Endoscopic total extraperitoneal repair of primary and recurrent inguinal hernias

Knook, M. T. T.; Weidema, W. F.; Stassen, Laurents P. S.; Steensel, C. J. Van

doi:10.1007/s004649901023

Cited by 66 publications

(58 citation statements)

References 28 publications

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“…7 The frequency of pneumoperitoneum during TEP has been reported to be between 10 and 64%. [14][15][16] In the present study, pneumoperitoneum was seen in 25 of the 72 (34.7%) participating patients. Shoulder tip pain was more frequent in patients with pneumoperitoneum, regardless of whether they were in the experimental or the control group.…”

Section: Discussionsupporting

confidence: 50%

Clinical effects of intrathecal fentanyl on shoulder tip pain in laparoscopic total extraperitoneal inguinal hernia repair under spinal anaesthesia: A double-blind, prospective, randomized controlled trial

et al. 2013

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Objective: The study evaluated the clinical intraoperative effects of intrathecal administration of fentanyl on shoulder tip pain in patients undergoing laparoscopic total extraperitoneal inguinal hernia repair (TEP) under spinal anaesthesia. Methods: Patients undergoing TEP were allocated in a double-blinded, prospective, randomized manner to two groups. Spinal anaesthesia was induced by intrathecal administration of 2.8 ml of 0.5% hyperbaric bupivacaine (14 mg) in the control group and with 2.6 ml of 0.5% hyperbaric bupivacaine (13 mg) and 10 mg fentanyl (0.2 ml) in the experimental group.Results: The quality of muscle relaxation, adequacy of operative space and incidence of pneumoperitoneum were similar in the two groups (n ¼ 36 per group). Compared with the control group, the experimental group had significantly fewer cases of hypotension (12 [

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Section: Discussionsupporting

confidence: 50%

Clinical effects of intrathecal fentanyl on shoulder tip pain in laparoscopic total extraperitoneal inguinal hernia repair under spinal anaesthesia: A double-blind, prospective, randomized controlled trial

et al. 2013

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“…[1][2][3] The current methods of laparoscopic hernia repair involve the application of a preperitoneal prosthetic mesh over the hernia spaces, creating a tension-free repair. 4,5 The mesh is fixed in place using metal staples to prevent graft displacement, with consequent hernia recurrence.…”

Section: Resultsmentioning

confidence: 99%

Use of Fibrin Sealant for Prosthetic Mesh Fixation in Laparoscopic Extraperitoneal Inguinal Hernia Repair

et al. 2001

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ObjectiveTo evaluate the efficacy of mesh fixation with fibrin sealant (FS) in laparoscopic preperitoneal inguinal hernia repair and to compare it with stapled fixation. Summary Background DataLaparoscopic hernia repair involves the fixation of the prosthetic mesh in the preperitoneal space with staples to avoid displacement leading to recurrence. The use of staples is associated with a small but significant number of complications, mainly nerve injury and hematomas. FS (Tisseel) is a biodegradable adhesive obtained by a combination of human-derived fibrinogen and thrombin, duplicating the last step of the coagulation cascade. It can be used as an alternative method of fixation. MethodsA prosthetic mesh was placed laparoscopically into the preperitoneal space in both groins in 25 female pigs and fixed with either FS or staples or left without fixation. The method of fixation was chosen by randomization. The pigs were killed after 12 days to assess early graft incorporation. The following outcome measures were evaluated: macroscopic findings, including graft alignment and motion, tensile strength between the grafts and surrounding tissues, and histologic findings (fibrous reaction and inflammatory response). ResultsThe procedures were completed laparoscopically in 49 sites. Eighteen grafts were fixed with FS and 16 with staples; 15 were not fixed. There was no significant difference in graft motion between the FS and stapled groups, but the nonfixed mesh had significantly more graft motion than in either of the fixed groups. There was no significant difference in median tensile strength between the FS and stapled groups. The tensile strength in the nonfixed group was significantly lower than the other two groups. FS triggered a significantly stronger fibrous reaction and inflammatory response than in the stapled and control groups. No infection related to method of fixation was observed in any group. ConclusionAn adequate mesh fixation in the extraperitoneal inguinal area can be accomplished using FS. This method is mechanically equivalent to the fixation achieved by staples and superior to nonfixed grafts. Biologic soft fixation with FS will prevent early graft migration and will avoid the complications associated with staple use.Laparoscopic hernia repair is an effective technique, offering more rapid recovery and less pain than with the traditional open approach; recurrence rates are equivalent to those of the traditional open approach.

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“…Die Kontrolluntersuchungen und Befragung erfolgten anhand des Studienprotokolls stationär täglich, nach Entlassung 6 (5-11) Wochen und 12 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) …”

Section: Organisation Der Kontrolluntersuchungenunclassified

“…Die Rezidivraten nach TEP variieren in den umfangreichen Operationsserien endoskopisch spezialisierter Kliniken nur gering zwischen 0,3% und 0,5% [4,15,17,19]. In kontrollierten oder randomisierten Studien im Vergleich mit anderen Verfahren betragen sie hingegen 2,15-7,4% [3,6,11].…”

Section: Rezidivratenunclassified

“…Die Rezidivrate von 5,1% in unserer Studie ist gemessen an den Erwartungen, der fachlichen Qualifikation der Operateure, dem technischen Aufwand und den eingesetzten Kosten enttäuschend hoch. Sie liegt aber durchaus im Bereich der Ergebnisse anderer randomisierter Studien [3,17]. Im Gegensatz zur TEP wurde die Operation nach Lichtenstein in unserer Studie vorwiegend als Anfänger-operation durchgeführt, dennoch blieben Rezidive aus.…”

Section: Abb 1 Wiederaufnahme Der Normalen Lebensgewohnheiten Nach Tunclassified

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Spannungsfreie Methoden der Operation prim�rer Leistenbr�che

Hildebrandt

Levantin

2003

Der Chirurg

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Endoscopic total extraperitoneal repair of primary and recurrent inguinal hernias

Abstract: This study confirms the preliminary success of TEP for primary inguinal hernia repair, as previously reported. The high recurrence rate after endoscopic repair of recurrent hernias needs to be studied further.

Cited by 66 publications

References 28 publications

Clinical effects of intrathecal fentanyl on shoulder tip pain in laparoscopic total extraperitoneal inguinal hernia repair under spinal anaesthesia: A double-blind, prospective, randomized controlled trial

Clinical effects of intrathecal fentanyl on shoulder tip pain in laparoscopic total extraperitoneal inguinal hernia repair under spinal anaesthesia: A double-blind, prospective, randomized controlled trial

Use of Fibrin Sealant for Prosthetic Mesh Fixation in Laparoscopic Extraperitoneal Inguinal Hernia Repair

Spannungsfreie Methoden der Operation prim�rer Leistenbr�che

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