Hernia : the journal of hernias and abdominal wall surgery
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Randomized Controlled Trial Comparative Study
Randomised clinical trial comparing lightweight mesh with heavyweight mesh for inguinal hernioplasty.
The aim of the present randomised clinical study was to compare the incidence of post-operative chronic groin pain and the feeling of a foreign body after inguinal hernioplasty with lightweight (LW) and heavyweight (HW) mesh, as well as to evaluate the patient's quality of life after inguinal hernia repair. ⋯ Our study shows that, compared with HW mesh, LW mesh has some advantages in reducing chronic groin pain at the operation site after inguinal hernioplasty. According to our study, there was no difference in the feeling of a foreign body and in the quality of life between the two study groups.
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An incisional hernia is a frequent complication of abdominal surgery. The repair of incisional hernias comes with a high risk of reherniation and serious complications. With the introduction of mesh repair, recurrence rates have decreased and subsequent clinical outcomes have improved. Whereas further research needs to be done to improve complication rates and recurrence, the focus has now been placed on quality-of-life outcomes in patients undergoing these repairs. The aim of this study was to investigate the long-term health-related quality of life (HRQL) of patients who were treated for incisional hernias using an onlay technique. ⋯ HRQL is the same in patients treated for an incisional hernia compared to the matched controls. Therefore, the onlay technique seems to be an acceptable method to repair large incisional hernias.
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Case Reports
Sciatic hernia: laparoscopic transabdominal extraperitoneal repair with plug and patch.
Sciatic hernia is a rare pelvic floor hernia that occurs through the greater or lesser sciatic foramen. Sciatic hernias often present as pelvic pain, particularly in women, and diagnosis can be difficult. ⋯ We show a laparoscopic technique using a plug of human allogeneic dermal matrix and lightweight polypropylene extraperitoneal patch avoiding fixation. The patient had significant improvement of her symptoms and no complications at 12 months follow-up.
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Randomized Controlled Trial
A method for the reduction of chronic pain after tension-free repair of inguinal hernia: iliohypogastric neurectomy and subcutaneous transposition of the spermatic cord.
We assessed the efficacy of iliohypogastric neurectomy and subcutaneous transposition of the spermatic cord and ilioinguinal and genital nerves on the incidence of postoperative chronic pain (PCP) after open inguinal hernia repair with polypropylene mesh. ⋯ This procedure decreases the incidence of physical activity-induced PCP, without increasing the risks of sensory changes.
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Sportsmen's groin, also known as sportsman's hernia, sports hernia, (athletic) pubalgia or athletic hernia, especially in professional sportsmen, is a difficult clinical problem, and may place an athlete's career at risk. It presents with acute or chronic inguinal pain exacerbated with physical activity. So far, the diagnostic criteria and treatment modalities are inconsistently described and there is no evidence-based consensus available to guide decision-making. ⋯ The Minimal Repair technique is an effective and safe way to treat sportsmen's groin.