Laparoscopic versus open groin hernia repair: are we getting closer to specific clinical recommendations?

Kehlet, Henrik

doi:10.1007/s10029-010-0742-4

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…Two groups of patients should be acknowledged in pain assessment: young people, professionally and physically active and middle-aged or older patients with limited physical activity. The risk of chronic pain occurrence in the 2 nd group is significantly lower [11]. Recently, the methods of implant fixation have been discussed during meetings.…”

Section: Introductionmentioning

confidence: 99%

The Glubran 2 glue for mesh fixation in Lichtenstein's hernia repair: a double-blind randomized study.

Dąbrowiecki¹,

Pierściński²,

Szczęsny³

2012

Videosurgery and Other Miniinvasive Techniques

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IntroductionWith an average incidence rate of 11%, chronic pain is considered the most serious complication of inguinal hernioplasty after surgical site infection. One of the proposed solutions to this problem is to use tissue adhesive for mesh fixation, which helps prevent nerve and tissue damage.AimThe goal of this study was to compare mesh fixation with the use of sutures vs. adhesive in Lichtenstein's inguinal hernia repair in a randomized, double-blind one-center study.Material and methodsThe study group consisted of 41 males with primary inguinal hernia undergoing Lichtenstein's repair (20 – adhesive; 21 – suture) and remaining in follow-up from July 2008 to November 2010. Randomization took place during the operation. The follow-up was performed by one surgeon (blinded) according to a pre-agreed schedule; the end-of-study unblinding was performed during the last follow-up visit, usually 16 months postoperatively.ResultsIn 1 patient from the “adhesive” group, a recurrence was observed one year after the initial repair. The early postoperative pain was less intense in this group. In later postoperative periods the method of mesh fixation had no influence on the pain experienced by the patient. Other complications were not correlated with the method of mesh fixation.ConclusionsIn this randomized, one-center double-blind clinical study of males with primary inguinal hernia it has been show during follow-up that the use of Glubran 2 cyanoacrylate adhesive for mesh implant fixation yields similar recurrence and chronic pain rates as the classical suture technique. In the early postoperative period, the pain reported by these patients was relatively weaker; patients undergoing adhesive mesh fixation experienced a quicker return to daily household activities.

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Section: Introductionmentioning

confidence: 99%

The Glubran 2 glue for mesh fixation in Lichtenstein's hernia repair: a double-blind randomized study.

Dąbrowiecki¹,

Pierściński²,

Szczęsny³

2012

Videosurgery and Other Miniinvasive Techniques

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“…Moderate or severe pain was reported by 2.7% of patients at 1 year and 1.9% at 5 years in the TEP group, and by 7.1% of patients at 1 year and 3.5% at 5 years in the Lichtenstein group. Several publications have shown that there is a reduced risk of developing chronic pain after laparoscopic compared with open inguinal herniorrhaphy [3,5,[10][11][12]. Whether this advantage of laparoscopic inguinal herniorrhaphy, in terms of reduced risk of development of chronic pain, also applies to the risk of development of dysejaculation and pain during sexual activity has not been well established.…”

Section: Discussionmentioning

confidence: 92%

Dysejaculation after laparoscopic inguinal herniorrhaphy: a nationwide questionnaire study

et al. 2011

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“…As such, the differences in acute pain between laparoscopic and open repair may be minor and be more reflective of differences in pain management between studies 4 . This was discussed by Kehlet in 2010 2 , but in that series the Lichtenstein arm was treated with general anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…However, fewer studies stratify patients into the type of activity and work they normally carry out. This is needed, as there are many factors which alter return to activities and work, such as age, health of the patient, occupation, post-operative advice, local cultures and definition of usual activity 2 . Taking these into consideration should give a more accurate determination of outcomes, and thus enable meaningful comparisons.…”

Section: Introductionmentioning

confidence: 99%

Short Term Pain and Return to Activities Following Lichtenstein Inguinal Hernia Repair

2012

IJS

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IntroductionThere has been extensive debate as to the merits of laparoscopic versus Lichtenstein hernia repair. Laparoscopic results have claimed less postoperative pain and more rapid return to normal activity. This study assesses the short-term results of a dedicated experienced hernia surgeon who uses the Lichtenstein technique with local anaesthesia and light sedation almost exclusively. It analyses post-operative pain, recovery, and return to normal activities and work.MethodologyThere were two study arms. The first was a randomly selected cohort of patients (n=405) who underwent single, bilateral or recurrent hernia repair from 2006 to 2008 by a single surgeon. The second was a prospective consecutive cohort (n=54) from 2010 who were stratified according to normal activity. Postoperative analgesia requirements, pain, and time of return to activities were recorded.ResultsIn cohort 1, return to work took a median of 6 days. Seventy-five per cent of patients were back to their normal activities and duties after 10 days. The median analgesia requirement was 2 days. In cohort 2, the median postoperative analgesia requirement was 3 days, with 75% requiring analgesia for no more than 6 days. The median return to normal activities or work was seven days, with 75% returning before 2 weeks. ConclusionLHR provides favourable short-term outcomes. Considering that convalescence is short or shorter and the rate of serious complications is low, this technique should be advocated more vigorously.

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Laparoscopic versus open groin hernia repair: are we getting closer to specific clinical recommendations?

Cited by 3 publications

References 8 publications

The Glubran 2 glue for mesh fixation in Lichtenstein's hernia repair: a double-blind randomized study.

The Glubran 2 glue for mesh fixation in Lichtenstein's hernia repair: a double-blind randomized study.

Dysejaculation after laparoscopic inguinal herniorrhaphy: a nationwide questionnaire study

Short Term Pain and Return to Activities Following Lichtenstein Inguinal Hernia Repair

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