Prospective randomized study comparing mesh displacement in enhanced-view totally extraperitoneal versus totally extraperitoneal laparoscopic inguinal hernia repair without mesh fixation.
Abdullah Hilmi Yilmaz, Mehmet Esref Ulutas, Saim Turkoglu
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引用次数: 0
Abstract
Purpose: In laparoscopic inguinal hernia repair, it is thought that the mesh can be displaced more in the enhanced-view totally extraperitoneal (eTEP) technique. The aim of this study was to compare eTEP and totally extraperitoneal (TEP) techniques without mesh fixation in terms of mesh displacement and hernia recurrence.
Methods: Between December 2022 and April 2023, 60 consecutive patients with unilateral inguinal hernia were randomized into two groups; eTEP group (n = 30) and TEP group (n = 30). There was without mesh fixation in both groups. Study was registered at http://Clinicaltrials.gov (NCT06070142). The mesh was marked with three radiopaque clips. Pelvic radiographs were performed to evaluate the displacement of the mesh. The primary outcome of this study was mesh displacement. In addition, this is the first study in the literature to compare eTEP and TEP techniques in terms of mesh displacement without fixation in laparoscopic inguinal hernia.
Results: There was no significant difference between the groups in terms of mesh displacement, recurrence, postoperative VAS scores, length of hospital stay, hematoma, and seroma formation. The operation time was higher in the eTEP group and was statistically significant.
Conclusion: Without mesh fixation, the eTEP technique does not increase the risk of mesh displacement and recurrence. The eTEP technique can be safely applied without mesh fixation in laparoscopic inguinal hernia repairs.
目的：在腹腔镜腹股沟疝修补术中，有观点认为增强视野完全腹膜外（eTEP）技术可使网片移位更多。本研究旨在从网片移位和疝气复发的角度，比较 eTEP 和无网片固定的完全腹膜外（TEP）技术：方法：2022年12月至2023年4月期间，将60例单侧腹股沟疝患者随机分为两组：eTEP组（30例）和TEP组（30例）。两组均无网片固定。研究已在 http://Clinicaltrials.gov（NCT06070142）上注册。网片上有三个不透射线的夹子。盆腔 X 光片用于评估网片的移位情况。这项研究的主要结果是网片移位。此外，这是文献中第一项比较 eTEP 和 TEP 技术在腹腔镜腹股沟疝无固定情况下网片移位情况的研究：结果：两组在网片移位、复发、术后 VAS 评分、住院时间、血肿和血清肿形成方面无明显差异。eTEP 组的手术时间更长，且有统计学意义：结论：在没有网片固定的情况下，eTEP 技术不会增加网片移位和复发的风险。结论：在没有网片固定的情况下，eTEP 技术不会增加网片移位和复发的风险，可以安全地应用于腹腔镜腹股沟疝修补术中：临床试验编号：NCT06070142：试验注册：临床试验编号：NCT06070142。
期刊介绍：
Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery.
Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.
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