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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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.
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The repair of hernias through iliac crest defects is challenging secondary to the inherent weakness of the abdominal musculature and the rigidity of the pelvis. The defect is surrounded by inadequate tissue to properly buttress the repair. Full-thickness tricortical bone harvested from the iliac may result in an incisional hernia through the bony defect. ⋯ There were no infectious or neurologic complications, and neither patient has recurred. The laparoscopic approach to the repair of hernias resulting from tricortical iliac crest bone harvest is safe and may be preferable to open repair. Advantages include durable repair, better interoperative visualization, and reduced post-operative pain, morbidity, and hospital stay.
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Ambulatory hernia surgery under local anesthesia is becoming more widely used worldwide. Although many reports include obese patients, there are no studies that report specifically on the feasibility and safety of ambulatory hernia surgery in this category of patients. This paper documents our experience in this respect. ⋯ We conclude that ambulatory abdominal wall hernia repair under local anesthesia is feasible in obese patients. Because of the increased length of surgery in these patients, monitored sedation and prophylactic antibiotic cover should be used. The slight decrease in patient satisfaction is balanced by the lower risks and higher costs associated with full general anesthetic.