Inguinal hernia repair

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Inguinal Hernia Repair with Local Anesthesia in the Outpatient—10 Year Experience

Inguinal Hernia Repair with Local Anesthesia in the Outpatient—10 Year Experience

Objective: To demonstrate the feasibility of inguinal hernia repair with local anesthesia in an out- patient regime, with safety, efficacy and short learning curve. Methods: We prospectively eva- luated 1186 patients undergoing inguinal hernia repair under local anesthesia on an outpatient basis between November 2004 and March 2014. Of the total number of hernias surgically treated in this period, 755 were operated on the right, 394 on the left and 37 bilateral. We used clinical, surgical and psychosocial criteria for inclusion in the procedure. The parameters for exclusion were complex, irreducible or recurrent hernia, obesity (BMI greater than 30 kg/m 2 ), patient’s re-
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Efficacy and Outcome of Laparoscopic Inguinal Hernia Repair- A Prospective Study

Efficacy and Outcome of Laparoscopic Inguinal Hernia Repair- A Prospective Study

Prospective study of Efficacy and outcome of Laparoscopic inguinal hernia repair was done in Netaji Subhas Chandra Bose Medical College Jabalpur over March 2015 to September 2016. Since this study was new in our institute and surgeons are in learning curve so we include only 20 patients for this study. Inclusion criteria of our study was- Direct/indirect inguinal hernia, Unilateral / bilateral inguinal hernia, Primary / recurrent inguinal hernia and Exclusion criteria was-Strangulated/ incarcerated/ obstructed hernia, Patient medically unfit for surgery, Blood coagulopathy.
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Delayed Mesh Infection: A Rare Complication of Laparoscopic Inguinal Hernia Repair (TEP—Totally Extra Peritoneal Repair)

Delayed Mesh Infection: A Rare Complication of Laparoscopic Inguinal Hernia Repair (TEP—Totally Extra Peritoneal Repair)

dal, V., Jangra, V.K., Khan, Z., Ahangar, S., Sharanappa, V., Khetan, M., John, S., Kal- han, S. and Bhatia, P. (2016) Delayed Mesh Infection: A Rare Complication of Laparos- copic Inguinal Hernia Repair (TEP—Totally Extra-Peritoneal Repair). Surgical Science, 7, 453-460.

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Efficacy of ultrasound-guided transversus abdominis plane block for postoperative analgesia in patients undergoing inguinal hernia repair

Efficacy of ultrasound-guided transversus abdominis plane block for postoperative analgesia in patients undergoing inguinal hernia repair

Materials and methods: Sixty patients scheduled for elective inguinal hernia repair were selected for the study. At the end of the surgical procedure, they were randomly divided into two groups. Ultrasound-guided TAP block was performed with 20 mL of ropivacaine 0.2% (group A) or normal saline (group B). Visual analog scale (VAS) scores were used to assess pain. Paracetamol was given if VAS .3 and tramadol was used when VAS .6. Patients were monitored for VAS scores and total analgesic consumption for the 24-hour period.

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Original Article Endoscopic totally extraperitoneal inguinal hernia repair versus open tension-free inguinal hernia repair for inguinal hernia

Original Article Endoscopic totally extraperitoneal inguinal hernia repair versus open tension-free inguinal hernia repair for inguinal hernia

the two groups. Patients in the laparoscopic group underwent general anesthesia, which took a shorter time, whereas those in the con- ventional group received continuous epidural anesthesia, taking a longer time. Although the required time varies for different ways of anes- thesia, operative duration was not affected since it was defined as the time from skin incision to suturing. Operative duration was remarkably shorter in the laparoscopic group than conventional group (P<0.05). Moreover, much less intraoperative bleeding, shorter postoperative hospital stays, and shorter time to postoperative ambulation were observed in the laparoscopic group (all P<0.05). Total hos- pitalization costs, however, were higher in the laparoscopic group (P<0.05). Higher costs of the laparoscopic group might be related to the different mesh used in the two groups and establishment of pneumoperitoneum in the laparoscopic group, consuming more materi- als. With advances in technology, hospitaliza- tion costs may be decreased. This is consistent with previous findings in the literature [21]. Regarding postoperative recurrence, a previ- ous study revealed that recurrence rates of the two study groups were 1-2%, hence, the differ- ences were insignificant [34]. On one hand, as laparoscopic TEP inguinal hernia repair was performed outside the peritoneum, patients in the laparoscopic group were prone to have peri- toneal adhesion. On the other hand, because conventional open tension-free inguinal hernia repair was an open surgery associated with more surgical trauma and damages to adjacent tissue, patients in the conventional group were more likely to have poor incision healing, scro- tal edema, urinary retention, and other compli- cations. However, in this present study, patients in the laparoscopic group and conventional group differed insignificantly in postoperative complications (P>0.05). With increasing atten- tion paid to the postoperative pain of patients in clinical research, postoperative pain has gradually become one of the markers for surgi- cal treatment [20]. In this current study, rates of 24-hour postoperative pain were lowered considerably in the laparoscopic group com- pared to the conventional group (P<0.05). The two groups differed slightly, however, in rates of chronic pain (P>0.05), similar to the results of a previous study [35].
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Comparision of safety and efficacy of unilateral paravertebral block with subarachnoid block for inguinal hernia repair

Comparision of safety and efficacy of unilateral paravertebral block with subarachnoid block for inguinal hernia repair

This is to certify that the dissertation titled, “COMPARISION OF SAFETY AND EFFICACY OF UNILATERAL PARAVERTEBRAL BLOCK WITH SUBARACHNOID BLOCK FOR INGUINAL HERNIA REPAIR” Submitted by Dr.PERIYANNAN.G in partial fulfilment for the award of the degree of DOCTOR OF MEDICINE in Anaesthesiology by The Tamilnadu Dr.M.G.R Medical University, Chennai is a bonafide record of work done by him in the INSTITUTE OF ANAESTHESIOLOGY& CRITICAL CARE, ,” Madras Medical College, during the academic year 2015-2018.

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Anterior transversalis fascia approach versus preperitoneal space approach for inguinal hernia repair in residents in northern China: study protocol for a prospective, multicentre, randomised, controlled trial

Anterior transversalis fascia approach versus preperitoneal space approach for inguinal hernia repair in residents in northern China: study protocol for a prospective, multicentre, randomised, controlled trial

Methods and analysis This will be a prospective, large sample, multicentre, randomised, controlled trial. Registration date is 1 December 2016. Actual study start date is 6 February 2017. Estimated study completion date is June 2020. A cohort of over 720 patients with inguinal hernias will be recruited from nine institutions in Liaoning Province, China. Patient randomisation will be stratified by centre to undergo inguinal hernia repair via the anterior transversalis fascia approach or the preperitoneal approach. Primary and secondary outcome assessments will be performed at baseline (prior to surgery), predischarge and at postoperative 1 week, 1 month, 3 months, 1 year and 2 years. The primary outcome is the incidence of postoperative chronic inguinal pain. The secondary outcome is postoperative complications (including rates of wound infection, haematoma, seroma and hernia recurrence).
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Prospective randomized trial of long term results of inguinal hernia repair using autoadhesive mesh compared to classical lichtenstein technique with sutures and polypropylene mesh

Prospective randomized trial of long term results of inguinal hernia repair using autoadhesive mesh compared to classical lichtenstein technique with sutures and polypropylene mesh

This is to certify that this dissertation work titled PROSPECTIVE RANDOMIZED TRIAL OF LONG TERM RESULTS OF INGUINAL HERNIA REPAIR USING AUTOADHESIVE MESH COMPARED TO CLASSICAL LICHTENSTEIN TECHNIQUE WITH SUTURES AND POLYPROPYLENE MESH of the candidate DR.RAGUPATHY.M.J with registration Number 221511311 for the award of M.S in the branch of General Surgery,I personally verified the urkund.com website for the purpose of plagiarism Check. I found that the uploaded thesis file contains 96 pages from introduction to conclusion and the result shows 1% (One) percentage of plagiarism in the dissertation.
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A comparative study of laparoscopic inguinal hernia repair and Stoppa repair in cases of bilateral inguinal hernia

A comparative study of laparoscopic inguinal hernia repair and Stoppa repair in cases of bilateral inguinal hernia

Pironi et al., (9) compared the results of open mesh technique and laparoscopic TAPP repair for inguinal hernia and found the median operative time was 71 minutes for open group and 92 min for laparoscopic group, no intraoperative complications and with postoperative complication rate 4.5% in patients open group and 3% in laparoscopic group, This could be attributed to proper patients' selection, allowing completion of all cases within reasonable duration of surgery without intraoperative complications and no conversion rate. A significant difference was observed in the median time to return to normal activities. They concluded that the safety and effectiveness of laparoscopic approach to inguinal hernia repair is an excellent alternative to conventional surgery with confirmed reduction of operative time, complications and recurrences.
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Role of Ilioinguinal Neurectomy in Entrapment Syndrome in Inguinal Hernia Repair

Role of Ilioinguinal Neurectomy in Entrapment Syndrome in Inguinal Hernia Repair

Background and Obje ctives: Chronic post herniorrhaphy groin pain is defined as pain lasting > 3 months after surgery, whic h is one of the mos t important c omplic ation occuring after inguinal hernia repair, occurs w ith greater frequency than previous ly thought . Chronic groin pain is one of the most s ignific ant complic ation follow ing inguinal hernia repair, and majority of chronic pain has been attrbuted to ilioinguinal nerve entrapment. Routine exc is ion of the ilioinguinal nerve in an attempt to decreas e the inc idence of chronic groin pain caus ed by nerve entrapment, inflammation, fibrotic reactions around the nerve.
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A comparative study of lichtenstein mesh repair vs nonmesh tissue repair desarda’s technique for inguinal hernia repair

A comparative study of lichtenstein mesh repair vs nonmesh tissue repair desarda’s technique for inguinal hernia repair

The observed complication rates and postoperative dysfunction have influenced many investigations to look for new hernia repair techniques or modify old methods. An example of such efforts is the Desarda method, which was presented in 2001 and become a new surgical method for tension free tissue based inguinal hernia repair (Desarda, 2001a; Desarda 2001b). 10,11 Because the results of our prospective study involving the technique were promising and comparable to results presented by other authors (Mitura and Romanczuk, 2008; Szopinski et al., 2005). 12,13
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Inguinal Hernia Repair: A Comparative study between Inguinal Field Block and General Anaesthesia

Inguinal Hernia Repair: A Comparative study between Inguinal Field Block and General Anaesthesia

anaesthesia for inguinal hernia repair. Dajun Song, MD, PhD et al compared the recovery profiles and costs of anaesthesia for outpatient unilateral, inguinal hernia repair and concluded that local anaesthesia with mild sedation resulted in greater patient satisfaction, lower pain scores and quicker time-to-home readiness.

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Risk factors for contralateral inguinal hernia repair after unilateral inguinal hernia repair in male adult patients: analysis from a nationwide population based cohort study

Risk factors for contralateral inguinal hernia repair after unilateral inguinal hernia repair in male adult patients: analysis from a nationwide population based cohort study

Methods: This retrospective cohort study identified from the Taiwan National Health Insurance Research Database (NHIRD). Information on all adult patients who underwent primary unilateral inguinal hernia repair without any other operation was collected using ICD-9 diagnostic and procedure codes. The exclusion criteria were laparoscopic hernia repair, non-primary repair, complicated hernia, other combined procedures, female and undetermined gender. Results: A total of 170,492 adult male patients were included, with a median follow-up of 87 months. The overall CIH rate was 10.5%, with a median time of 48 months to a subsequent hernia operation. The 1-year, 2-year, 3-year and 5- year-recurrent rate was 2.6, 3, 4.3, and 6.7% respectively. Further, 3.7% patients who underwent CIH repair had a complicated inguinal hernia. Multivariate analysis demonstrated that age > 45 y, direct hernia, cirrhosis (HR = 1.564), severe liver disease (HR = 1.663), prostate disease (HR = 1.178), congestive heart failure (HR = 1.138), and history of malignancy (HR = 1.116) had a significantly higher risk of CIH repair.
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A Comprehensive study on Complications of Laparoscopic Inguinal Hernia Repair

A Comprehensive study on Complications of Laparoscopic Inguinal Hernia Repair

During the developmental years of laparoscopic inguinal hernia repair the importance of closing all fascial defects greater then 5 mm was not recognized. This resulted in the development of Richter's hernia with bowel obstruction in occasional patients. Several devices that can be used to close fascial defects larger than 5 mm are now routinely available commercially. Inadequate peritoneal closure over the prosthesis after the TAPP repair may leave gaps that allow bowel to migrate into the preperitoneal space and thereby result in bowel obstruction. Operative strategies to minimize this complication have been described in the section on operative techniques. With the advent of the TEP repair it was hoped that bowel-related complications would be minimized or eliminated. However, frequently unrecognized peritoneal defects are common after the TEP repair, especially in patients with previous lower abdominal surgery, and intestinal obstruction has been reported.Delayed adhesive small bowel obstruction is theoretically possible because of the intra-abdominal dissection. Fortunately, this complication is exceedingly rare.
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Evaluation of cases of laparoscopic inguinal hernia repair at government medical college Vadodara

Evaluation of cases of laparoscopic inguinal hernia repair at government medical college Vadodara

In 1982, Dr Ger and colleagues performed the first laparoscopic inguinal hernia repair in dogs by stapling the abdominal opening of the patent processus vaginalis. 2 Other minimally invasive techniques were later developed, including a plug and patch repair and an intraperitoneal onlay mesh repair. 5 The intraperitoneal onlay mesh [IPOM] repair involved placing mesh over ORIGINAL ARTICLE

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The Tilburg double blind randomised controlled trial comparing inguinal hernia repair according to Lichtenstein and the transinguinal preperitoneal technique

The Tilburg double blind randomised controlled trial comparing inguinal hernia repair according to Lichtenstein and the transinguinal preperitoneal technique

Methods: The TULIP is a double-blind randomised controlled trial in which 300 patients will be randomly allocated to anterior inguinal hernia repair according to Lichtenstein or the transinguinal preperitoneal technique with soft mesh. All unilateral primary inguinal hernia patients eligible for operation who meet inclusion criteria will be invited to participate in this trial. The primary endpoint will be direct postoperative- and chronic pain. Secondary endpoints are operation time, postoperative complications, hospital stay, costs, return to daily activities (e.g. work) and recurrence. Both groups will be evaluated.
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Surgical physiology of inguinal hernia repair - a study of 200 cases

Surgical physiology of inguinal hernia repair - a study of 200 cases

Inguinal structures, as living entities that move and func- tion cannot really be appreciated either by dissection on cadavers or operations on patients under general or spinal anaesthesia.[6] Live demonstration of movements of the posterior wall and the musculo-aponeurotic structures around the inguinal canal during the acts of internal ab- dominal 'blows' (raised intra abdominal pressure) is so far not possible. Imaging of the inguinal canal in patients, with or without hernia, on sonography machines is also not satisfactory because of the small size of the canal and the fact that all structures are seen in black and white. Many operations developed to date deal only with the anatom- ical aspects of the repair. Any failure in these operations is be- cause the physiological aspects have not been considered while developing a new operating technique. The author has devel- oped a new technique [5] of pure tissue repair of any type of inguinal hernia without a mesh, based on the concept of constructing a strong and physiologically dynamic pos- terior wall to the inguinal canal with the help of the exter- nal oblique muscle and its aponeurosis. A strip of the external oblique aponeurosis gives replacement to the ab- sent aponeurotic extensions in the posterior wall, making it strong, and the additional strength of the external ob- lique muscle to the weakened internal oblique and the transversus abdominis muscle keeps it physiologically dynamic. The first recorded observation of dynamic activ- ity in the internal ring of a living nonanaesthetized hu- man being was done in only one patient by Tobin et al.[7] Many such studies of dynamic activity in the internal ring have been done in dogs.[8] Peacock EE [9] states that little is known about the muscular activity in the internal ring because conventional repair of groin hernia does not ade- quately expose the normal muscle fibers. Preperitoneal ex- posure is, of course, performed in an anaesthetized patient; consequently little information has been ac-
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Risk factors for early recurrence after inguinal hernia repair

Risk factors for early recurrence after inguinal hernia repair

Family history is an important predictors for the develop- ment of inguinal hernias[3] as well as for hernia recur- rence[4] and indicates that genetic factors play a role for disease manifestation at least in a subgroup of hernia patients. Especially collagen genes are suspicious genes because studies on the biology of hernia formation sug- gest that disturbances in collagen metabolism contribute to high recurrence rates[5,6]. A decreased ratio of type I/III collagen is reported for inguinal, incisional and especially

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Prospective Randomized Trial of Polypropylene Mesh Compared with Darn in Inguinal Hernia Repair

Prospective Randomized Trial of Polypropylene Mesh Compared with Darn in Inguinal Hernia Repair

Despite short follow up periods, the outstanding feature of all open tension free repair is the exceedingly low recurrence rate and low postoperative pain now being widely reported. Many of these are large series from large specialized centre. It has been advised that all the centers particularly training centers use mesh because of low recurrence rate. However, judging the success of hernia solely in terms of recurrence rate is too limiting. The factors needed to be taken into account when assessing the choice of operation as suggested by RUTKOW is,

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Ultra Pro Hernia System for Repair of Primary Complex Inguinal Hernia: Should It Be the Technique of Choice?

Ultra Pro Hernia System for Repair of Primary Complex Inguinal Hernia: Should It Be the Technique of Choice?

The current study assessed the efficacy of UHS in inguinal hernia repair. The mean operative time was 48 minutes, no operative complications was reported. Only 2 superficial wound infections were seen and treated medically without surgical intervention. The post-operative pain was minimal and none of the pa- tients reported any chronic groin pain after 12 months of surgery. No recurrence was encountered during a mean follow up period of 26 months. These results are comparable to results of many other studies [20] [21]. When comparing UHS with the classic Lichtenstein repair of inguinal hernia, many studies showed equivalent results for both techniques regarding intra and post-operative com- plications, length of hospital stay, duration of analgesics use, and time to return to usual activities [10] [11] [22]. Regarding operative time, some studies showed shorter operative time for UHS [20] [23]; other studies had longer operative time for UHS compared to Lichtenstein repair [24].
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