Seroma Prevention Technique Following Endoscopic Direct Inguinal Hernia Repair

Panse, Mangesh; Deshpande, Nitin; Mandhane, Anirudha; Bhalerao, Pankaj

doi:10.14260/jemds/931

Cited by 5 publications

(6 citation statements)

References 7 publications

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“…In a meta-analysis of randomized controlled trials, a significantly higher incidence of seromas was found after laparoendoscopic inguinal hernia repair, with 1590 patients, versus Lichtenstein repair, with 1620 patients (12.2 vs. 8.9%; p = 0.003) [ 6 ]. If no measures are taken for prevention of seroma after TEP or TAPP repair for direct inguinal hernia, the incidence reported is 4–5% [ 7 ]. In large registry studies of primary unilateral inguinal hernia repair in men with the laparoendoscopic technique, the incidence of seroma has been reported as 0.5% for TEP and 3% for TAPP [ 8 , 9 ].…”

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confidence: 99%

Seroma following transabdominal preperitoneal patch plasty (TAPP): incidence, risk factors, and preventive measures

et al. 2017

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BackgroundThe reported range of seroma formation in the literature after TEP repair is between 0.5 and 12.2% and for TAPP between 3.0 and 8.0%. Significant clinical factors associated with seroma formation include old age, a large hernia defect, an extension of the hernia sac into the scrotum, as well as the presence of a residual indirect sac. Seroma formation is a frequent complication of laparoendoscopic mesh repair of moderate to large-size direct (medial) inguinal hernia defects. This present analysis of data from the Herniamed Hernia Registry now explores the influencing factors for seroma formation in male patients after TAPP repair of primary unilateral inguinal hernia.MethodsIn total, 20,004 male patients with TAPP repair of primary unilateral inguinal hernia were included in uni- and multivariable analysis.ResultsUnivariable analysis revealed the highly significant impact of the fixation technique on the seroma rate (non-fixation 0.7% vs. tacks 2.1% vs. glue 3.9%; p < 0.001). Multivariable analysis showed that glue compared to tacks (OR 2.077 [1.650; 2.613]; p < 0.001) and non-fixation (OR 5.448 [4.056; 7.317]; p < 0.001) led to an increased seroma rate. A large hernia defect (III vs. I: OR 2.868 [1.815; 4.531]; p < 0.001; II vs. I: OR 2.157 [1.410; 3.300]; p < 0.001) presented a significantly higher risk of seroma formation. Likewise, medial compared to lateral inguinal hernias had a higher seroma rate (OR 1.272 [1.020; 1.585]; p = 0.032).ConclusionsMesh fixation with tacks or glue, a larger hernia defect, and medial defect localization present a higher risk for seroma development in TAPP inguinal hernia repair.

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confidence: 99%

Seroma following transabdominal preperitoneal patch plasty (TAPP): incidence, risk factors, and preventive measures

et al. 2017

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“…28 Seroma developed early (within 1 month) though spontaneously resolved relatively quickly and occurred almost exclusively following repair of direct hernia in this study. This fact highlights the importance of inversion of fascia transversalis either by fixing it to pubic bone or by application of endoloop at the base of inverted fascia and amputating the redundant portion, 29,30 neither of which was performed in this study. Chronic pain developed late (by 6 months) and carried a rather protracted course, but resolved with counseling, analgesics and neuromodulating drugs like amitriptyline in vast majority of cases.…”

Section: Wjolsmentioning

confidence: 80%

A Comparative Randomized Parallel Group Study between the Classical TAPP Repair and Modified TAPP Surgical Method for Inguinal Hernia Repair

Ghosh¹

2014

WJOLS

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Objective: To compare equality of clinical outcome of simultaneous bilateral transabdominal preperitoneal (TAPP) repair of inguinal hernia by classical TAPP, with meticulous closure of peritoneal flap and modified TAPP, with peritoneal nonclosure and controlled release of pneumoperitoneum. Study to answer the research question-'is meticulous closure of peritoneal flap, the only way to provide adequate cover for the mesh in TAPP repair?' Summary and background data: The objective of meticulous closure of peritoneum is to prevent internal herniation while covering the mesh adequately to avoid contact between mesh and abdominal viscera. The study proposes same objective can also be achieved with nonclosure of peritoneum. Patients and methods: Between August 2011 and July 2012, 130 inguinal hernias of 65 patients who underwent TAPP repair were randomized in two groups. One group (n = 65) of hernias received classical repair with peritoneal closure (control), while the other (n = 65) without closure (study). The primary end points were bowel related complications and recurrence. Results: The two groups were comparable in age and types of hernia. Transabdominal preperitoneal was successfully done in all cases. No bowel-related complication and recurrence occurred in either group. Mean operating time was significantly less with modified TAPP (65 mins vs 76 mins, p < 0.05). Lower incidence of chronic pain (3 vs 13.84%, p = 0.007) and seroma (7.69 vs 15.38%) was achieved during mean follow-up of 628 days. Conclusion: The randomized prospective parallel group study demonstrated equality in clinical outcome on both primary end points by providing equivalent peritoneal cover for the mesh as meticulous peritoneal closure does in classical TAPP.

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“…Cases of hernias with patent processus vaginalis in boys aged 16, were treated by herniotomy at deep ring by z-suture alone in other studies. However, we performed it by formal TEP and mesh fi xation¹ [3][4][5][6][7][8][9][10][11][12][13][14][15][16] .…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic totally extra peritoneal (TEP) inguinal hernia repair: A series of 47 cases

Shrestha

2017

J. Kathmandu Med. Coll.

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Background: Over the past years, several surgical techniques have been evolved, among which total extraperitoneal inguinal hernia repair is the laparoscopic technique which is more popular now. Objective: To evaluate the outcome of totally extra peritoneal laparoscopic hernioplasty in terms of operation time, hospital stay and complications. Methods: The prospectively designed descriptive study was carried out at Department of Surgery Unit III, Kathmandu Medical College Teaching Hospital from February 2014 to April 2015. Forty seven consecutive patients above 15 years of age underwent totally extra peritoneal repairs for inguinal hernias. The selection criteria were reducible primary or recurrent, unilateral, direct and indirect inguinal hernias. All the relevant details of each patient were noted subsequently and analyzed statistically using Statistical Program for Social Sciences (SPSS) version 15. Results: The mean age of patient was 49±2.5 years. The mean operation time was 65±5.3 minutes. There were no serious complications except four (8.5%) cases of groin seroma which resolved after single time aspiration. Three (6.3%) cases had developed recurrence, two (4.2%) had developed hydrocele in a median follow up period of 6±1.5 (range, 3-9months). The mean inpatient hospital stay was 1.7±0.2 (range, 1-2.4days). Conclusion: Total extra peritoneal hernioplasty is safe and feasible with acceptable complications and recurrence rates.

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Seroma Prevention Technique Following Endoscopic Direct Inguinal Hernia Repair

Cited by 5 publications

References 7 publications

Seroma following transabdominal preperitoneal patch plasty (TAPP): incidence, risk factors, and preventive measures

Seroma following transabdominal preperitoneal patch plasty (TAPP): incidence, risk factors, and preventive measures

A Comparative Randomized Parallel Group Study between the Classical TAPP Repair and Modified TAPP Surgical Method for Inguinal Hernia Repair

Laparoscopic totally extra peritoneal (TEP) inguinal hernia repair: A series of 47 cases

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