disability Questionnaire to assess sensory loss and pain disability objectively.Results: At completion of 6 monthly follow up pain at rest (none in group ‘A’ compared with 3 in group ‘B’), after coughing 5 times (none in group ‘A’ compared with 7 in group ‘B’), after climbing 4 flights of stairs(3 in group ‘A’ compared with 16 in group ‘B’) and after cycling for 20 minutes (11 in group ‘A’ compared with 22 in group ‘B’) were all significantly lesser in the neurectomy group as compared with the non neurectomy group. More importantly, exertional chronic pain incidence at 6 months was significantly less in group ‘A’.Conclusions: It was concluded that pain after inguinal mesh hernioplasty is a cause of morbidity, pain was complained of by a significantly larger number of non-neurectomised patients at 6 months of follow-up, prophylactic ilioinguinal neurectomy is associated with reduced exertional chronic groin pain, disability caused by pain after inguinal hernioplasty, is significantly reduced by ilioinguinal neurectomy and an extremely significant reduction in the requirement of medication is brought about by neurectomy compared with controls.

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Section: Clinical Testing At 6 Monthssupporting

confidence: 79%

A clinical study of the incidence and disability caused by mesh neuralgia after inguinal mesh hernioplasty and the effects of prophylactic ilioinguinal neurectomy and its role in preventing chronic groin pain after inguinal hernioplasty

Sunkar¹,

Brashier²,

Bhagwat³

et al. 2018

Int Surg J

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“…Negative randomized controlled trials [2,12,15,17], suggesting that the laparoscopic technique offers little gain, have been offset by many positive randomized controlled trials [8,10,11,13,14,[18][19][20][21][22][23]. However, faster return to work, touted as the salient advantage of the laparoscopic repair by its proponents, was not supported by data in six trials [2,8,12,15,17,19].…”

mentioning

confidence: 89%

Meta-analyses of randomized controlled trials of laparoscopic vs conventional inguinal hernia repairs

1999

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“…When fixation below the iliopubic tract is avoided, the incidence of nerve injury dramatically improves [37]. Controlled studies now demonstrate an advantage for the laparoscopic repair [30,39]. A more recent study by Rosenberger et al [32], however, has demonstrated that in 15-25% of patients the posterior nerves are aberrantly located above the iliopubic tract, placing them at risk even when the fixation is properly placed.…”

Section: How Far Have We Come?mentioning

confidence: 97%

Primary inguinal hernia repair: open or laparoscopic, that is the question

Mellinger

Felix

2004

Surg Endosc

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Controlled multicenter trial of laparoscopic transabdominal preperitoneal hernioplasty vs Shouldice herniorrhaphy

Abstract: Laparoscopic hernia repair causes less pain than the conventional operation and enables the patient to return to full work and usual activities earlier. The recurrence rate will not be known for 5 years.

Cited by 59 publications

References 2 publications

A clinical study of the incidence and disability caused by mesh neuralgia after inguinal mesh hernioplasty and the effects of prophylactic ilioinguinal neurectomy and its role in preventing chronic groin pain after inguinal hernioplasty

A clinical study of the incidence and disability caused by mesh neuralgia after inguinal mesh hernioplasty and the effects of prophylactic ilioinguinal neurectomy and its role in preventing chronic groin pain after inguinal hernioplasty

Meta-analyses of randomized controlled trials of laparoscopic vs conventional inguinal hernia repairs

Primary inguinal hernia repair: open or laparoscopic, that is the question

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