Laparoscopy Versus Open Incarcerated Inguinal Hernia Repair in Octogenarians: Single-Center Experience With World Review

Abstract

Objectives: The clinical study is aiming to discuss the therapeutic benefit of laparoscopic hernia (LH) repair with comparing conventional open hernia (OH) repair in incarcerated hernia in octogenarians. Materials and Methods: The clinical data of 29 octogenarian incarcerated hernia patients who underwent hernia repair from November 2013 to March 2017 were retrospectively analyzed. The variables analyzed include baseline, operation characteristics, and clinical outcomes. The patients were divided into LH and OH according to the surgical approach and their clinical parameters were compared. Descriptive statistics were calculated, and outcomes were compared using the Fisher exact test and the student t test, a P≤0.05 was considered significant. Results: Of reported 18 octogenarian patients, 7 patients underwent LH, whereas the remaining 11 patients underwent OH. The median age of the patients was 86 (81 to 97). All patients in LH group and 3 patients in OH group underwent nonmesh repair. In total, 8 patients in OH group underwent mesh repair. Simultaneous intestinal resection was needed in 4 patients (2 in LH, 2 in OH) due to the necrotic bowel. No mortality was observed in all subjects. The results showed significantly shorter operation time (50±5 vs. 110±3 min; P=0.000), hospital stay (6±1 vs. 12±3 d; P=0.04). There were no noteworthy postoperative complications and during the follow-up period, no patient experienced recurrent hernia in both groups. Conclusions: LH nonmesh repair has not increased the morbidity and mortality but showed shorter hospital stay and fast recovery and no recurrence in octogenarian incarcerated hernia patients. Therefore, LH in octogenarian incarcerated hernia patients might be preferred approach in sophisticated hands with acceptable outcomes.

Percutaneous Internal Ring Suturing (PIRS) – The Benefits of Laparoscopic Inguinal Hernia Repair

“…It also allows the inspection of female reproductive organs, such as ovaries, fallopian tubes, and uterus. 28 , 35 In our material, we observed the complete androgen insensitivity syndrome (CAIS), 36 where male gonads moved to inguinal canals on both sides in phenotypically 4-year-old girl. 21 , 23 In laparoscopy, it is possible to observe the disorders in the bowel movement, determine the presence of the Meckel’s diverticulum (a similar case was discussed by Quail et al) 37 and to assess the position of the appendix.…”

“…Payiziwula et al reported in early postoperative time a sliding hernia not recognized during laparoscopic inguinal hernia repair (bladder herniating into the right inguinal region, consistent with an extraperitoneal invisible, undetectable hernia). 35 …”

Laparoscopic versus open groin hernia repair in older adults: a systematic review and meta‐analysis

“…Following this screen, a total of five articles have been selected for inclusion in the final systematic review. [16][17][18][19][20] This process is illustrated in the PRISMA Flowchart as shown in Figure 1.…”

“…17,18 Reporting of follow-up period varied across studies. Two studies did not report the follow-up period, 16,17 one study reported a 2.3 year median follow-up, 19 one study reported a mean follow-up period of 24 (laparoscopic group) to 25 (open group) months 20 while one study reported 96% of patients completing a 60-month follow-up period. 18…”

Application of spatial replacement method in the treatment of laparoscopic incarcerated femoral hernia – A case report

“…However, incarcerated hernia contents may return to the abdominal cavity owing to anesthetics and muscle relaxants, leading to potential necrotic contents that may lead to intestinal perforation, abdominal infection, or fatal sepsis. The introduction of laparoscopic techniques has greatly sharpened the surgical paradigm and is more prevalent in hernia surgery, with plausible clinical outcomes [9] . Using a laparoscope can facilitate the direct assessment of an incarcerated bowel, and the viability of the bowel can be evaluated [10] .…”