Laparoscopic Total Extraperitoneal Hernia Repair Outcomes

Reiner, Mark A.; Bresnahan, Erin

doi:10.4293/jsls.2016.00043

Cited by 32 publications

(29 citation statements)

References 31 publications

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“…By meta-analysis, we found it was a tendency for patients under SA to experience more urinary retention than GA, in agreement with the most recent guidelines concluding that urinary retention might be more frequent following regional anesthesia [21]. Moreover, Reiner and his colleagues found that the age of the patients with urinary retention was significantly higher than patients without urinary retention, and suggested that urinary retention is seen more often in elderly patients [22]. Another study demonstrated that using short-acting agent, lidocaine, for SA virtually eliminates problems with urinary retention that occurs with long-acting SA agents [3].…”

Section: Discussionsupporting

confidence: 88%

Comparison of spinal anesthesia and general anesthesia in inguinal hernia repair in adult: a systematic review and meta-analysis

Pang

Wang

et al. 2020

BMC Anesthesiol

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Background: Inguinal hernia repair is one of the most commonly performed surgical procedures. To date, there is no consensus on which anesthesia should be used. The objective of this meta-analysis was to assess the efficacy of spinal anesthesia (SA) vs. general anesthesia (GA) in inguinal hernia repair in adults. Methods: Eligible studies were identified before January 2020 from PubMed, Embase, ScienceDirect, Cochrane Library, Scopus database as well as reference lists. Outcomes included surgery time, the time in the operation room, the length of hospital stay, pain scores, patient satisfaction, and postoperative complications. Subgroup analysis based on surgical approaches was conducted. Results: Six randomized controlled trials (RCT) and five cohort studies were included. A total of 2593 patients were analyzed. Compared to GA, SA was associated with a longer surgery time (weighted mean difference [WMD]: − 3.28, 95%confident interval [CI]: − 5.76, − 0.81), particularly in laparoscopic repair. Postoperative pain at 4 h and 12 h were in favor of SA following either open or laparoscopic repairs (standard mean difference [SMD]: 1.58; 95%CI: 0.55, 2.61, SMD: 0.99, 95%CI: 0.37, 1.60, respectively); and considering borderline significance, patients receiving SA might be more satisfied with the anesthesia they used for herniorrhaphy (SMD:-0.32, 95%CI: − 0.70, 0.06). Some major complications of scrotal edema, seroma, wound infection, recurrence, shoulder pain were comparable between the two groups. However, patients receiving SA had an increased risk of postoperative urinary retention and headache when compared with GA (relative ratio [RR]: 0.44, 95% CI: 0.23, 0.86, RR: 0.33, 95% CI: 0.12, 0.92, respectively). There was a tendency that the incidence of postoperative nausea and vomiting was lower in SA than GA (RR: 2.12, 95%CI: 0.95, 4.73), especially in open herniorrhaphy. Conclusions: SA can be another good choice for pain relief no matter in open or laparoscopic hernia repairs, but it can't be confirmed that SA is better than GA.

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Section: Discussionsupporting

confidence: 88%

Comparison of spinal anesthesia and general anesthesia in inguinal hernia repair in adult: a systematic review and meta-analysis

Pang

Wang

et al. 2020

BMC Anesthesiol

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“…15 Reiner MA et al performed a retrospective chart review and examined outcomes of 1240 laparoscopic hernia operations in 783 patients, focusing on intra-operative and early postoperative complications, pain, and time until return to work and normal physical activities and found that patients took an average of 3.0 days (median, 3.0; range, 1-41) to return to routine work and significant physical activity (office work) took an average of 3.8 days (median, 3.0; range, 0-28). 16 Compared to present findings, the time to return to normal routine activities and pain scores was less in triangular TEP technique with The different quality of life (QOL) outcomes measured in Carolina comfort scale (CCS) viz. pain, movement limitation and sensation of mesh decreased with time in the 6-month follow up period.…”

Section: Discussioncontrasting

confidence: 83%

Patient related outcomes and ergonomic evaluation of triangular 3-port or ‘two-hand’ TEP hernioplasty: a preliminary analysis in a university hospital

et al. 2018

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Background: Standard TEP technique requires three skin incisions for placement of three trocars in the midline. This can be done by 3 port triangular technique or two-hand technique. This study reports a preliminary analysis of peri-operative outcomes and ergonomics characteristics of this procedure in our setup.Methods: N=10 patients underwent triangular 3 port technique or two-hand TEP hernioplasty after informed written consent in Department of Surgery, King George’s Medical University UP between January to June 2016 after institutional ethical approval. Patient related outcomes in terms of quality of life (QOL) and ergonomic evaluation of the technique have been reported in this study.Results: The mean duration of surgery was 79.4±4.5 minutes with duration of hospital stay 2.4±0.5 days. The time to return to routine work was 1.0±0.2 days and office work was 4.0±1.8 days. Hernioplasty related QOL calculated using Carolina comfort scale showed improved with increased follow up period. Ergonomically the procedure can be safely performed without added stress on the surgeon.Conclusions: ‘Two-hand approach’ or triangular 3-port TEP hernioplasty is ergonomically feasible and enables a surgeon to perform surgery safely using basic principles of laparoscopy.

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“… 18 However, our laparoscopic repair durations were shorter than those reported in the literature. 20 The duration was longer in the TEP-SA group than in TEP-GA ( P <0.001). This might be because of the prolonged anesthesia used in SA.…”

Section: Discussionmentioning

confidence: 91%

Open mesh and laparoscopic total extraperitoneal inguinal hernia repair under spinal and general anesthesia

Sunamak

Dönmez²,

Dogan

et al. 2018

TCRM

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IntroductionMesh placement is the main standard in repair of inguinal hernia, and laparoscopic repair is the standard of care via spinal, epidural, or combined anesthesia. Here, we compared open and laparoscopic total extraperitoneal (TEP) repairs under general (GA) and spinal anesthesia (SA).MethodsInguinal hernia patients (n=440) were analyzed retrospectively. There were four groups: Group 1 was TEP under GA (TEP-GA) (n=111); Group 2 was open mesh repair (OM) under SA (n=116) (OM-SA); Group 3 was open mesh repair under GA (n=117) (OM-GA); Group four was TEP under SA (n=96) (TEP-SA). The age, body mass index, duration of operation, hospital stay, postoperative Visual Analog Scale scores, recurrence, postoperative pain, urinary retention, headache, and patient satisfaction were all recorded.ResultsThere was no significant difference in terms of hypotension, vomiting, seroma and scrotal edema, recurrence, and wound infection incidence between the groups. However, the operation duration, hospital stay period, headache, urinary retention, postoperative Visual Analog Scale scores, chronic pain, and patient satisfaction showed significant differences between groups.ConclusionLaparoscopic TEP hernia repair is a safe and effective method along with its advantages of shorter hospital stay, less recurrence, less postoperative pain, higher patient satisfaction, and similar postoperative complication rates. SA has the disadvantage of higher incidence of headache and urinary retention compared to GA.

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Laparoscopic Total Extraperitoneal Hernia Repair Outcomes

Cited by 32 publications

References 31 publications

Comparison of spinal anesthesia and general anesthesia in inguinal hernia repair in adult: a systematic review and meta-analysis

Comparison of spinal anesthesia and general anesthesia in inguinal hernia repair in adult: a systematic review and meta-analysis

Patient related outcomes and ergonomic evaluation of triangular 3-port or ‘two-hand’ TEP hernioplasty: a preliminary analysis in a university hospital

Open mesh and laparoscopic total extraperitoneal inguinal hernia repair under spinal and general anesthesia

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