totally extraperitoneal endoscopic inguinal hernia repair using mini instruments: pushing the boundaries of minimally invasive hernia surgery

نویسندگان

marcelo de paula loureiro minimally invasive surgery of jacques perissat institute, positivo university, curitiba, brazil; rua angelo bom 315, p.o. box: 81210340, curitiba, brazil. tel: +5541-91989610, fax: +5541-32596799

pedro trauczynski minimally invasive surgery of jacques perissat institute, positivo university, curitiba, brazil

christiano claus minimally invasive surgery of jacques perissat institute, positivo university, curitiba, brazil

gustavo carvalho minimally invasive surgery of jacques perissat institute, positivo university, curitiba, brazil; federal university of pernambuco, recife, brazil

چکیده

background inguinal hernia is the most prevalent surgical disease in clinical practice. endoscopic inguinal hernia repair has been shown to be slightly superior to open approaches. recent modifications in the minilaparoscopic technique may improve the totally extraperitoneal repair (tep) results. objectives we have performed a prospective study to analyze the feasibility of laparoscopic inguinal hernia repair using mini instruments. main measured outcomes included postoperative pain, return to work activities and aesthetics. technical aspects, including operative time and intraoperative and postoperative complications were also analyzed. patients and methods from october, 2009 to may, 2011 consecutive patients undergoing tep inguinal hernia repair using mini-instruments were included in the study protocol. exclusion criteria was the same as for standard laparoscopic hernia repair. in all cases, a standardized laparoscopic technique using mini instruments was performed. a study protocol was applied prospectively for data collection, including operative time, hospital stay, need for pain medication, return to work and, patient’s aesthetic evaluation of the scars. results were expressed in mean ± sd. results sixty consecutive patients diagnosed with inguinal hernia underwent tep inguinal hernia repair using mini instruments. of these, 53 were men and seven were women. the mean age was 50 ± 32 years. in eight cases, the hernias were recurrent and ten were bilateral. a total of 70 hernias were treated. the average operative time was ± 35 min. the mean hospital stay was 18 ± 6 hours. analgesia was necessary for more than 2 days in 8 patients (13.3 %). there was one conversion to open surgery. sixteen of the male workers (37 %) had to take 1 week off work. in total, 58 (96 %) of the patients considered the aesthetic outcome to be excellent. patients were followed for 30 days. no recurrences were noted in this period. conclusions totally extraperitoneal endoscopic inguinal hernia repair using mini instruments is feasible, and applicable to routine surgical practice with good short-term clinical and aesthetic results. further comparative studies with standard laparoscopic extraperitoneal and open hernia repair are needed to access its long term results.

برای دانلود باید عضویت طلایی داشته باشید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Learning curve for laparoscopic totally extraperitoneal repair of inguinal hernia.

BACKGROUND Laparoscopic totally extraperitoneal (TEP) repair has been accepted as a popular procedure for inguinal hernia repair, but surgeons still encounter technical difficulties owing to unfamiliar pelvic anatomy and limited working space. We sought to estimate the learning curve for laparoscopic TEP repair without supervision. METHODS We retrospectively analyzed the medical records of pa...

متن کامل

Intestinal Obstruction After Totally Extraperitoneal Laparoscopic Inguinal Hernia Repair

Laparoscopic hernia repair is a frequently performed operation. Although it has many advantages over open inguinal hernia repair, laparoscopic surgery is not without complications. Small bowel obstruction is a complication unique to laparoscopic repair of inguinal hernias. It is reported following transabdominal preperitoneal repairs. We present a case of small bowel incarceration through a per...

متن کامل

Single incision approach to totally extraperitoneal inguinal hernia repair

INTRODUCTION Nowadays the vast majority of inguinal hernia repairs are laparoscopically assisted. Single incision laparoscopy aims to accelerate recovery and provide a better cosmetic outcome after the operation. AIM To present our own modification of the totally extraperitoneal (TEP) procedure with a single incision and without a multiport, and compare the results with those obtained in the ...

متن کامل

Initial experience of single port laparoscopic totally extraperitoneal hernia repair: nearly-scarless inguinal hernia repair

PURPOSE In the early 1990's laparoscopic hernioplasty gained popularity worldwide. Thereafter, laparoscopic surgeons have attempted to improve cosmesis using single port surgery. This study aims to introduce and assess the safety and feasibility of single port laparoscopic total extraperitoneal (TEP) hernia repair with a nearly-scarless umbilical incision. METHODS Sixty three single port lapa...

متن کامل

Laparoscopic Extraperitoneal Repair of Amyand's Inguinal Hernia

Amyand's hernia (appendix in the sac of an inguinal hernia) although rare is a fairly well-recognized clinical entity. It is associated with an increased risk of developing appendicitis. Amyand's hernia can be repaired by open or laparoscopic methods. We present the case of a laparoscopic extraperitoneal repair with a potential hazard when repairing this type of hernia in this manner, and we re...

متن کامل

First case of single incision laparoscopic surgery for totally extraperitoneal inguinal hernia repair.

Laparoscopic approach to inguinal hernia repair is indicated for recurrent and bilateral hernias or as patient choice in unilateral primary hernias. Totally extraperitoneal (TEP) approach has some advantages over transabdominal preperitoneal (TAPP) approach, but has proved to be more technically demanding. It cannot be emphasized enough that every incision and trocar placement poses a risk of b...

متن کامل

منابع من

با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید


عنوان ژورنال:
journal of minimally invasive surgical sciences

جلد ۲، شماره ۳، صفحات ۸-۱۲

کلمات کلیدی

میزبانی شده توسط پلتفرم ابری doprax.com

copyright © 2015-2023