State of the art: open mesh-based inguinal hernia repair

AbstractOpen inguinal hernia repair remains the most universal, ubiquitous, reliable, and cost-effective method of addressing the global burden of groin hernias. Advances in anatomic understanding and technique have refined a few well-established techniques that can address the majority of the burden of disease with low rates of morbidity, recurrence, and chronic pain. Prosthetic reinforcement has become routine because of the clear reduction in recurrence rates in general practice conferred by mesh and the less-appreciated consideration of simplification of the repair whereby operator variability, hernia type, anatomic variation, patient habitus, tissue deficiencies, and surgical technique are homogenized by reproducible standard techniques. While minimally invasive laparoscopic and robotic approaches have increased in popularity, availability, and reliability, open inguinal-repair techniques continue to provide durability, low risk, minimal cost, ease of training and dissemination, and excellent outcomes and remain a fundamental foundation for the practice and art of hernia surgery. Additionally, as chronic pain and quality of life metrics supersede recurrence as the primary clinical outcome of inguinal hernia repair, the ability to offer a “tailored approach” with several options ranging from tissue- and mesh-based open repairs to minimally invasive prosthetic reinforcement has become an important consideration in providing each patient with different options a...
Source: Hernia - Category: Sports Medicine Source Type: research

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ConclusionThis meta-analysis and trial sequential analysis report no difference in recurrence rates between laparoscopic and open primary unilateral inguinal hernia repairs. Rates of acute and chronic pain are significantly less in the laparoscopic group.
Source: Hernia - Category: Sports Medicine Source Type: research
ConclusionHernia surgery, although an everyday event for many practitioners, requires the same rigor as all other visceral surgery.
Source: Journal of Visceral Surgery - Category: Surgery Source Type: research
This study is a multicentre randomised controlled clinical trial. From November 2012 to May 2015, 193 patients undergoing LIVHR for primary incisional hernia with fascial defect size from 2 to 7  cm were recruited in 11 Finnish hospitals. Patients were randomised to either a laparoscopic (LG) or a hybrid (HG) repair group. The main outcome measure was hernia recurrence, evaluated clinically and radiologically at a 1-year follow-up visit. At the same time, chronic pain scores and QoL were a lso measured.ResultsAt the 1-year-control visit, we found no difference in hernia recurrence between the study groups. Altogether,...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Conclusion: In experienced hands, TEP procedure has better early and late postoperative results than OLR, whereas recurrence rates are similar. PMID: 30761846 [PubMed - in process]
Source: Turkish Journal of Medical Sciences - Category: General Medicine Tags: Turk J Med Sci Source Type: research
Authors: Yildirim D, Donmez T, Ozcevik H, Cakir M, Demiryas S, Akturk OM Abstract Introduction: Endoscopic hernia repair integrates the advantages of tension-free preperitoneal mesh support of the groin with the advantages of minimally invasive surgery procedures. Aim: To compare outcomes between slit mesh (SM) and nonslit mesh (NSM) placement in laparoscopic totally extraperitoneal (TEP) inguinal hernia repair. Material and methods: This is a retrospective study of 353 patients who underwent TEP inguinal hernia repair between January 2010 and December 2011. One hundred forty-nine and 154 hernias were opera...
Source: Videosurgery and Other Miniinvasive Techniques - Category: Surgery Tags: Wideochir Inne Tech Maloinwazyjne Source Type: research
AbstractBackgroundLaparoscopic intraperitoneal mesh repair has become one of the most commonly performed minimally invasive procedures. Nevertheless, despite improved overall outcome, postoperative seroma formation remains the most frequent complication. Our objective was to investigate the effectiveness of cauterization of the hernia sac in terms of reducing the incidence of postoperative seroma formation.MethodsA retrospective analysis of 94 patients who underwent standard laparoscopic intraperitoneal mesh repair without closure of the central defect (sIPOM) between June 2011 and December 2014 was conducted. In 20 of tho...
Source: Hernia - Category: Sports Medicine Source Type: research
AbstractBackgroundAlthough inguinal hernia is one of the most common conditions requiring surgical treatment, no reliable information is available on the quality of life of patients with inguinal hernias before surgery. Additionally, patients with intense inguinal pain prior to surgery are more susceptible to postoperative chronic pain. In such cases, less invasive laparoscopic techniques can be used, allowing atraumatic mesh fixation to reduce postoperative pain. The aim of the study was to determine, whether these treatments for patients with preoperative pain would minimize upsetting experiences after surgery.Materials ...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
ConclusionsTAPP procedure for bilateral inguinal hernia effectively reduces early postoperative pain, hospital stay and postoperative complications.
Source: The American Journal of Surgery - Category: Surgery Source Type: research
AbstractBackgroundLaparoscopic intraperitoneal mesh repair has become one of the most commonly performed minimally invasive procedures. Nevertheless, despite improved overall outcome, postoperative seroma formation remains the most frequent complication. Our objective was to investigate the effectiveness of cauterization of the hernia sac in terms of reducing the incidence of postoperative seroma formation.MethodsA retrospective analysis of 94 patients who underwent standard laparoscopic intraperitoneal mesh repair without closure of the central defect (sIPOM) between June 2011 and December 2014 was conducted. In 20 of tho...
Source: Hernia - Category: Sports Medicine Source Type: research
ConclusionsThe HerniaSurge Group has developed these extensive and inclusive guidelines for the management of adult groin hernia patients. It is hoped that they will lead to better outcomes for groin hernia patients wherever they live. More knowledge, better training, national audit and specialization in groin hernia management will standardize care for these patients, lead to more effective and efficient healthcare and provide direction for future research.
Source: Hernia - Category: Sports Medicine Source Type: research
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