Hernia : the journal of hernias and abdominal wall surgery
-
Clinical Trial
The Endoloop technique for the primary closure of direct inguinal hernia defect during the endoscopic totally extraperitoneal approach.
Seroma is a frequent complication of endoscopic totally extraperitoneal (TEP) mesh repair of direct inguinal hernia that may cause discomfort and anxiety. Its volume is proportional to the size of the preperitoneal dead space created after the reduction of the hernia. Attempts to reduce its incidence have included tacking the transversalis fascia (TF) to the pubic ramus or closed suction drainage of the preperitoneal space. Both of these techniques are not without problems. The aim of this study was to evaluate the efficiency of a new alternate technique that must be safe and easily reproducible, using a widely available and inexpensive pre-tied suture loop (Endoloop(®) Ligature) for plication of the weakened TF. ⋯ The primary closure of direct inguinal hernia defects with a pre-tied suture loop during endoscopic TEP repair is safe, efficient, and very reliable for the prevention of post-operative seroma formation, without increasing the risk of developing chronic groin pain or hernia recurrence. This technique should be the preferred method over stapling of the TF or the insertion of a closed suction drainage device in such a situation.
-
The value of computed tomography (CT) for the diagnosis of clinically occult (hidden) groin hernia was assessed in a series of patients presenting with undiagnosed groin pain. ⋯ This prospective non-contrast CT study of patients with undiagnosed chronic groin pain detected the majority of occult hernias requiring surgical intervention. These results suggest that CT can be a useful adjunct to the evaluation of patients presenting with chronic undiagnosed groin pain, but that experienced clinical judgment remains a critical element in the diagnostic pathway.
-
Randomized Controlled Trial Multicenter Study Comparative Study
Randomized controlled multicenter international clinical trial of self-gripping Parietex™ ProGrip™ polyester mesh versus lightweight polypropylene mesh in open inguinal hernia repair: interim results at 3 months.
To compare clinical outcomes following sutureless Parietex™ ProGrip™ mesh repair to traditional Lichtenstein repair with lightweight polypropylene mesh secured with sutures. ⋯ Surgery duration, early postoperative, pain and infection rates were significantly reduced with self-gripping polyester mesh compared to Lichtenstein repair with polypropylene mesh. The use of fixation increased postoperative pain in the P group. The absence of early recurrence highlights the gripping efficiency effect.
-
Randomized Controlled Trial Comparative Study
Lichtenstein, prolene hernia system, and UltraPro Hernia System for primary inguinal hernia repair: one-year outcome of a prospective randomized controlled trial.
The optimal technique for open inguinal hernia repair is yet to be determined. ⋯ The Lichtenstein technique, PHS, and UHS seem all acceptable approaches for open inguinal hernia repair in local anesthesia and day-care surgery regarding perioperative course, rehabilitation, complications, recurrence rates, development of chronic groin pain, and improvement in quality of life after 12 months. However, due to reduced costs and lack of need for the exploration of the preperitoneal space, the Lichtenstein technique should be recommended as first choice.
-
Randomized Controlled Trial Comparative Study
Sutureless hernioplasty with light-weight mesh and fibrin glue versus Lichtenstein procedure: a comparison of outcomes focusing on chronic postoperative pain.
Groin hernia is one of the most common disease requiring surgical intervention (8-10% of the male population). Nowadays, the application of prosthetic materials (mesh) is the technique most widely used in hernia repair. Although they are simple and rapid to perform, and lower the risk of recurrence, these techniques may lead to complications. The aim of the present study is to assess the incidence and degree of chronic pain, as well as the impairment in daily life, in two procedures: (1) the "Lichtenstein technique" with polypropylene mesh fixed with non-absorbable suture, and (2) the "sutureless" technique carried out by using a partially absorbable mesh (light-weight mesh) fastened with fibrin glue. ⋯ Our experience shows that the combined use of light-weight mesh and fibrin glue gives significantly better results in terms of postoperative pain and return to daily life.