Feasibility of a new approach for creating a preperitoneal space in transabdominal preperitoneal repair inguinal hernia repair: using a sandwich approach

Nagahisa, Yoshio; Homma, Shusaku; Chen, Kai; Sakurai, Reo; Hattori, Nobuaki; Kawamoto, Yoshimi; Hashida, Kazuki; Okabe, Masaru; Itou, T

doi:10.1007/s00595-016-1435-0

Cited by 7 publications

(10 citation statements)

References 13 publications

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“…3 ). Similarly, Nagahisa et al [ 15 ] suggested that this part of the fascia should be incised. Our view of space separation and mesh placement is consistent with that of Mirilas et al [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Urogenital fascia anatomy study in the inguinal region of 10 formalin-fixed cadavers: new understanding for laparoscopic inguinal hernia repair

Qin

Yan

et al. 2021

BMC Surg

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Purpose To investigate the urogenital fascia (UGF) anatomy in the inguinal region, to provide anatomical guidance for laparoscopic inguinal hernia repair (LIHR). Methods The anatomy was performed on 10 formalin-fixed cadavers. The peritoneum and its deeper fascial tissues were carefully dissected. Results The UGF’s bilateral superficial layer extended and ended in front of the abdominal aorta. At the posterior axillary line, the superficial layer medially reversed, with extension represented the UGF's deep layer. The UGF's bilateral deep layer medially extended beside the vertebral body and then continued with the transversalis fascia. The ureters, genital vessels, and superior hypogastric plexus moved between both layers. The vas deferens and spermatic vessels, ensheathed by both layers, moved through the deep inguinal ring. From the deep inguinal ring to the midline, the superficial layer extended to the urinary bladder’s posterior wall, whereas the deep layer extended to its anterior wall. Both layers ensheathed the urinary bladder and extended along the medial umbilical ligament to the umbilicus and in the sacral promontory, extended along the sacrum, forming the presacral fascia. The superficial layer formed the rectosacral fascia at S4 sacral vertebra, and the deep layer extended to the pelvic diaphragm, terminating at the levator ani muscle. Conclusion The UGF ensheaths the kidneys, ureters, vas deferens, genital vessels, superior hypogastric plexus, seminal vesicles, prostate, and urinary bladder. This knowledge of the UGF’s anatomy in the inguinal region will help find correct LIHR targets and reduce bleeding and other complications.

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Section: Discussionmentioning

confidence: 99%

Urogenital fascia anatomy study in the inguinal region of 10 formalin-fixed cadavers: new understanding for laparoscopic inguinal hernia repair

Qin

Yan

et al. 2021

BMC Surg

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“…Abdominal CO 2 pressure was established as 10 mmHg during the procedure. We dissected the preperitoneal layer using the Sandwich approach, because it is feasible for patients with prominent adhesion and is able to be safely performed by young surgeons [ 2 ]. We dissected all the hernia sac and did not retract the transversalis fascia.…”

Section: Methodsmentioning

confidence: 99%

Strangulated Hernia Can Be a Risk Factor of Seroma following Laparoscopic Transabdominal Preperitoneal Repair

Matsumoto

Nagahisa

Hashida

et al. 2018

Minimally Invasive Surgery

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Purposes Seroma is a postoperative complication following laparoscopic transabdominal preperitoneal repair (TAPP) for inguinal hernioplasty. Seroma naturally resolves in most cases, but it can lead to an increased amount of visits to the outpatient clinic and can result in anxiety of the patient. Local inflammation of the inguinal area is etiology of seroma formation. Strangulated hernia involves severe inguinal pain and can lead to severe inflammation and subsequent seroma. There have been no reports demonstrating the links of seroma and strangulated hernia. This study aimed to retrospectively evaluate the risk of seroma after TAPP and to identify the association between strangulated hernia and seroma. Methods We treated 300 inguinal hernias by TAPP between 2013 and 2016 at Kurashiki Central Hospital. We used the Chi-square test. Factors significant in each association were further examined using multiple subsequent logistic regressions. Results A total of 222 hernias were eligible for analysis. The incidence of seroma was 11% (n=25). There were nine cases of strangulated hernias, and three (33%) resulted in seroma. The ratio of strangulated hernia of seroma group is significantly high (p<0.03). Multiple subsequent logistic regressions showed that strangulated hernia was associated with a significantly increased risk for seroma formation (p = 0.023; OR 6.564; 95% CI 1.29-33.3). Conclusion This study shows that strangulated hernia can be a risk factor in seroma formation. This risk should be incorporated into a management plan of TAPP for strangulated hernia, with careful consideration of patients' concerns.

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“…The onset of chronic postoperative inguinal pain is multifactorial and includes patient-related factors and technical factors (12)(13)(14). Among the technical factors are the repair technique, nerve handling, and type of prosthetic material and its fixation (15)(16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

“…Intra‐abdominal CO 2 pressure was maintained at 10 mmHg during the procedure. All TAPP repairs employed the sandwich approach, in which a preperitoneal cavity was created for mesh replacement while all preperitoneal fascias were preserved . The lateral layers were equivalent to the retroperitoneal spermatic sheath , thus preventing any nerves from being touched during creation of the preperitoneal cavity.…”

Section: Methodsmentioning

confidence: 99%

Feasibility of a novel tacking method of securing mesh in transabdominal preperitoneal inguinal hernia repair: Secure tacking against recurrence

Nagahisa

Kawashima

Matsumoto

et al. 2018

Asian J Endoscop Surgery

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Feasibility of a new approach for creating a preperitoneal space in transabdominal preperitoneal repair inguinal hernia repair: using a sandwich approach

Abstract: The sandwich approach is feasible as another standard dissective procedure for TAPP.

Cited by 7 publications

References 13 publications

Urogenital fascia anatomy study in the inguinal region of 10 formalin-fixed cadavers: new understanding for laparoscopic inguinal hernia repair

Urogenital fascia anatomy study in the inguinal region of 10 formalin-fixed cadavers: new understanding for laparoscopic inguinal hernia repair

Strangulated Hernia Can Be a Risk Factor of Seroma following Laparoscopic Transabdominal Preperitoneal Repair

Feasibility of a novel tacking method of securing mesh in transabdominal preperitoneal inguinal hernia repair: Secure tacking against recurrence

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