Day-case endoscopic totally extraperitoneal inguinal hernioplasty versus open Lichtenstein hernioplasty for unilateral primary inguinal hernia in males

Lau, Hung; Patil, NG; Yuen, WK

doi:10.1007/s00464-005-0203-9

Cited by 97 publications

(81 citation statements)

References 20 publications

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“…The benefits of day-case TEP included less postoperative pain, a faster return to work, and a lower incidence of chronic inguinal pain. 25 However only very few studies support laparoscopic inguinal hernia repair as day care surgery.…”

Section: Day Care Surgerymentioning

confidence: 99%

Laparoscopic vs. open inguinal hernia repair: A systematic review of literature

Gupta

Kumar

et al. 2014

Asian J Med Sci

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Section: Day Care Surgerymentioning

confidence: 99%

Laparoscopic vs. open inguinal hernia repair: A systematic review of literature

Gupta

Kumar

et al. 2014

Asian J Med Sci

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“…TEP hernia repair avoids the need to open the peritoneum and reduces the risk of intraperitoneal complications. 2 Advantages of the laparoscopic method include: quicker return to normal physical activities; 3,4 reduced postoperative pain and lower risk of chronic pain in the groin; 5,6 the potential to repair bilateral hernias using the same three ports; avoidance of scarred tissue planes in recurrent hernias. However, laparoscopic procedures mandate general anaesthesia, and are associated with slightly longer operating times and higher short-term costs.…”

mentioning

confidence: 99%

Incidental Non-Inguinals Hernias in Totally Extra-Peritoneal Hernia Repair

Old

Kulkarni

Hardy

et al. 2015

annals

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Introduction Totally extra-peritoneal (TEP) inguinal hernia repair allows identification and repair of incidental non-inguinal groin hernias. We assessed the prevalence of incidental hernias during TEP inguinal hernia repair and identified the risk factors for incidental hernias. Materials and Methods Consecutive patients undergoing TEP repair from May 2005 to November 2012 were the study cohort. Inspection for ipsilateral femoral, obturator and rarer varieties of hernia was undertaken during TEP repair. Patient characteristics and operative findings were recorded on a prospectively collected database. Results A total of 1,532 TEP repairs were undertaken in 1,196 patients. Ninety-three patients were excluded due to incomplete data, leaving 1,103 patients and 1,404 hernias for analyses (1,380 male; 802 unilateral and 301 bilateral repairs; median age, 59 years). Among the 37 incidental hernias identified (2.6% of cases), the most common type of incidental hernia was femoral (n=32, 2.3%) followed by obturator (n=2, 0.1%). Increasing age was associated with an increased risk of incidental hernia, with a significant linear trend (p<0.01). The risk for patients >60 years of age was 4.0% vs 1.4% for those aged <60 years (p<0.01). Incidental hernias were found in 29.2% of females vs 2.2% of males, (p<0.0001). Risk of incidental hernia in those with a recurrent inguinal hernia was 3.0% vs 2.6% for primary repair (p=0.79). Conclusions Incidental hernias during TEP inguinal hernia repair were found in 2.6% of cases and, though infrequent, could cause complications if left untreated. The risk of incidental hernia increased with age and was significantly higher in patients aged >60 years and in females.

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“…The peroperative care and surgical technique were standardized and the same in all patients. The operative details of the TEP technique have been described previously [28,29]. In particular, the mesh graft was not fixated since staples may induce specific complaints that can be ascribed to nerve entrapment and haematoma.…”

Section: Methodsmentioning

confidence: 99%

Three-month results of the effect of Ultrapro or Prolene mesh on post-operative pain and well-being following endoscopic totally extraperitoneal hernia repair (TULP trial)

et al. 2015

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Background Recurrence rates after inguinal hernia repair have been reduced to a few per cent, since mesh repair has become standard of care. Lightweight meshes reduce postoperative pain and stiffness in open anterior repair, but for endoscopic repair, the discussion about this benefit is ongoing. This study was done to analyse the effects of lightweight mesh versus heavyweight mesh following endoscopic totally extraperitoneal (TEP) hernia repair. Methods In a single-centre double-blindly randomized clinical trial, 950 patients with unilateral primary inguinal hernia were randomized to undergo endoscopic TEP using either an Ultrapro Ò or a Prolene Ò mesh. Data were collected by validated questionnaires at day 1, day 7, after 6 weeks and after 3 months, and clinical assessment was performed after 3 months. The presence of groin pain after 3 months, defined as an NRS score [3, was evaluated as the primary outcome measure. Secondary outcomes were foreign body feeling and the impact of pain and foreign body feeling on daily activities.Results At 3-month follow-up, the incidence of pain (NRS 4-10) was 2 versus 0.9 % in the lightweight and heavyweight mesh group, respectively (p = 0.17). Pain interfered with daily activities in 1.7 % of the lightweight and 1.5 % of heavyweight group. In the lightweight group, 20 % of patients reported a foreign body feeling versus 18 % in the heavyweight group (p = 0.62). No differences between the groups were observed regarding time to return to work, interference with sports and sexual activities, testicular pain and ejaculatory pain. Severe preoperative pain (OR 2.01, 95 % CI 1.21-3.35, p = 0.01) was the only independent predictor of any post-operative pain after 3 months. Conclusion Three months after TEP inguinal repair, there were no significant differences between lightweight and heavyweight mesh use regarding the incidence of pain, foreign body feeling or any other endpoint.

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Day-case endoscopic totally extraperitoneal inguinal hernioplasty versus open Lichtenstein hernioplasty for unilateral primary inguinal hernia in males

Abstract: Day-case TEP was superior to open Lichtenstein hernioplasty for the repair of unilateral primary inguinal hernia in males. The benefits of day-case TEP included less postoperative pain, a faster return to work, and a lower incidence of chronic groin pain.

Cited by 97 publications

References 20 publications

Laparoscopic vs. open inguinal hernia repair: A systematic review of literature

Laparoscopic vs. open inguinal hernia repair: A systematic review of literature

Incidental Non-Inguinals Hernias in Totally Extra-Peritoneal Hernia Repair

Three-month results of the effect of Ultrapro or Prolene mesh on post-operative pain and well-being following endoscopic totally extraperitoneal hernia repair (TULP trial)

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