Laparoscopic versus open repair of groin hernia: a randomised comparison

O’Dwyer, P. J.; Macintyre, I. M. C.; Donaldson, Cam; Baxter, J. N.; Ross, Sue; Scott, Neil; Grant, Albert; Wright, David M.; McIntosh, Emma; Knight, D. M. A.; Crofts, T. J.; Nixon, S. J.; Fullarton, Grant; Greig, David M; Wilson, G P; Hedges, A R; Hamer-Hodges, D W; Murphy, Joan; Samy, Ahmed; Carey, P. D.; Wallace, James R.; Landsdown, M; Sunderland, G. T.; Mohammed, R; Baker, Talia; Spychal, Robert; Moran, Cathal J.; Murray, William R.; Darzi, Ara; Maa, John; Bell, George; Ornstein, H; Gorey, T. F.; Kumar, Suresh; Campbell, Martin; Kennedy, Amy; Toryerson, D; Fife, L; Paterson, Caron; Jaap, L; Zarins, Kristaps

doi:10.1016/s0140-6736(98)10010-7

Cited by 285 publications

(11 citation statements)

References 13 publications

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“…Thirty-three randomized controlled trials with a total of 5,053 random patients were used for the evaluation [11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45]. Due to the separate publication of partial aspects [40, 45]and late results [11, 12, 14, 18], a total of 36 publications was analyzed.…”

Section: Resultsmentioning

confidence: 99%

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Endoscopic Inguinal Hernia Repair in Comparison with Shouldice and Lichtenstein Repair

Schmedt¹,

Leibl²,

Bittner³

2002

Dig Surg

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Aims: This article provides an overview of randomized studies which compare endoscopic hernia repair techniques (TAPP/TEP) with the Shouldice and Lichtenstein repair. Methods: Systematic analysis of 33 published studies which meet the criteria of a randomized controlled trial with a high evidence level. Results: The majority of the studies document statistically significant advantages of the endoscopic repair techniques in relation to wound pain (15/22), need for analgesics (16/21), return-to-work time (16/22) and physical activity (18/25), although only one study showed significant advantages of the Lichtenstein method. Six of 28 studies showed a lower morbidity in comparison to open approaches, although 22 of 28 studies documented no significant difference. The first long-term studies with follow-up periods between 5 and 6 years also show advantages of the endoscopic techniques. Conclusion: Even with cautious interpretation of the data, it is clear that endoscopic techniques are more comfortable for patients and that morbidity is no higher than for open procedures. Due to the short follow-up periods final evaluation regarding long-term complications and recurrence is not yet possible.

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Section: Resultsmentioning

confidence: 99%

“…Due to the separate publication of partial aspects [40, 45]and late results [11, 12, 14, 18], a total of 36 publications was analyzed. Four studies were published as abstracts only [16, 29, 35, 42].…”

Section: Resultsmentioning

confidence: 99%

Endoscopic Inguinal Hernia Repair in Comparison with Shouldice and Lichtenstein Repair

Schmedt¹,

Leibl²,

Bittner³

2002

Dig Surg

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“…In our series, this inadvertently persisting sensation loss during regular procedures affects a considerable proportion of patients treated with the Lichtenstein procedure (Table 1), and under-reporting of these sensory loss findings is possible. The TIPP technique, as described by Pélissier, seems to be associated with less chronic pain, comparable to the total extra peritoneal (TEP) technique [8–10] The drawback of endoscopic hernia repair over the open approach is the added cost, particularly when disposable instruments are used [11]. The other disadvantage of endoscopy compared with open hernia repair is that general anaesthesia is necessary [12].…”

Section: Discussionmentioning

confidence: 99%

The transinguinal preperitoneal hernia correction vs Lichtenstein’s technique; is TIPP top?

Koning

Koole

Jongh

et al. 2010

Hernia

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BackgroundChronic pain is the main drawback of the Lichtenstein procedure for inguinal hernia repair, with a reported incidence of 15–40%. The transinguinal pre-peritoneal (TIPP) technique seems to be associated with less chronic pain, comparable to the total extra peritoneal (TEP) technique. The aim of this study was to evaluate 3 years of TIPP and Lichtenstein experience since the start of our Hernia Center Brabant in January 2006.MethodsPatient records of unilateral primary inguinal anterior hernia corrections (TIPP and Lichtenstein) performed since the opening of Hernia Center Brabant (2006–2008) were evaluated in a retrospective study. ASA class 4 and 5, <18 years, recurrences and bilateral hernias were excluded. In the TIPP technique, a Polysoft™ Hernia Patch was placed into the preperitoneal space using an anterior protocol led approach. The Lichtenstein technique was performed as described by Amid [Amid et al (1996) Eur J Surg 162:447–453] and modified with a soft mesh. One of the hernia surgeons decided peroperatively which technique to perform. Baseline characteristics and postoperative complications were assessed retrospectively. The attempted follow up period was 6 months. Chronic pain was assessed in both groups as mild (VAS 1–3), moderate (VAS 4–6) or severe (VAS 7–10). Chronic pain was defined in both groups as any pain sensation lasting longer than 3 months postoperatively, or when local injection of analgesia was necessary. Patients who did not come back because of chronic pain after regular follow up were regarded as free of pain.ResultsA total of 496 patients were included in this study; 225 TIPP and 271 Lichtenstein anterior inguinal hernia operations were analyzed. Data from one TIPP-patient were lost. Both groups were comparable with regard to baseline characteristics regarding age (p = 0.059), gender (p = 0.478) and ASA-classification (p = 0.104). TIPP: mean age 52.7 years, ASA-classification I: 54%, II: 36% and III: 5.3%. A total of 7.6% complications were assessed; recurrence (n = 1), bleeding (and re-operation) (n = 4); 10 patients (4.4%) experienced chronic pain. Persisting sensation loss occurred in 0.9%. Lichtenstein: mean age 57.3 years, ASA-classification I: 51%, II: 38% and III: 11%. A total of 8.5% complications were assessed; recurrence (n = 3), bleeding (and re-operation) (n = 3); 11 Lichtenstein patients (4.1%) experienced chronic pain. Persisting sensation loss occurred in 2.2%. Limitations of this retrospective study were incomplete follow up (31.3% had only one post operative visit 14 days after surgery) and these patients were further regarded as free of pain. Therefore, possible under-reporting of chronic pain could be present. The study was not double blind.ConclusionThis retrospective study design revealed no significantly better results for the TIPP procedure as compared to the Lichtenstein technique. The incidence of chronic pain reported in this retrospective study has been low in both groups since the opening of the Hernia Center Brabant. These results form the basis...

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“…Nevertheless, surgeons are faced with various mesh-related complications such as discomfort and pain [1, 2], fistula and seroma formation [3, 4, 5, 6]or a restriction of the abdominal wall mobility [7]. Investigating the origin of these mesh-related complications the extent of the foreign body reaction to meshes and a provoked scar tissue formation have been suggested as possible causal factors which depend on the amount and structure of the incorporated material [8, 9, 10, 11].…”

Section: Introductionmentioning

confidence: 99%

Vypro II<sup>®</sup> Mesh in Hernia Repair: Impact of Polyglactin on Long-Term Incorporation in Rats

Rösch¹,

Junge²,

Quester

et al. 2003

Eur Surg Res

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Background: To the Vypro II^® mesh, a large-pore-sized multifilamentous polypropylene mesh for hernia repair, supplementary polyglactin 910 multifilaments were added to improve intraoperative handling. As it has been suggested that polyglactin induces fibroplastic reactions and wound complications, this study was designed to evaluate the long-term tissue reaction to polyglactin in the Vypro II mesh. Materials and Methods: Two mesh materials, the Vypro II composite mesh (PP + PG) and the pure polypropylene variant (PP), were compared after inlay implantation in a standardized rodent animal model. After 14, 28, 42, 56, 84 and 112 days of implantation, histological analysis of the inflammatory response was performed: material absorption, inflammatory tissue reaction, fibrosis and granuloma formation were investigated. Results: Total absorption of polyglactin filaments of the Vypro II mesh occurred between 56 and 84 days of implantation. Both the inflammatory and the fibrotic reaction were initially increased in the PP + PG mesh group. These differences disappeared in the following implantation period. After 112 days, inflammation was even less pronounced in the PP + PG mesh group. Conclusion: The present data confirm a short-term polyglactin-induced increase in inflammation and fibrosis around implanted Vypro II meshes in rats. With regard to the long-term tissue response, even an anti-inflammatory property of polyglactin multifilaments in low-weight and large-pored polypropylene meshes cannot be ruled out.

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Laparoscopic versus open repair of groin hernia: a randomised comparison

Cited by 285 publications

References 13 publications

Endoscopic Inguinal Hernia Repair in Comparison with Shouldice and Lichtenstein Repair

Endoscopic Inguinal Hernia Repair in Comparison with Shouldice and Lichtenstein Repair

The transinguinal preperitoneal hernia correction vs Lichtenstein’s technique; is TIPP top?

Vypro II<sup>®</sup> Mesh in Hernia Repair: Impact of Polyglactin on Long-Term Incorporation in Rats

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