The Learning curve for totally extraperitoneal laparoscopic inguinal hernia repair

Liem, Mike S L; Steensel, C. J. Van; Boelhouwer, Roelof U.; Weidema, W. F.; Clevers, G. J.; Meijer, W. S.; Vente, J. P.; Vries, L.S. de; Vroonhoven, Theo J. M. V. van

doi:10.1016/s0002-9610(97)89569-4

Cited by 194 publications

(143 citation statements)

References 12 publications

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“…In addition to the use of the self-fixating mesh being responsible for the reduction of surgical time, as already verified by some series 3,17 , we emphasize that laparoscopic repair was not an increasing factor of the operative time. Although in some series laparoscopic access is associated with longer surgery duration 5,10 , it is known that the surgeon's experience is inversely proportional to the operative time in laparoscopic herniorrhaphy [26][27][28] . In the present study, surgeons with expertise in the method performed the laparoscopic procedures, which justifies the low operative time.…”

Section: Discussionmentioning

confidence: 99%

Herniorrafia inguinal convencional com tela autofixante versus videolaparoscópica totalmente extraperitoneal com tela de polipropileno: resultados no pós-operatório precoce

Cunha-e-Silva

Oliveira

Ayres

et al. 2017

Rev. Col. Bras. Cir.

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RESUMO Objetivo: avaliar o resultado no pós-operatório precoce do tratamento da hérnia inguinal pela técnica convencional com tela autofixante versus videolaparoscópica totalmente extraperitoneal com uso da tela de polipropileno. Foram comparados, sobretudo, dor, tempo cirúrgico e complicações precoces. Métodos: estudo prospectivo, de série de casos, realizado na Clínica Cirúrgica A, do Hospital Universitário Gaffrée e Guinle (HUGG), no qual 80 casos consecutivos foram estudados. Apenas pacientes com hérnia inguinal unilateral, não recidivada e operadas em caráter eletivo foram incluídas no estudo. Os pacientes foram divididos em dois grupos, de 40 pacientes cada; grupo AF (técnica convencional com uso de tela autofixante) e grupo VL (técnica videolaparoscópica com uso de tela de polipropileno). Os pacientes foram acompanhados até o 45º dia de pós-operatório. Resultados: dos 80 pacientes operados no estudo, 98,7% pertenciam ao sexo masculino e a maioria era portadora de hérnia inguinal direita indireta (Nyhus II). Não houve diferença entre os grupos estudados no que diz respeito à dor e tempo operatório. No entanto, ocorreram mais complicações (seroma e hematoma) no grupo da cirurgia aberta. Conclusão: as duas operações realizadas se mostraram factíveis, seguras e estão relacionadas à mínima dor pós operatório e a um baixo tempo cirúrgico.

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Section: Discussionmentioning

confidence: 99%

Herniorrafia inguinal convencional com tela autofixante versus videolaparoscópica totalmente extraperitoneal com tela de polipropileno: resultados no pós-operatório precoce

Cunha-e-Silva

Oliveira

Ayres

et al. 2017

Rev. Col. Bras. Cir.

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“…Some studies have reported on the learning curve for laparoscopic TEP repair; [5][6][7][8] one suggested a learning curve of 80 cases, 6 and another suggested 20-50 cases. 7 Lal and colleagues 8 recommended that a minimum of 10 independent open Stoppa preperitoneal procedures might be helpful to learn how to perform laparoscopic TEP repair.…”

Section: Discussionmentioning

confidence: 99%

“…10 Liem and colleagues 5 examined the learning experience of 4 different surgeons, each having performed 30 consecutive laparoscopic TEP repairs; however, no conclusions were drawn on the exact duration of the learning curve for the procedure. Lau and colleagues 6 suggested that the learning curve for laparoscopic TEP repair was 80 procedures, and Aeberhard and colleagues 11 reported that the duration of surgery dropped significantly to less than 1 hour after performing 100 repairs.…”

Section: Discussionmentioning

confidence: 99%

Learning curve for laparoscopic totally extraperitoneal repair of inguinal hernia

2012

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“…The incidence of peritoneal tears and intra-abdominal gas leakage is reported to be 40-47 per cent 16,17 . This often complicates the TEP operation and can become a reason for conversion, which is reported in 5 per cent of procedures 18 . In this study intra-abdominal gas leakage was encountered relatively frequently and it is reasonable to assume that this was due to peritoneal tears.…”

Section: Discussionmentioning

confidence: 99%

“…A similar finding was encountered in another large randomized trial, in which a single institution had a disproportionately high number of recurrences 10 . The learning curve for laparoscopic hernia repair is reported as being between 30 and 250 operations 18,26 . This is more than the 25 TEP repairs required before the surgeons could participate in the present study.…”

Section: Discussionmentioning

confidence: 99%

Short-term results of a randomized clinical trial comparing Lichtenstein open repair with totally extraperitoneal laparoscopic inguinal hernia repair

Eklund¹,

Rudberg²,

Smedberg

et al. 2006

British Journal of Surgery

130

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Background: Laparoscopic herniorrhaphy has emerged as a recognized operative method for inguinal hernia repair. This study compared the short-term results of two tension-free methods of repair: totally extraperitoneal (TEP) laparoscopic patch repair and the open Lichtenstein mesh technique.Methods: A total of 1513 men from 11 hospitals who presented with a primary unilateral inguinal hernia were randomized to one of the two methods. Operating time, short-term complications, reoperations, postoperative pain, consumption of analgesics, sick leave and time to resumption of normal physical activities were recorded. Results: Some 1371 of the 1513 men underwent surgery, 665 in the TEP group and 706 in the Lichtenstein group. The median duration of operation was 55 min for both procedures and 91·0 per cent of the patients in both groups were discharged on the day of operation. Patients in the TEP group experienced less postoperative pain (P < 0·001), consumed fewer analgesics (P < 0·001), had a shorter period of sick leave (7 versus 12 days; P < 0·001) and a shorter time to resumption of normal physical activity (20 versus 31 days; P < 0·001). Conclusion:The TEP technique took no longer to perform, and was associated with less postoperative pain, a shorter period of sick leave and a faster recovery, compared with open Lichtenstein hernia repair.

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The Learning curve for totally extraperitoneal laparoscopic inguinal hernia repair

Cited by 194 publications

References 12 publications

Herniorrafia inguinal convencional com tela autofixante versus videolaparoscópica totalmente extraperitoneal com tela de polipropileno: resultados no pós-operatório precoce

Herniorrafia inguinal convencional com tela autofixante versus videolaparoscópica totalmente extraperitoneal com tela de polipropileno: resultados no pós-operatório precoce

Learning curve for laparoscopic totally extraperitoneal repair of inguinal hernia

Short-term results of a randomized clinical trial comparing Lichtenstein open repair with totally extraperitoneal laparoscopic inguinal hernia repair

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