Pub Date : 2021-10-01DOI: 10.4103/ijawhs.ijawhs_35_21
José Ortiz Cubero, Marco Soto-Bigot, Marcelo Chaves-Sandí, Armando Méndez-Villalobos, J. Martínez-Hoed
PURPOSE: The aim of this article is to establish which is the best peri- and intraoperative approach for patients with giant inguinoscrotal hernia. METHODS: A systematic review of the literature was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria through a search in PubMed, Scielo, and other resources, from January 2011 to April 2020. Prospective, retrospective, case reports, and clinical series were included. Patients who underwent emergency procedures and studies involving children or pregnant women were excluded. RESULTS: A total of 24 publications related to giant inguinal hernia were identified, which together group a total of 81 patients. The average age of the patients was 62 years. Of the 81 patients, in 10 cases (12%), loss of domain was objectively established. In patients with loss of domain, preoperative pneumoperitoneum (PPP) + botulinum toxin type A (TBA) was used in 80% of the cases. In 10% only NPP was used and in the remaining 10% only TBA was used. Regarding the repair technique, 70% used the anterior route. The most frequent surgery was Lichtenstein’s procedure (38%), followed by Stoppa’s procedure (9%) and transabdominal preperitoneal procedure (9%). The most frequent complication was the development of seromas. The median postoperative follow-up was 15 months. CONCLUSIONS: Inguinoscrotal hernias with loss of domain are rare, and therefore their management is far from being clearly defined. In those cases, where the loss of domain is confirmed, both botulinum toxin and preoperative pneumoperitoneum have been used, without documenting major complications.To repair the defect, the most widely used technique is Lichtenstein’s procedure; however, the possibility of long-term recurrence should be assessed. The retrorectal repair could reduce the risk of recurrence as it is associated with greater mesh overlap.
{"title":"Surgical treatment for inguinoscrotal hernia with loss of dominion with preoperative progressive pneumoperitoneum and botulinum toxin: Case report and systematic review of the literature","authors":"José Ortiz Cubero, Marco Soto-Bigot, Marcelo Chaves-Sandí, Armando Méndez-Villalobos, J. Martínez-Hoed","doi":"10.4103/ijawhs.ijawhs_35_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_35_21","url":null,"abstract":"PURPOSE: The aim of this article is to establish which is the best peri- and intraoperative approach for patients with giant inguinoscrotal hernia. METHODS: A systematic review of the literature was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria through a search in PubMed, Scielo, and other resources, from January 2011 to April 2020. Prospective, retrospective, case reports, and clinical series were included. Patients who underwent emergency procedures and studies involving children or pregnant women were excluded. RESULTS: A total of 24 publications related to giant inguinal hernia were identified, which together group a total of 81 patients. The average age of the patients was 62 years. Of the 81 patients, in 10 cases (12%), loss of domain was objectively established. In patients with loss of domain, preoperative pneumoperitoneum (PPP) + botulinum toxin type A (TBA) was used in 80% of the cases. In 10% only NPP was used and in the remaining 10% only TBA was used. Regarding the repair technique, 70% used the anterior route. The most frequent surgery was Lichtenstein’s procedure (38%), followed by Stoppa’s procedure (9%) and transabdominal preperitoneal procedure (9%). The most frequent complication was the development of seromas. The median postoperative follow-up was 15 months. CONCLUSIONS: Inguinoscrotal hernias with loss of domain are rare, and therefore their management is far from being clearly defined. In those cases, where the loss of domain is confirmed, both botulinum toxin and preoperative pneumoperitoneum have been used, without documenting major complications.To repair the defect, the most widely used technique is Lichtenstein’s procedure; however, the possibility of long-term recurrence should be assessed. The retrorectal repair could reduce the risk of recurrence as it is associated with greater mesh overlap.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"67 1","pages":"156 - 165"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78253255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.4103/ijawhs.ijawhs_25_21
L. Tastaldi, Yota Suzuki, Daniel Galvin, V. Klimberg
Management of incisional hernias in patients with cirrhosis, ascites, or bowel covered only by skin poses a challenge for the reconstructive surgeon. We hypothesized that a completely extraperitoneal repair with coverage of the hernia defect with autologous tissue and onlay mesh reinforcement could be an alternative for a durable repair.
{"title":"De-epitheliazation (DEEP) and fascial closure with onlay mesh repair: An alternative technique for ventral hernia repair: A case report","authors":"L. Tastaldi, Yota Suzuki, Daniel Galvin, V. Klimberg","doi":"10.4103/ijawhs.ijawhs_25_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_25_21","url":null,"abstract":"Management of incisional hernias in patients with cirrhosis, ascites, or bowel covered only by skin poses a challenge for the reconstructive surgeon. We hypothesized that a completely extraperitoneal repair with coverage of the hernia defect with autologous tissue and onlay mesh reinforcement could be an alternative for a durable repair.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"6 1","pages":"231 - 233"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75827587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.4103/ijawhs.ijawhs_32_21
N. Sánchez, Fernando Cetolini, R. Scaravonati, Sebastián Roche, C. Brandi, S. Bertone
BACKGROUND: In recent years, laparoscopic inguinal hernia repair has become one of the elective techniques, attributing the advantages of minimally invasive procedures to it. However, the high costs related to the need for hospitalization and materials make them a limitation at the time of its indication. OBJECTIVE: Evaluate the feasibility of performing this procedure in an outpatient surgery center and the cost analysis of an outpatient procedure regarding the same in the setting of hospitalization. Retrospective cohort study of feasibility and minimization cost. METHODS: A retrospective analysis was carried out on a prospective database in which all patients were included in those who underwent laparoscopic inguinal hernioplasty on an outpatient basis between August 2015 and June 2018. Feasibility is expressed as the percentage of patients who were referred from the outpatient surgery unit. A cost minimization study was conducted taking the average cost of performing an ambulatory procedure versus the same procedure requiring a day of hospitalization. This work has been reported in line with the CHEERS criteria. RESULTS: 116 patients were operated as outpatients, of which 109 were men (93.96%). The median age was 56.5 years (RIQ 19). 102 patients (87.93%) were operated on due to bilateral inguinal hernia, and 14 of them (12.07%) due to recurrent unilateral hernia, adding a total of 218 inguinal hernioplasties. The mean operative time in bilateral interventions was 112 minutes (DS 24) and in the unilateral recurrences it was 79 minutes (DS 13). 114 patients were discharged from the outpatient unit with 98.3% feasibility. The average postoperative stay was 2.53 h (DS 1). The average cost of ambulatory inguinal hernioplasty was $17725.1 vs $27297.3 in hospitalization. The same implies a cost reduction of 35%. CONCLUSIONS: Laparoscopic inguinal hernioplasty is a feasible and safe technique to perform on an outpatient basis. It provides a significant reduction in the costs of the procedure.
背景:近年来，腹腔镜腹股沟疝修补术因其微创手术的优势而成为可选技术之一。然而，与住院和材料需求相关的高昂费用使其在指征时受到限制。目的:评价在门诊手术中心实施该手术的可行性，并分析在住院情况下门诊手术的成本。可行性和最小化成本的回顾性队列研究。方法:对前瞻性数据库进行回顾性分析，该数据库包括2015年8月至2018年6月在门诊基础上接受腹腔镜腹股沟疝成形术的所有患者。可行性表示为从门诊外科单位转诊的患者百分比。进行了一项成本最小化研究，将门诊手术的平均成本与需要住院一天的相同手术的平均成本进行了比较。这项工作的报道符合CHEERS标准。结果:116例患者门诊手术，其中男性109例(93.96%)。中位年龄为56.5岁(RIQ 19)。因双侧腹股沟疝行手术102例(87.93%)，单侧复发疝行手术14例(12.07%)，合计行218例腹股沟疝修补术。双侧干预的平均手术时间为112分钟(DS 24)，单侧复发的平均手术时间为79分钟(DS 13)。114例患者出院，成功率98.3%。术后平均住院时间为2.53 h (DS 1)。门诊腹股沟疝成形术的平均费用为17725.1美元，住院费用为27297.3美元。这意味着成本降低35%。结论:腹腔镜腹股沟疝成形术在门诊是一种可行且安全的技术。它大大降低了手术的成本。
{"title":"Ambulatory laparoscopic inguinal hernioplasty: Feasibility and cost minimization analysis","authors":"N. Sánchez, Fernando Cetolini, R. Scaravonati, Sebastián Roche, C. Brandi, S. Bertone","doi":"10.4103/ijawhs.ijawhs_32_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_32_21","url":null,"abstract":"BACKGROUND: In recent years, laparoscopic inguinal hernia repair has become one of the elective techniques, attributing the advantages of minimally invasive procedures to it. However, the high costs related to the need for hospitalization and materials make them a limitation at the time of its indication. OBJECTIVE: Evaluate the feasibility of performing this procedure in an outpatient surgery center and the cost analysis of an outpatient procedure regarding the same in the setting of hospitalization. Retrospective cohort study of feasibility and minimization cost. METHODS: A retrospective analysis was carried out on a prospective database in which all patients were included in those who underwent laparoscopic inguinal hernioplasty on an outpatient basis between August 2015 and June 2018. Feasibility is expressed as the percentage of patients who were referred from the outpatient surgery unit. A cost minimization study was conducted taking the average cost of performing an ambulatory procedure versus the same procedure requiring a day of hospitalization. This work has been reported in line with the CHEERS criteria. RESULTS: 116 patients were operated as outpatients, of which 109 were men (93.96%). The median age was 56.5 years (RIQ 19). 102 patients (87.93%) were operated on due to bilateral inguinal hernia, and 14 of them (12.07%) due to recurrent unilateral hernia, adding a total of 218 inguinal hernioplasties. The mean operative time in bilateral interventions was 112 minutes (DS 24) and in the unilateral recurrences it was 79 minutes (DS 13). 114 patients were discharged from the outpatient unit with 98.3% feasibility. The average postoperative stay was 2.53 h (DS 1). The average cost of ambulatory inguinal hernioplasty was $17725.1 vs $27297.3 in hospitalization. The same implies a cost reduction of 35%. CONCLUSIONS: Laparoscopic inguinal hernioplasty is a feasible and safe technique to perform on an outpatient basis. It provides a significant reduction in the costs of the procedure.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"34 1","pages":"181 - 187"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89707023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.4103/2589-8736.334555
{"title":"Erratum: Comparing outcomes of the endoscopic and open external oblique myofascial release","authors":"","doi":"10.4103/2589-8736.334555","DOIUrl":"https://doi.org/10.4103/2589-8736.334555","url":null,"abstract":"","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"44 1","pages":"235 - 235"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83593646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.4103/ijawhs.ijawhs_61_21
S. Roll, Luca Giovanni Antonio Pivetta, Renata Lima Konichi, Victor Fujikawa, Pedro Lucarelli Antunes, J. D. de Carvalho, J. Macret, Eduardo Maranhão Dia, M. Francis, H. Ribeiro, Pedro Freitas Amaral, R. Silva
AIM: To report the outcomes of questionnaire assessment about the teaching of the abdominal wall surgery and the incorporation of the techniques taught during the general surgery and digestive tract surgery residency into the individual practice. METHODS: The graduated surgeons and resident doctors from 2014 to 2019 were invited to answer a standardized questionnaire about the abdominal wall surgery teaching program, mastery of specific techniques, and medical practice of each. We performed a chi-square test to evaluate whether the degree of satisfaction correlates to the degree of personal confidence and whether it correlates to performing the procedure in this practice. RESULTS: When assessing the degree of self-confidence to perform specific procedures, all students were confident in performing the Lichtenstein procedure; 22% were confident in transabdominal pre-peritoneal hernioplasty (TAPP); 77% were confident in Rives-Stoppa and anterior separation technique; and 18% were confident in Transversus Abdominis Muscle Release (TAR) technique. The statistical analysis showed a correlation between teaching program satisfaction and the degree of self-confidence only for the TAR procedure (P = 0,06). The analysis also showed a correlation between the degree of self-confidence to perform a specific procedure and its usage on daily practice only for the Rives-Stoppa procedure (P = 0,00). CONCLUSION: These results show the importance of a structured Abdominal Wall Surgery Program, as well as the continuing education evaluation and quality improvement, as the instrument exposed, which to our knowledge, is the first questionnaire to assess the teaching of the abdominal wall and it may be considered a helpful tool.
{"title":"Evaluation of the satisfaction and effectiveness of the learning in abdominal wall surgery in residents of the digestive system surgery at a tertiary public hospital in Brazil","authors":"S. Roll, Luca Giovanni Antonio Pivetta, Renata Lima Konichi, Victor Fujikawa, Pedro Lucarelli Antunes, J. D. de Carvalho, J. Macret, Eduardo Maranhão Dia, M. Francis, H. Ribeiro, Pedro Freitas Amaral, R. Silva","doi":"10.4103/ijawhs.ijawhs_61_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_61_21","url":null,"abstract":"AIM: To report the outcomes of questionnaire assessment about the teaching of the abdominal wall surgery and the incorporation of the techniques taught during the general surgery and digestive tract surgery residency into the individual practice. METHODS: The graduated surgeons and resident doctors from 2014 to 2019 were invited to answer a standardized questionnaire about the abdominal wall surgery teaching program, mastery of specific techniques, and medical practice of each. We performed a chi-square test to evaluate whether the degree of satisfaction correlates to the degree of personal confidence and whether it correlates to performing the procedure in this practice. RESULTS: When assessing the degree of self-confidence to perform specific procedures, all students were confident in performing the Lichtenstein procedure; 22% were confident in transabdominal pre-peritoneal hernioplasty (TAPP); 77% were confident in Rives-Stoppa and anterior separation technique; and 18% were confident in Transversus Abdominis Muscle Release (TAR) technique. The statistical analysis showed a correlation between teaching program satisfaction and the degree of self-confidence only for the TAR procedure (P = 0,06). The analysis also showed a correlation between the degree of self-confidence to perform a specific procedure and its usage on daily practice only for the Rives-Stoppa procedure (P = 0,00). CONCLUSION: These results show the importance of a structured Abdominal Wall Surgery Program, as well as the continuing education evaluation and quality improvement, as the instrument exposed, which to our knowledge, is the first questionnaire to assess the teaching of the abdominal wall and it may be considered a helpful tool.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"2 1","pages":"211 - 217"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82159840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.4103/ijawhs.ijawhs_42_21
Y. Puckett, Beatrice Caballero, Shirley McReynolds, Robyn E. Richmond, C. Ronaghan
PURPOSE: The objective of this study was to demonstrate an alternative option for definitive fascial closure and accelerated wound healing of catastrophic open abdominal wounds utilizing a novel technique combining a mechanical closure system with biologic xenograft. MATERIALS AND METHODS: All patients who underwent abdominal closure with a dynamic wound closure system with biologic xenograft were analyzed between 2016 and 2017. ABRA® dynamic wound closure system was placed and adjusted daily until fascial closure was achieved. ACeLL® urinary porcine bladder matrix was placed in midline of wound once fascial closure was achieved. Information was abstracted on patient demographics and extent of open abdomen (OA) and postoperative outcomes. RESULTS: Fifty patients underwent novel closure of the OA with mean age of 48.3 years with males comprising 72%. The average body mass index was 35.0. Majority (62%) of OAs were secondary to abdominal sepsis. The average myofascial gap prior to closure of abdomen was 19.0 cm, incision length 28.9 cm, and visceral extrusion 7.7 cm. Prior to installation, the abdomen on average had 3.6 laparotomies and was open for 8.6 days. Primary myofascial closure was achieved in 49/50 (98%) patients; 3/50 (8.3%) developed a hernia. Surgical site infection (SSI) occurred in 4/50 (8%). CONCLUSION: We present a novel technique to achieve primary myofascial closure rate in critically ill patients with OA associated with low hernia rate and SSI.
{"title":"Successful closure of the open abdomen utilizing novel technique of dynamic closure system with biologic xenograft","authors":"Y. Puckett, Beatrice Caballero, Shirley McReynolds, Robyn E. Richmond, C. Ronaghan","doi":"10.4103/ijawhs.ijawhs_42_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_42_21","url":null,"abstract":"PURPOSE: The objective of this study was to demonstrate an alternative option for definitive fascial closure and accelerated wound healing of catastrophic open abdominal wounds utilizing a novel technique combining a mechanical closure system with biologic xenograft. MATERIALS AND METHODS: All patients who underwent abdominal closure with a dynamic wound closure system with biologic xenograft were analyzed between 2016 and 2017. ABRA® dynamic wound closure system was placed and adjusted daily until fascial closure was achieved. ACeLL® urinary porcine bladder matrix was placed in midline of wound once fascial closure was achieved. Information was abstracted on patient demographics and extent of open abdomen (OA) and postoperative outcomes. RESULTS: Fifty patients underwent novel closure of the OA with mean age of 48.3 years with males comprising 72%. The average body mass index was 35.0. Majority (62%) of OAs were secondary to abdominal sepsis. The average myofascial gap prior to closure of abdomen was 19.0 cm, incision length 28.9 cm, and visceral extrusion 7.7 cm. Prior to installation, the abdomen on average had 3.6 laparotomies and was open for 8.6 days. Primary myofascial closure was achieved in 49/50 (98%) patients; 3/50 (8.3%) developed a hernia. Surgical site infection (SSI) occurred in 4/50 (8%). CONCLUSION: We present a novel technique to achieve primary myofascial closure rate in critically ill patients with OA associated with low hernia rate and SSI.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"47 1","pages":"195 - 201"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79254725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.4103/2589-8736.334554
{"title":"Erratum: Mesh salvage following deep surgical site infection","authors":"","doi":"10.4103/2589-8736.334554","DOIUrl":"https://doi.org/10.4103/2589-8736.334554","url":null,"abstract":"","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"100 1","pages":"234 - 234"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89278861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.4103/ijawhs.ijawhs_85_21
R. Bittner, E. Felix
Those who do not know the past cannot understand the present and cannot shape the future. (Helmut Kohl, Chancellor of Germany 1982–1998). INTRODUCTION: Historical development of open and laparoendoscopic inguinal hernia repair is presented. Advantages and disadvantages of currently used techniques as well as problems related to the implementation of the minimal invasive techniques in daily surgical work are discussed. MATERIALS AND METHODS: Intensive study of the literature and our own personal experience with the performance of transabdominal preperitoneal patch plasty (TAPP) and totally extraperitoneal patch plasty (TEP) were used. Systematic descriptions of the TAPP and TEP techniques to achieve the best results are summarized. The penetration rate of the laparoendoscopic techniques worldwide is reviewed. RESULTS: Laparoendoscopic inguinal hernia repair is superior to open surgery with respect to all pain-associated parameters. Profound knowledge of the anatomy of the groin, of the pathophysiology of hernia development as well as of the working mechanisms of the surgical techniques are described as being the key features for successful treatment. The worldwide penetration rate of TAPP/TEP is dependent on the respective country and varies between 1% and 80%. The main reasons for these striking differences are the preference of individual surgeons, available resources of the specific national health care systems, differences in training facilities, and even differences in insurance coverage. New imaging systems as well as robot-assisted techniques are still need to be evaluated sufficiently for final recommendations. CONCLUSION: TAPP and TEP are well-established techniques of minimally invasive repair of inguinal hernias. Both techniques are safe, reliable, and cost-effective. Despite some meaningful advantages in comparison to open surgery, the penetration rate in most of the countries, however, remains low. Improvement of training techniques and facilities is urgently needed. Robot-assisted techniques and the use of simulators may be the promoter of laparoscopic inguinal hernia repair in the future.
{"title":"History of inguinal hernia repair, laparoendoscopic techniques, implementation in surgical praxis, and future perspectives: Considerations of two pioneers","authors":"R. Bittner, E. Felix","doi":"10.4103/ijawhs.ijawhs_85_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_85_21","url":null,"abstract":"Those who do not know the past cannot understand the present and cannot shape the future. (Helmut Kohl, Chancellor of Germany 1982–1998). INTRODUCTION: Historical development of open and laparoendoscopic inguinal hernia repair is presented. Advantages and disadvantages of currently used techniques as well as problems related to the implementation of the minimal invasive techniques in daily surgical work are discussed. MATERIALS AND METHODS: Intensive study of the literature and our own personal experience with the performance of transabdominal preperitoneal patch plasty (TAPP) and totally extraperitoneal patch plasty (TEP) were used. Systematic descriptions of the TAPP and TEP techniques to achieve the best results are summarized. The penetration rate of the laparoendoscopic techniques worldwide is reviewed. RESULTS: Laparoendoscopic inguinal hernia repair is superior to open surgery with respect to all pain-associated parameters. Profound knowledge of the anatomy of the groin, of the pathophysiology of hernia development as well as of the working mechanisms of the surgical techniques are described as being the key features for successful treatment. The worldwide penetration rate of TAPP/TEP is dependent on the respective country and varies between 1% and 80%. The main reasons for these striking differences are the preference of individual surgeons, available resources of the specific national health care systems, differences in training facilities, and even differences in insurance coverage. New imaging systems as well as robot-assisted techniques are still need to be evaluated sufficiently for final recommendations. CONCLUSION: TAPP and TEP are well-established techniques of minimally invasive repair of inguinal hernias. Both techniques are safe, reliable, and cost-effective. Despite some meaningful advantages in comparison to open surgery, the penetration rate in most of the countries, however, remains low. Improvement of training techniques and facilities is urgently needed. Robot-assisted techniques and the use of simulators may be the promoter of laparoscopic inguinal hernia repair in the future.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"13 1","pages":"133 - 155"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87717046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.4103/ijawhs.ijawhs_22_21
V. Dharmaratnam, Z. Lee, Jeremy Tian Hui Tan, Tiffany Ying Lye
A primary femorocele is an uncommon pathology wherein fluid accumulates within the sac of a femoral hernia due to occlusion of communication with the peritoneal cavity and in the absence of ascites. Here, we report the case of a primary femorocele in a 45-year-old female patient who presented to our hospital with right groin swelling. The diagnosis of a primary femorocele was only made on surgical exploration, which deferred from the initial preoperative diagnosis made using ultrasonography. Surgical excision and repair were undertaken with the use of a mesh plug.
{"title":"Diagnostic challenges and operative considerations of a primary femorocele: Case report","authors":"V. Dharmaratnam, Z. Lee, Jeremy Tian Hui Tan, Tiffany Ying Lye","doi":"10.4103/ijawhs.ijawhs_22_21","DOIUrl":"https://doi.org/10.4103/ijawhs.ijawhs_22_21","url":null,"abstract":"A primary femorocele is an uncommon pathology wherein fluid accumulates within the sac of a femoral hernia due to occlusion of communication with the peritoneal cavity and in the absence of ascites. Here, we report the case of a primary femorocele in a 45-year-old female patient who presented to our hospital with right groin swelling. The diagnosis of a primary femorocele was only made on surgical exploration, which deferred from the initial preoperative diagnosis made using ultrasonography. Surgical excision and repair were undertaken with the use of a mesh plug.","PeriodicalId":34200,"journal":{"name":"International Journal of Abdominal Wall and Hernia Surgery","volume":"2 1","pages":"224 - 227"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74699955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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