Are immunosuppressive conditions and preoperative corticosteroid treatment risk factors in inguinal hernia repair?

ConclusionIn primary unilateral inguinal hernia surgery, an immunosuppressive condition and/or preoperative corticosteroid treatment does not appear to have a negative influence on wound complications.
Source: Surgical Endoscopy - Category: Surgery Source Type: research

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This study aimed to evaluate the treatment efficacy of meshes seeded with cells (mesh-cell group) for AWHs, compared to meshes without cells (mesh group). Cochrane Library, Web of Science and PubMed were searched for studies that provided data about meshes, cells and AWHs. Twenty-six studies involving 578 animals were included. We found that the mesh-cell group could better control hernia recurrent than the mesh group (OR = 0.25, 95% CI = 0.15-0.42). Although the mesh-cell group did not reduce the incidence of adhesions (OR = 0.67, 95% CI = 0.26-1.74), it alleviated the extent of adhesions (WMD = -1.48, 95% CI = -1.86 to -...
Source: Asian Journal of Surgery - Category: Surgery Authors: Source Type: research
Conclusion: Both the TREPP and TIPP technique resulted in a low incidence of CPIP after 1-year follow-up. The TREPP method can be considered a solid method for inguinal hernia repair if expertise is present. The learning curve of the TREPP techniques needs further evaluation. Trial Registration: ISRCTN18591339
Source: Annals of Surgery - Category: Surgery Tags: ESA-RANDOMIZED CONTROLLED TRIALS Source Type: research
AbstractThe aim of this study was to review the latest evidence on the robotic approach (RHR) for inguinal hernia repair comparing the pooled outcome of this technique with those of the standard laparoscopic procedure (LHR). A systematic literature search was performed in PubMed, Web of Science and Scopus for studies published between 2010 and 2021 concerning the comparison between RHR versus LHR. After screening 582 articles, 9 articles with a total of 64,426 patients (7589 RHRs) were eligible for inclusion. Among preoperative variables, a pooled higher ratio of ASA  >  2 patients was found in the robotic...
Source: Journal of Robotic Surgery - Category: Surgery Source Type: research
ConclusionPre-skin incision wound infiltration with dexmedetomidine –bupivacaine mixture provides prolonged local anesthetic effect, decreases the need for rescue analgesics, and provides better sedation than bupivacaine–magnesium sulfate mixture or bupivacaine alone in patients undergoing surgeries for hernia repair.
Source: QJM - Category: Internal Medicine Source Type: research
ConclusionThe results indicated that routine nerve identification and preservation was associated with a significantly lower incidence of postoperative neuralgia compared with no nerve identification.
Source: QJM - Category: Internal Medicine Source Type: research
AbstractBackgroundThe fundamental mechanism of abdominal wall hernia formation is the loss of structural integrity at the musculotendinous layer. The exact cause of inguinal hernia is still unknown but the factors contributing in its occurrence include; preformed congenital sac, chronic passive rise in the intra-abdominal pressure and weak abdominal wall.Aim of the WorkTo assess intra-operative difficulties of laparoscopic inguinal hernia repair using two different meshes: The conventional polyproline mesh and the three-dimensional (3D) mesh, as regard the operative time. And early post-operative complications including po...
Source: QJM - Category: Internal Medicine Source Type: research
I'm taking care of an outpatient patient: 60y/o woman with chronic abdominal pain with prior history of gastric bypass, appendectomy, incisional hernia repair. Her pain had been previously controlled with oxycodone 10mg a couple times a day, but recently less effective due to emesis. GI is following now, has her on Zofran, Reglan, Promethazine but the nausea is still pretty severe. Patient is cachectic and having trouble with PO intake. Utox is appropriate. I'm considering a Fentanyl patch... Read more
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
Medium-weight mesh was introduced to cut chronic pain associated with heavy-weight mesh, but it hasn't been subject to a randomized trial until now.Medscape Medical News
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: General Surgery News Source Type: news
Ann R Coll Surg Engl. 2021 Sep;103(8):569-575. doi: 10.1308/rcsann.2020.7105.ABSTRACTINTRODUCTION: Chronic postsurgical pain (CPP) remains the main complication after Lichtenstein hernioplasty. The open new simplified totally extraperitoneal (ONSTEP) technique is a more recent transinguinal procedure that seems to be associated with less CPP. The aim of this study was to compare outcomes of the ONSTEP versus the Lichtenstein procedure for primary inguinal hernia.METHODS: In this prospective, double-blinded and single-centre clinical trial, CPP at the six-month follow up assessed by a visual analogue scale was the primary e...
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Source Type: research
A transverse abdominis plane (TAP) block is one option in the management of chronic groin pain after inguinal hernia repair. Steroid-induced lipoatrophy following local injection is an infrequent complication of this procedure, but can be distressing to patients when it does occur. A 36-year-old male patient of ours sustained this rare procedural complication and underwent successful reversal of the lipoatrophy through serial intralesional isotonic saline injections. The serial intralesional injection of isotonic saline is technically simple and may be an effective means of treating lipoatrophy. Pain specialists may opt to...
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Report Source Type: research
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