Complications in groin hernia surgery and the way out

Surgical Endoscopy, 2013

Scandinavian Journal of Surgery

Background: A contralateral occult inguinal hernia is frequently observed in patients planned for a unilateral laparoscopic inguinal hernia repair. Surgical strategy for contralateral groin management in patients scheduled for an endo-laparoscopic unilateral inguinal hernia repair is controversial and based on questionable evidence. This study aimed to gather international opinion concerning the surgical strategy for the contralateral asymptomatic side when no hernia or lipoma is clinically evident at the preoperative examination or anamnesis. Methods: An international Internet-based questionnaire was sent to all the members of the European Hernia Society, the Americas Hernia Society, and the Asia Pacific Hernia Society. The clinical scenario for responders was a patient with a unilateral symptomatic inguinal hernia planned for endo-laparoscopic repair with no preoperative symptoms/lump on the contralateral side. Results: A total of 640 surgeons replied (response rate = 26%), of who...

Hernia repair is a frequent elective surgical operation. Unsatisfactory results in some cases have led to the persistence of a variety of different operative methods. Our study aimed to determine the frequency of postoperative complications with different surgery methods and evaluate the correlation of complications with patient characteristics and health. Materials and methods: We examined 403 patients with an inguinal hernia who underwent hernioplasty, including 98 by the method of Liechtenstein, 74 by the method of Gvenetadze, 231 by the laparoscopic method. Patients were aged 18-80 years with a mean age of 56.914.6 years. Statistical analysis was performed using SPSS 22. Results: The frequency of total perioperative complications of surgery was 52 (53.06 %), according to the method of Lichtenstein, 13 (17.57%) according to the method of Gvenetadze, and 23 (9.96 %) according to laparoscopic surgery. The following postoperative complications were observed: damage to the colon, bleeding from the lower epigastric vessels, urinary retention, neuralgia, hematomas, and delayed postoperative wound healing, higher in patients undergoing Lichtenstein surgery (p <0.05). The Liechtenstein method significantly increases the likelihood of complications; odds ratio OR=8.23 (95% CI: 4.87-13.94), with the Gvenetadze method, the relative chance decreases insignificantly OR=0.722 (95% CI: 0.30-1.39), with the laparoscopic method, the relative chance of complications are significantly reduced OR=0.20 (95% CI: 0.12- 0.34). Conclusions: The odds ratio of postoperative complications of hernioplasty increases with the Liechtenstein method and decreases with laparoscopy. A comparison of the open methods of hernioplasty shows an advantage of the Gvenetadze method over the Liechtenstein method.

Surgical Endoscopy, 1994

Although the laparoscopic technique is a new approach to groin hernia, it is becoming more widely accepted as an alternative to traditional open techniques. This study is a preliminary review of complications and recurrences. A questionnaire specific for complications was sent to each investigator. From 12/89 to 4/93, 1,514 hernias were repaired; 119 (7.8%) were bilateral and 192 (12.7%) recurrent. There were 860 indirect, 560 direct, 43 pantaloon, 37 femoral, and 6 obturator hernias, and 8 were not specified; 553 were repaired using a transabdominal preperitoneal mesh technique (TAPP), 457 with a total extraperitoneal technique (TEP), 320 with intraperitoneal onlay mesh (IPOM), 102 by ring closure, and 82 involved plug and patch technique. Eighteen intraoperative and 188 postoperative complications were seen. The total complication rate was 13.6%, of which 1.2% were intraoperative. Of the intraoperative complications, 12 were related to the laparoscopic technique, three were related to the hernia repair, and one was related to anesthesia. The rate of conversion to open was 0.8%. Of the postoperative complications, there were 95 local, 25 neurologic, 23 testicular, 23 urinary, 10 mesh, and 12 miscellaneous. There were 34 recurrences after the 1,514 hernia repairs (2.2%). The follow-up was reported in 828 patients for an average of 13 months. The recurrence rate varied drastically with the technique: A 22% recur-Presented at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES),

Birat Journal of Health Sciences

Introduction: Groin hernias are common problem worldwide with approximate incidence of 5%. Indirect inguinal hernia is the commonest hernia irrespective of gender. The prevalence as well as complication of inguinal hernia will increase with increasing age. Strangulation, the most common serious complication of inguinal hernia occurs in 1 to 3 % of the patients. Outcome of the treatment depends on the duration of presentation, co-morbidities and extent of the surgery.Objective: The objectives were to study the different clinical presentation, surgical options and outcome of complicated groin hernia in tertiary care centre.Methodology: This retrospective review of case sheet was conducted in the department of surgery. We reviewed the record file of complicated groin hernia patients, irrespective of age and gender from January 2008 to December 2016 (8 years). Ethical Clearance was obtained from institutional review committee. Statistical analysis was performed using SPSS for windows, v...

Asian Journal of Endoscopic Surgery, 2017

Open anterior repair for inguinal hernia offers several distinct advantages over endoscopic repair, especially when real-world effectiveness is taken into account. The learning curve for endoscopic techniques is long, whereas the Lichtenstein and other open tension-free techniques are easier to teach and replicate at all levels. The outcomes of Lichtenstein repairs for primary inguinal hernia as performed by non-experts and supervised residents are comparable to those of experts. Moreover, open tension-free repair does not require expensive instruments or dedicated equipment, other than the prosthetic mesh. As such, it is feasible in any operating room anywhere in the world with limited costs. In our opinion, the most important advantage offered by open tension-free repair is that it can be performed under local anesthesia. Nevertheless, local anesthesia has some disadvantages: it requires training, excellent knowledge of the anatomy and the necessary technique, patience, and gentle handling of the tissues. Open inguinal hernia repair is a procedure that every surgeon should know and be able to perform because it is necessary to treat two conditions, groin hernia recurrence after a posterior approach (both laparoscopic and open) and pubic inguinal pain syndrome.

The Professional Medical Journal, 2006

Objective: To know the results of two commonly employed surgical proceduresi.e., Darning and used of Mesh for inguinal hernia repair in adults, considering the cost effectiveness and bettercompliance. Design: Case descriptive study. Place and duration of study: Combined Military Hospital, Chunian - DisttKasur, from November 2004 to April 2006. Patients and Methods: Sixty adult males with the mean age of 48 yearshad inguinal hernia repair. Only two surgical procedure adopted. Group I includes 10 patients (16.3%) who hadprosthetic Mesh repair. Operative time and hospital stay was almost same in both groups. Results: Out of 60 cases,38 patients (63%) had right sided, 19(32%) had left sided and 03(05%) had bilateral inguinal hernia. 42(70%) hadindirect hernia, 17(28.3%) had direct hernia and only 01 patient (1.7%) had both types of hernia. In group-1, 04 patients(8%) had postoperative discomfort in the groin, 02 patients (4%) had scrotal haematoma and 01 patient (2%) hadsuperficial woun...

JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons

Since the advent of laparoscopic inguinal hernia repair, the procedure has invited numerous controversies, and although the procedure has some definitive advantages, no definitive indications for its use have been formulated. The objective of this study was to investigate a novel method for inguinal hernia repair (through a small 2 cm to 2.5 cm) single skin incision that combines the time-tested fundamentals of Lichtenstein&#39;s tension-free repair with the advantages of laparoscopic assistance. The study was conducted as a randomized, controlled trial over a 1-year period and included 50 patients. Only patients with simple reducible hernias without associated comorbid conditions were included. The patients were randomized into 2 groups of 25 patients each. One group underwent conventional tension-free meshplasty, while the other group underwent the repair through a single 2-cm to 2.5-cm skin incision with laparoscopic assistance. This repair was carried out with the help of an ind...

British Journal of Surgery, 1995

A novel tension-free prosthetic mesh repair for an 1994, 22 primary unilateral hernia, and two bilateral inguinal hernia is described. This is performed through a repairs were undertaken. The mean (range) age was 47 2-cm groin incision and the inguinal canal is traversed (35-64) years in 23 men and one woman. The mean with the aid of a 5-mm videoendoscope. Spermatic cord (range) operative time was 42 (35-58) min. All patients mobilization, identification and excision of the indirect left hospital on the day after surgery. One patient sac, and posterior wall repair are carried out under developed a scrotal swelling that required a scrotal endoscopic guidance. Between October 1993 and January support.

European Journal of Medical and Health Sciences

Inguinal hernia is a frequent pathology affecting mainly men, and is defined by the emergence of abdominal viscera through an area of natural weakness in the abdominal wall formed by the inguinal region. They include congenital hernias, which arise from the lack of obliteration of the peritoneovaginal canal, and acquired hernias, which are related to the weakening of the muscular and fascial structures of the inguinal region. In view of its extremely serious evolutionary risk, the treatment of inguinal hernia is exclusively surgical and almost systematic. The real challenge in the treatment of groin hernia is the use of the most suitable surgical repair technique. Our work is a retrospective comparative study of 100 patients operated on for inguinal hernia, 50% of whom were operated on using the Shouldice technique and 50% using the Lichtenstein technique in the visceral surgery department (Wing 3) of the CHU IBN ROCHD OF CASABLANCA over a period of 2 years from 1 January 2005 to 31...