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Erschienen in: Hernia 1/2008

01.02.2008 | Original Article

Total extra-peritoneal repair of groin hernia: prospective evaluation at a tertiary care center

verfasst von: M. C. Misra, V. K. Bansal, S. Kumar, B. Prashant, H. K. Bhattacharjee

Erschienen in: Hernia | Ausgabe 1/2008

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Abstract

Background

The laparoscopic repair of groin hernia is increasingly being used. However, the relative merits and demerits of laparoscopic repair are debatable. The present study was undertaken to evaluate the total extra-peritoneal (TEP) repair of groin hernia.

Methods

This prospective study was undertaken at a single surgical unit between January 2004 and June 2006. Consecutive patients with elective groin hernias were offered laparoscopic TEP repair. Indigenous balloon or telescopic dissection was used to create extra-peritoneal space. Polypropylene mesh was used in all of the patients and mesh fixation was performed with tackers.

Results

A total of 185 patients with age range 18–92 years were included; 180 were males. TEP repair was attempted in 298 groin hernias in 185 patients with a success rate of 89.5%. Indigenous balloon or telescopic dissection was used to create extra-peritoneal space. Thirty-one (31, 10.5%) TEP repairs were converted to transabdominal pre-peritoneal or open repair. Two patients developed recurrence during follow-up.

Conclusion

TEP is an excellent technique for laparoscopic groin hernia repair, with acceptable rates of complication.
Literatur
1.
Zurück zum Zitat McCormack K, Wake BL, Perez J, Fraser C, Cook J, McIntosh E, Vale L, Grant A (2005) Laparoscopic surgery for inguinal hernia repair: systematic review of effectiveness and economic evaluation. Health Technol Assess 9:1–203PubMed McCormack K, Wake BL, Perez J, Fraser C, Cook J, McIntosh E, Vale L, Grant A (2005) Laparoscopic surgery for inguinal hernia repair: systematic review of effectiveness and economic evaluation. Health Technol Assess 9:1–203PubMed
2.
Zurück zum Zitat Ger R (1991) Laparoscopic hernia operation (in German). Chirurg 62:266–270PubMed Ger R (1991) Laparoscopic hernia operation (in German). Chirurg 62:266–270PubMed
3.
Zurück zum Zitat Schultz LS, Graber JN, Pietrafitta JJ, Hickock DF (1990) Early results with laparoscopic inguinal herniorrhaphy are promising. Clin Laser Mon 8:103–105PubMed Schultz LS, Graber JN, Pietrafitta JJ, Hickock DF (1990) Early results with laparoscopic inguinal herniorrhaphy are promising. Clin Laser Mon 8:103–105PubMed
4.
Zurück zum Zitat Filipi CJ, Gaston-Johansson F, McBride PJ, Murayama K, Gerhardt J, Cornet DA, Lund RJ, Hirai D, Graham R, Patil K, Fitzgibbons R Jr, Gains RD (1996) An assessment of pain and return to normal activity. Laparoscopic herniorrhaphy vs. open tension-free Lichtenstein repair. Surg Endosc 10:983–986PubMedCrossRef Filipi CJ, Gaston-Johansson F, McBride PJ, Murayama K, Gerhardt J, Cornet DA, Lund RJ, Hirai D, Graham R, Patil K, Fitzgibbons R Jr, Gains RD (1996) An assessment of pain and return to normal activity. Laparoscopic herniorrhaphy vs. open tension-free Lichtenstein repair. Surg Endosc 10:983–986PubMedCrossRef
5.
Zurück zum Zitat Arregui ME, Navarrete J, Davis CJ, Castro D, Nagan RF (1993) Laparoscopic inguinal herniorrhaphy. Techniques and controversies. Surg Clin North Am 73:513–527PubMed Arregui ME, Navarrete J, Davis CJ, Castro D, Nagan RF (1993) Laparoscopic inguinal herniorrhaphy. Techniques and controversies. Surg Clin North Am 73:513–527PubMed
6.
Zurück zum Zitat Wellwood J, Sculpher MJ, Stoker D, Nicholls GJ, Geddes C, Whitehead A, Singh R, Spiegelhalter D (1998) Randomised controlled trial of laparoscopic versus open mesh repair for inguinal hernia: outcome and cost. BMJ 317:103–110PubMed Wellwood J, Sculpher MJ, Stoker D, Nicholls GJ, Geddes C, Whitehead A, Singh R, Spiegelhalter D (1998) Randomised controlled trial of laparoscopic versus open mesh repair for inguinal hernia: outcome and cost. BMJ 317:103–110PubMed
7.
Zurück zum Zitat Champault GG, Rizk N, Catheline JM, Turner R, Boutelier P (1997) Inguinal hernia repair: totally preperitoneal laparoscopic approach versus Stoppa operation: randomized trial of 100 cases. Surg Laparosc Endosc 7:445–450PubMedCrossRef Champault GG, Rizk N, Catheline JM, Turner R, Boutelier P (1997) Inguinal hernia repair: totally preperitoneal laparoscopic approach versus Stoppa operation: randomized trial of 100 cases. Surg Laparosc Endosc 7:445–450PubMedCrossRef
8.
Zurück zum Zitat Arvidsson D, Berndsen FH, Larsson LG, Leijonmarck CE, Rimbäck G, Rudberg C, Smedberg S, Spangen L, Montgomery A (2005) Randomized clinical trial comparing 5-year recurrence rate after laparoscopic versus shouldice repair of primary inguinal hernia. Br J Surg 92:1085–1091PubMedCrossRef Arvidsson D, Berndsen FH, Larsson LG, Leijonmarck CE, Rimbäck G, Rudberg C, Smedberg S, Spangen L, Montgomery A (2005) Randomized clinical trial comparing 5-year recurrence rate after laparoscopic versus shouldice repair of primary inguinal hernia. Br J Surg 92:1085–1091PubMedCrossRef
9.
Zurück zum Zitat Wara P, Bay-Nielsen M, Juul P, Bendix J, Kehlet H (2005) Prospective nationwide analysis of laparoscopic versus Lichtenstein repair of inguinal hernia. Br J Surg 92:1277–1281PubMedCrossRef Wara P, Bay-Nielsen M, Juul P, Bendix J, Kehlet H (2005) Prospective nationwide analysis of laparoscopic versus Lichtenstein repair of inguinal hernia. Br J Surg 92:1277–1281PubMedCrossRef
10.
Zurück zum Zitat Grant AM, Scott NW, O’Dwyer PJ; MRC Laparoscopic Groin Hernia Trial Group (2004) Five-year follow-up of a randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg 91:1570–1574PubMedCrossRef Grant AM, Scott NW, O’Dwyer PJ; MRC Laparoscopic Groin Hernia Trial Group (2004) Five-year follow-up of a randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg 91:1570–1574PubMedCrossRef
11.
Zurück zum Zitat Kald A, Anderberg B, Smedh K, Karlsson M (1997) Transperitoneal or totally extraperitoneal approach in laparoscopic hernia repair: results of 491 consecutive herniorrhaphies. Surg Laparosc Endosc 7:86–89PubMedCrossRef Kald A, Anderberg B, Smedh K, Karlsson M (1997) Transperitoneal or totally extraperitoneal approach in laparoscopic hernia repair: results of 491 consecutive herniorrhaphies. Surg Laparosc Endosc 7:86–89PubMedCrossRef
12.
Zurück zum Zitat Wake BL, McCormack K, Fraser C, Vale P, Perez J, Grant AM (2005) Transabdominal pre-peritoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair. Cochrane Database Syst Rev 25:CD004703 Wake BL, McCormack K, Fraser C, Vale P, Perez J, Grant AM (2005) Transabdominal pre-peritoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair. Cochrane Database Syst Rev 25:CD004703
13.
Zurück zum Zitat Schrenk P, Woisetschläger R, Rieger R, Wayand W (1996) Prospective randomized trial comparing postoperative pain and return to physical activity after transabdominal preperitoneal, total preperitoneal or Shouldice technique for inguinal hernia repair. Br J Surg 83:1563–1566PubMedCrossRef Schrenk P, Woisetschläger R, Rieger R, Wayand W (1996) Prospective randomized trial comparing postoperative pain and return to physical activity after transabdominal preperitoneal, total preperitoneal or Shouldice technique for inguinal hernia repair. Br J Surg 83:1563–1566PubMedCrossRef
14.
Zurück zum Zitat Barkun JS, Wexler MJ, Hinchey EJ, Thibeault D, Meakins JL (1995) Laparoscopic versus open inguinal herniorrhaphy: preliminary results of a randomized controlled trial. Surgery 118:703–709PubMedCrossRef Barkun JS, Wexler MJ, Hinchey EJ, Thibeault D, Meakins JL (1995) Laparoscopic versus open inguinal herniorrhaphy: preliminary results of a randomized controlled trial. Surgery 118:703–709PubMedCrossRef
15.
Zurück zum Zitat Wright DM, Kennedy A, Baxter JN, Fullarton GM, Fife LM, Sunderland GT, O’Dwyer PJ (1996) Early outcome after open versus extraperitoneal endoscopic tension-free hernioplasty: a randomized clinical trial. Surgery 119:552–557PubMedCrossRef Wright DM, Kennedy A, Baxter JN, Fullarton GM, Fife LM, Sunderland GT, O’Dwyer PJ (1996) Early outcome after open versus extraperitoneal endoscopic tension-free hernioplasty: a randomized clinical trial. Surgery 119:552–557PubMedCrossRef
16.
Zurück zum Zitat Wright D, Petterson C, Scott N, Hair A, O’Dwyer PJ (2002) Five-year follow-up of patients undergoing laparoscopic or open groin hernia repair: a randomized controlled trial. Ann Surg 235:333–337PubMedCrossRef Wright D, Petterson C, Scott N, Hair A, O’Dwyer PJ (2002) Five-year follow-up of patients undergoing laparoscopic or open groin hernia repair: a randomized controlled trial. Ann Surg 235:333–337PubMedCrossRef
17.
Zurück zum Zitat Tamme C, Scheidbach H, Hampe C, Schneider C, Köckerling F (2003) Totally extraperitoneal endoscopic inguinal hernia repair (TEP). Surg Endosc 17:190–195PubMedCrossRef Tamme C, Scheidbach H, Hampe C, Schneider C, Köckerling F (2003) Totally extraperitoneal endoscopic inguinal hernia repair (TEP). Surg Endosc 17:190–195PubMedCrossRef
Metadaten
Titel
Total extra-peritoneal repair of groin hernia: prospective evaluation at a tertiary care center
verfasst von
M. C. Misra
V. K. Bansal
S. Kumar
B. Prashant
H. K. Bhattacharjee
Publikationsdatum
01.02.2008
Verlag
Springer-Verlag
Erschienen in
Hernia / Ausgabe 1/2008
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-007-0281-9

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