Mesh Splitting versus nonsplitting in Laparoscopic Transabdominal Preperitoneal Inguinal Hernia Repair
EAES Academy. Albalkiny S. 07/05/22; 363106; P151
Dr. Sherif Albalkiny
Contributions
Contributions
Abstract
Aim
Our research was performed to determine the effects of mesh tailoring and splitting
to enclose the spermatic cord and to equate this technique in terms of risks, quality
of life, and recurrence rate to the conventional transabdominal preperitoneal (TAPP) procedure.
Patients and methods
A total of 40 patients with mean age of 33.6±8.8 years, ranging from 18 to 60 years,
underwent laparoscopic hernia repair (TAPP), where group I underwent repair with
mesh splitting technique, whereas group II underwent the standard TAPP approach
without mesh splitting. All patients participated in the study completed 2 years of
follow-up. Full clinical assessment for all patients was performed, and any postoperative complications such as postoperative pain, wound infection, seroma, hematoma, or recurrence were recorded. After 1 year, testicular perfusion was assessed as well. For evaluation of the quality of life, MOS 36- Health Survey (SF-36) was used.
Results:
There was no significant difference between the two groups in terms of recovery
time to normal physical activity. All patients reported that their chronic groin pain
was reduced over time and completely disappeared after 6 months. The most
common encountered complication was postoperative seroma, which occurred in
22 (55%) patients. In terms of incidence of recurrence, only one case was reported
in group II after 3 months of follow-up.
Conclusions:
No difference in postoperative complaints or complications was demonstrated with
mesh splitting and fashioning in laparoscopic hernia repair.
Moreover, proper surgical handling and reduction of suturing and fixation in addition
to avoiding nerve and vessels injuries are the main keys to prevent post hernioplasty
chronic pain. Additionally, this study could not demonstrate any effects on the
testicular integrity from implantation of splitted or nonsplitted mesh.
Our research was performed to determine the effects of mesh tailoring and splitting
to enclose the spermatic cord and to equate this technique in terms of risks, quality
of life, and recurrence rate to the conventional transabdominal preperitoneal (TAPP) procedure.
Patients and methods
A total of 40 patients with mean age of 33.6±8.8 years, ranging from 18 to 60 years,
underwent laparoscopic hernia repair (TAPP), where group I underwent repair with
mesh splitting technique, whereas group II underwent the standard TAPP approach
without mesh splitting. All patients participated in the study completed 2 years of
follow-up. Full clinical assessment for all patients was performed, and any postoperative complications such as postoperative pain, wound infection, seroma, hematoma, or recurrence were recorded. After 1 year, testicular perfusion was assessed as well. For evaluation of the quality of life, MOS 36- Health Survey (SF-36) was used.
Results:
There was no significant difference between the two groups in terms of recovery
time to normal physical activity. All patients reported that their chronic groin pain
was reduced over time and completely disappeared after 6 months. The most
common encountered complication was postoperative seroma, which occurred in
22 (55%) patients. In terms of incidence of recurrence, only one case was reported
in group II after 3 months of follow-up.
Conclusions:
No difference in postoperative complaints or complications was demonstrated with
mesh splitting and fashioning in laparoscopic hernia repair.
Moreover, proper surgical handling and reduction of suturing and fixation in addition
to avoiding nerve and vessels injuries are the main keys to prevent post hernioplasty
chronic pain. Additionally, this study could not demonstrate any effects on the
testicular integrity from implantation of splitted or nonsplitted mesh.
Aim
Our research was performed to determine the effects of mesh tailoring and splitting
to enclose the spermatic cord and to equate this technique in terms of risks, quality
of life, and recurrence rate to the conventional transabdominal preperitoneal (TAPP) procedure.
Patients and methods
A total of 40 patients with mean age of 33.6±8.8 years, ranging from 18 to 60 years,
underwent laparoscopic hernia repair (TAPP), where group I underwent repair with
mesh splitting technique, whereas group II underwent the standard TAPP approach
without mesh splitting. All patients participated in the study completed 2 years of
follow-up. Full clinical assessment for all patients was performed, and any postoperative complications such as postoperative pain, wound infection, seroma, hematoma, or recurrence were recorded. After 1 year, testicular perfusion was assessed as well. For evaluation of the quality of life, MOS 36- Health Survey (SF-36) was used.
Results:
There was no significant difference between the two groups in terms of recovery
time to normal physical activity. All patients reported that their chronic groin pain
was reduced over time and completely disappeared after 6 months. The most
common encountered complication was postoperative seroma, which occurred in
22 (55%) patients. In terms of incidence of recurrence, only one case was reported
in group II after 3 months of follow-up.
Conclusions:
No difference in postoperative complaints or complications was demonstrated with
mesh splitting and fashioning in laparoscopic hernia repair.
Moreover, proper surgical handling and reduction of suturing and fixation in addition
to avoiding nerve and vessels injuries are the main keys to prevent post hernioplasty
chronic pain. Additionally, this study could not demonstrate any effects on the
testicular integrity from implantation of splitted or nonsplitted mesh.
Our research was performed to determine the effects of mesh tailoring and splitting
to enclose the spermatic cord and to equate this technique in terms of risks, quality
of life, and recurrence rate to the conventional transabdominal preperitoneal (TAPP) procedure.
Patients and methods
A total of 40 patients with mean age of 33.6±8.8 years, ranging from 18 to 60 years,
underwent laparoscopic hernia repair (TAPP), where group I underwent repair with
mesh splitting technique, whereas group II underwent the standard TAPP approach
without mesh splitting. All patients participated in the study completed 2 years of
follow-up. Full clinical assessment for all patients was performed, and any postoperative complications such as postoperative pain, wound infection, seroma, hematoma, or recurrence were recorded. After 1 year, testicular perfusion was assessed as well. For evaluation of the quality of life, MOS 36- Health Survey (SF-36) was used.
Results:
There was no significant difference between the two groups in terms of recovery
time to normal physical activity. All patients reported that their chronic groin pain
was reduced over time and completely disappeared after 6 months. The most
common encountered complication was postoperative seroma, which occurred in
22 (55%) patients. In terms of incidence of recurrence, only one case was reported
in group II after 3 months of follow-up.
Conclusions:
No difference in postoperative complaints or complications was demonstrated with
mesh splitting and fashioning in laparoscopic hernia repair.
Moreover, proper surgical handling and reduction of suturing and fixation in addition
to avoiding nerve and vessels injuries are the main keys to prevent post hernioplasty
chronic pain. Additionally, this study could not demonstrate any effects on the
testicular integrity from implantation of splitted or nonsplitted mesh.
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