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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of the study was to evaluate the safety and efficacy of two techniques of laparoscopic hernia repair: the transabdominal preperitoneal technique (TAPP) and the intraperitoneal onlay mesh technique (IPOM). In May 1992 a prospective randomized trial was initiated to compare TAPP and IPOM. Until October 1994, 115 patients with 148 hernias took part in the trial (59 TAPP and 56 IPOM). The TAPP took significantly longer than did the IPOM. There were no intraoperative complications, conversions to open repair, or postoperative deaths in either group. There were 10 (16.9% of patients) postoperative complications in the TAPP group and 14 (25%) in the IPOM group. The difference was not statistically significant. Neuralgias occurred in 3 cases of TAPP and 11 cases of IPOM (p < 0.05), local hematoma in 6 cases of TAPP and 3 cases of IPOM (NS), and urinary retention in 1 case of TAPP and in no case of IPOM (NS). Recurrences occurred in no cases of TAPP and in 8 cases (11.1% of hernias) of IPOM (p < 0.01). The results of the present report suggest that the IPOM technique for laparoscopic hernia repair should be avoided, whereas TAPP appears to be an excellent technique with no early recurrences.
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PMID:Laparoscopic hernia repair: a prospective comparison of TAPP and IPOM techniques. 943 29

Late results of TAPP have been assessed in a group of 79 patients operated for inguinal hernia- in the years 1994-1996. Altogether 87 TAPP were performed in this group (8 bilateral herniorrhaphies) all of them classified according to ASA scale from I degree-III degree. Following Schumpelick hernia classification there were: M = 41, L = 35, F = 11, I degree = 31, II degree = 27, III degree = 21. 31 hernias were recurrent and 11 were irreducible. The patients have been followed up for at least 1 year (on average 16 months). TAPP was lasting in this group of patients from 40-120 min (on average 70 min) including bilateral repairs. There was 1 intraoperative bleeding which had been the cause of conversion to the open operation. No wound infection was noticed. Postoperative inguinal hematoma which resolved spontaneously was noticed in 4 cases. The patients left hospital the day after TAPP. 2 recurrences were noticed so far (2.3%), 3 patients complained of transient inguinal neuralgia. Late results of TAPP in the rest of the patients have been very good.
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PMID:[Late results of laparoscopic surgery for inguinal hernia (TAPP)]. 944 94

Laparoscopic hernia repair has evolved considerably since its introduction. Different methods have been described, and multiple studies have been performed reporting widely varying outcomes. This study was undertaken to review all the major publications on laparoscopic herniorrhaphy from 1993 to 1996 and evaluate the rates of recurrence and complications involved in the various techniques. In a total of 11,222 laparoscopic hernia repairs, the procedure performed most frequently was the transabdominal preperitoneal patch (TAPP), followed by the total extraperitoneal patch (TEP). There were 300 (2.7%) recurrences. From 9,955 hernia repairs, there were 1,534 (15.4%) complications. Hematoma/seroma (456), neuralgia (199), urinary retention (150), and chronic pain (39) were the most frequently reported complications. Laparoscopic herniorrhaphy is a higher effective method of hernia repair with results comparable with the open technique. TAPP is still the most widely performed technique. TEP is becoming more popular, mainly because of its excellent outcome. The major drawback of TEP is the difficulty of reproducibility by different general surgeons with comparable results. Other techniques such as plug and patch carry a high rate of recurrence and complications and should probably be completely abandoned.
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PMID:Laparoscopic herniorrhaphy: review of complications and recurrence. 953

Totally extraperitoneal laparoscopic hernia repair is an efficient but technically demanding procedure. As mechanisms of hernia recurrence may be related to these technical difficulties, we have modified a previously described double-mesh technique in an effort to simplify the procedure. Extraperitoneal laparoscopic hernia repairs were performed in 82 male and 17 female patients having inguinal, femoral, and recurrent bilateral hernias. A standard propylene mesh measuring 15 x 15 cm was cut into two pieces of 4 x 15 cm and 11 x 15 cm. The smaller mesh was placed over both inguinal rings without splitting. The larger mesh was then inserted over the first mesh and stapled to low-risk zones, reinforcing the large-vessel area and the nerve transition zone. The mean procedure duration was 60 minutes for unilateral and 100 minutes for bilateral hernia repair. Patients were discharged from the hospital within 48 hours. The mean postoperative follow-up was 22 months, with no recurrences, neuralgia, or bleeding complications. Over a 2-year period, this technique was found to be satisfactory without recurrences or significant complications. In our hands, this technique was easier to perform: it allows for a less than perfect positioning of the meshes and avoids most of the stapling to crucial zones.
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PMID:Laparoscopic inguinal hernia repair with extraperitoneal double-mesh technique. 1063 9

The authors report on their 8-year experience with inguinal prosthetic repair. Their personal experience includes 1000 hernioplasties, 639 of which performed using the "plug and patch" technique. The postoperative morbidity was 2.7% and patients were unsatisfied only in 1.8% of cases (self-evaluation test). Follow-up was carried out by means of phone enquiries supplemented by a clinical examination in selected cases and in a control group of asymptomatic patients. 85.4% of the study population and 94.8% of patients operated on in the last 38 months were contacted by phone. The recurrence rate after "plug and patch" repair was statistically adjusted according to the maximal bias test, taking into account the percentage of patients lost to follow-up. Other late complications were severe neuralgia (0.9%) and rejection of the prosthesis (0.1%). Migration of the plug was never observed. The authors confirm that the aims of inguinal hernia surgery (significant reduction of recurrences and minimal discomfort for the patient) can be best achieved in suitable facilities (hernia centres) by a dedicated team of experienced professionals.
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PMID:[1,000 prosthetic hernia repairs: experience of a dedicated team]. 1093 73

The authors describe a 6-year experience with mesh repair of inguinal and femoral hernia in a surgical teaching department. Two hundred and ninety-seven hernioplasties were performed in 256 consecutive patients: 237 Trabucco sutureless and 11 Lichtenstein tension-free hernioplasties for inguinal hernia; 21 tension-free hernioplasties for femoral hernia; 20 Wantz GPRVS and 8 Rutkow tension-free hernioplaties for recurrences. Local anaesthesia was used in 59% of cases. Seventy-two patients (28.1%) refused this type of anaesthesia. The hospital stay was two days in all cases. The local postoperative morbidity rate was 8.7% (wound infections: 1.0%; neuralgia: 1.3%; haematomas: 2.0%; seromas: 2.3%; no testicular atrophies). The recurrence rate was 1.9% in the group of patients undergoing surgery from 1994 to 1997 (103 herniorrhaphies; follow-up: 3-6 years) and 0% in the group of patients operated on after 1997 (170 herniorrhaphies; follow-up: 2 years-6 months). The results confirm that the use of a prosthetic mesh (patch and plug) is the treatment of choice for hernia repair. Moreover, this experience in a surgical teaching department shows that these procedures can be safely and effectively performed by all surgeons.
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PMID:[Mesh repair of inguinal and femoral hernia]. 1119 May 53

To emphasize the importance of the experience of the operating team, we compared the two largest materials in the total extraperitoneal (TEP) and the transabdominal preperitoneal (TAPP) procedures in Poland. We performed 1225 procedures on 1110 patients (368 TEP and 809 TAPP). The experience of the operating teams measured by the mean number of procedures/surgeon was comparable. The mean operating time and hospitalization duration did not differ markedly. There was no procedure-related mortality. Intraoperative complications were infrequent. The ratio of early local complication (neuralgia, hematoma, and seroma) was slightly higher in the TEP group. We observed a higher recurrence rate following the TAPP procedure (2.84% vs 1.92%). However, after excluding the learning period this dropped markedly to much lower, comparable values (TEP: 0.98%; TAPP: 1.14%). In laparoscopic hernia repair the experience of the operating team seems to be more important than choice of technique (TEP vs TAPP).
Hernia 2001 Jun
PMID:Experience--the key factor in successful laparoscopic total extraperitoneal and transabdominal preperitoneal hernia repair. 1150 53

Two cases of strangulated obturator hernia were presented. Both cases were diagnosed during surgical intervention. In one case the postoperative recovery was not successful--mostly because of delay in referring to the surgeon. Described cases confirm diagnostic difficulties associated with this rare type of hernia. The attention should be paid to association of obstructive symptoms with obturator neuralgia and/or painful mass in rectal examination.
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PMID:[Two cases of strangulated obturator hernia]. 1290 Dec 75

Direct surgical repair of instabilities of the anterior spinal column has gained in importance. New techniques and instruments have led to better operative results. Inspite of the growing number of interventions at the anterior spinal column only little data is available on the typical intra- and postoperative complications of these anterior approaches Between 4/1998 and 8/2002, 85 patients in two neurosurgical centres were treated using an anterolateral transthoracic approach for various lesions of the thoracic and thoracolumbar spine. We used a minithoracotomy with video-endoscopic guidance in 75 of these patients. Intra- and postoperative complications were evaluated retrospectively. Two operations had to be abandoned, in all other cases surgery was performed as planned. Postoperatively, eleven patients complained of temporary intercostal neuralgia (12.9%), two patients (2.3%) had a pulmonary insufficiency which was treated conservatively, another patient needed drainage of a pleural effusion. One intraoperative injury to the thoracic duct was treated conservatively, one hernia of the abdominal wall had to be corrected surgically. Relevant injuries to the vessels did not occur, blood loss was 520 ml on average. There was no surgical mortality; one revision surgery had to be performed because of bone graft dislocation. The rate of severe approach-related complications was 4/85 = 4.7% (two abandoned procedures, one injury to the thoracic duct, one abdominal hernia). Transthoracic anterolateral stabilisation via a minithoracotomy with video-endoscopic guidance is an effective surgical approach to treat instabilities of the anterior parts of the thoracic spine and the thoracolumbar area with low complication rates.
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PMID:Approach-related complications of transthoracic spinal reconstruction procedures. 1498 69

Pain after open mesh repair of groin hernia has a multifactorial etiology. Suturing technique for anchoring the mesh is important. Sutures placed too tightly, a common practice, are often the site of pain and point tenderness. These "pain points" are often precisely felt by patients and may vary in their intensity and duration. We believe that this type of suturing-technique-related pain can be significantly reduced by an "air-knotting" technique described below. The mesh was anchored with sutures tied in a subtle air-knot. In the event of accidentally incorporating a nerve in the knot, an air knot is less likely to cause the distressing symptoms of entrapment neuralgia. All knots are tied above the mesh and not across the edge of the mesh. Using this technique, we believe a significant reduction in the sharp, well-localized point pain can be achieved.
Hernia 2004 Dec
PMID:Reducing the pain of open groin hernia repair. 1523 38


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