Optimization of TAPP in case of recurrent inguinal hernias after Liechtenstein surgery
EAES Academy. Feleshtynsky Y. 07/05/22; 363104; P149
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Abstract
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The classic method of TAPP in case of recurrence of inguinal hernia after Liechtenstein surgery does not always ensure the reliability of the closure of the mesh implant hernia defect, accompanied by recurrence (5-10%).
The aim:
Increase the effectiveness of TAPP in case of recurrence of inguinal hernia after Liechtenstein surgery.
Material and method:
Surgical treatment of 68 patients with recurrent inguinal hernias after Liechtenstein surgery was performed using advanced and classical TAPP methods. Age of patients from 25 to 80 years, mean age 58±1.3. All patients were male. Depending on the method of operation, patients were divided into two groups. In the first (main) group in 34 patients the operation was performed according to our improved TAPP, which consists in strengthening the inguinal area using a mesh implant 15x15 cm, larger than the classic with an overlap on the upper edge of the defect 4-5 cm and fixing with Liqui Band Fix 8 glue around the perimeter ulcer fixation on the lower edge of the defect. In the second group (comparison), 34 patients performed the classic TAPP technique using a ProTack herniostepler. Patient groups were comparable in age and size of recurrent inguinal hernias.
Results and discussion. In the postoperative period, chronic inguinal pain was observed in 3 (8.8%) patients of the comparison group. No chronic inguinal pain was observed in patients of the main group. Long-term results were studied by repeated examinations and ultrasound diagnostics for a period of 1 to 3 years. Recurrences of inguinal hernia were found in 4 (11.8%) patients of the comparison groups. The absence of recurrence among patients in the main group was achieved due to the wider coverage of the inguinal defect and fixation of the network with glue, especially in the lower parts, which eliminates nerve trauma and migration of the network.
Conclusion. Improved TAPP in recurrent inguinal hernia after Liechtenstein surgery using a larger mesh implant with adhesive fixation improves treatment outcomes compared to classical TAPP.
The aim:
Increase the effectiveness of TAPP in case of recurrence of inguinal hernia after Liechtenstein surgery.
Material and method:
Surgical treatment of 68 patients with recurrent inguinal hernias after Liechtenstein surgery was performed using advanced and classical TAPP methods. Age of patients from 25 to 80 years, mean age 58±1.3. All patients were male. Depending on the method of operation, patients were divided into two groups. In the first (main) group in 34 patients the operation was performed according to our improved TAPP, which consists in strengthening the inguinal area using a mesh implant 15x15 cm, larger than the classic with an overlap on the upper edge of the defect 4-5 cm and fixing with Liqui Band Fix 8 glue around the perimeter ulcer fixation on the lower edge of the defect. In the second group (comparison), 34 patients performed the classic TAPP technique using a ProTack herniostepler. Patient groups were comparable in age and size of recurrent inguinal hernias.
Results and discussion. In the postoperative period, chronic inguinal pain was observed in 3 (8.8%) patients of the comparison group. No chronic inguinal pain was observed in patients of the main group. Long-term results were studied by repeated examinations and ultrasound diagnostics for a period of 1 to 3 years. Recurrences of inguinal hernia were found in 4 (11.8%) patients of the comparison groups. The absence of recurrence among patients in the main group was achieved due to the wider coverage of the inguinal defect and fixation of the network with glue, especially in the lower parts, which eliminates nerve trauma and migration of the network.
Conclusion. Improved TAPP in recurrent inguinal hernia after Liechtenstein surgery using a larger mesh implant with adhesive fixation improves treatment outcomes compared to classical TAPP.
The classic method of TAPP in case of recurrence of inguinal hernia after Liechtenstein surgery does not always ensure the reliability of the closure of the mesh implant hernia defect, accompanied by recurrence (5-10%).
The aim:
Increase the effectiveness of TAPP in case of recurrence of inguinal hernia after Liechtenstein surgery.
Material and method:
Surgical treatment of 68 patients with recurrent inguinal hernias after Liechtenstein surgery was performed using advanced and classical TAPP methods. Age of patients from 25 to 80 years, mean age 58±1.3. All patients were male. Depending on the method of operation, patients were divided into two groups. In the first (main) group in 34 patients the operation was performed according to our improved TAPP, which consists in strengthening the inguinal area using a mesh implant 15x15 cm, larger than the classic with an overlap on the upper edge of the defect 4-5 cm and fixing with Liqui Band Fix 8 glue around the perimeter ulcer fixation on the lower edge of the defect. In the second group (comparison), 34 patients performed the classic TAPP technique using a ProTack herniostepler. Patient groups were comparable in age and size of recurrent inguinal hernias.
Results and discussion. In the postoperative period, chronic inguinal pain was observed in 3 (8.8%) patients of the comparison group. No chronic inguinal pain was observed in patients of the main group. Long-term results were studied by repeated examinations and ultrasound diagnostics for a period of 1 to 3 years. Recurrences of inguinal hernia were found in 4 (11.8%) patients of the comparison groups. The absence of recurrence among patients in the main group was achieved due to the wider coverage of the inguinal defect and fixation of the network with glue, especially in the lower parts, which eliminates nerve trauma and migration of the network.
Conclusion. Improved TAPP in recurrent inguinal hernia after Liechtenstein surgery using a larger mesh implant with adhesive fixation improves treatment outcomes compared to classical TAPP.
The aim:
Increase the effectiveness of TAPP in case of recurrence of inguinal hernia after Liechtenstein surgery.
Material and method:
Surgical treatment of 68 patients with recurrent inguinal hernias after Liechtenstein surgery was performed using advanced and classical TAPP methods. Age of patients from 25 to 80 years, mean age 58±1.3. All patients were male. Depending on the method of operation, patients were divided into two groups. In the first (main) group in 34 patients the operation was performed according to our improved TAPP, which consists in strengthening the inguinal area using a mesh implant 15x15 cm, larger than the classic with an overlap on the upper edge of the defect 4-5 cm and fixing with Liqui Band Fix 8 glue around the perimeter ulcer fixation on the lower edge of the defect. In the second group (comparison), 34 patients performed the classic TAPP technique using a ProTack herniostepler. Patient groups were comparable in age and size of recurrent inguinal hernias.
Results and discussion. In the postoperative period, chronic inguinal pain was observed in 3 (8.8%) patients of the comparison group. No chronic inguinal pain was observed in patients of the main group. Long-term results were studied by repeated examinations and ultrasound diagnostics for a period of 1 to 3 years. Recurrences of inguinal hernia were found in 4 (11.8%) patients of the comparison groups. The absence of recurrence among patients in the main group was achieved due to the wider coverage of the inguinal defect and fixation of the network with glue, especially in the lower parts, which eliminates nerve trauma and migration of the network.
Conclusion. Improved TAPP in recurrent inguinal hernia after Liechtenstein surgery using a larger mesh implant with adhesive fixation improves treatment outcomes compared to classical TAPP.
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