Laparoscopy/minimally invasive surgery
Impact of slit and nonslit mesh technique on testicular perfusion and volume in the early and late postoperative period of the totally extraperitoneal preperitoneal technique in patients with inguinal hernia

https://doi.org/10.1016/j.amjsurg.2008.11.038Get rights and content

Abstract

Aims

Using slit and nonslit mesh in laparoscopic totally extraperitoneal preperitoneal (TEPP) inguinal hernia repair are well-known approaches. The aim of this prospective, randomized, clinical study was to assess testicular perfusion after these procedures.

Methods

In the study period, 40 male patients with unilateral inguinal hernia were assigned into 2 equal groups as follows: slit (S) and nonslit (NS). TEPP hernia repair was performed in all patients. In the 2 groups, testicular arterial blood flow and testis volumes were measured by Doppler ultrasonography preoperatively, on the 5th postoperative day, and 6 months postoperatively, respectively.

Results

No statistically significant difference was found between the preoperative, 5th day postoperatively, and 6-month arterial resistance index (ARI) results when comparing the S and NS groups in ultrasonographic testicular blood flow studies. There was no statistically significant difference of testicular volume between the preoperative period, the 5th postoperative day, and 6 months postoperatively in the 2 groups.

Conclusions

According to the results, no statistically significant difference was found in terms of testicular perfusion and volume between those 2 methods of TEPP repair for inguinal hernia.

Section snippets

Patients and Methods

After the approval of the Local Ethics Committee of Vakif Gureba Training and Research Hospital, this study was performed between May 2004 and December 2007. The study was designed as a randomized prospective controlled study.

Results

The mean age of the patients was 50.4 years ± 14.3 years in the S group (range 29–76), whereas it was 57.3 years ± 12.0 years in the NS group (range 27–72). Demographic data and patient parameters were shown in Table 1. Despite the fact that the NS group was slightly older than S group, there were no significant differences between the NS and S groups with respect to age, hernia side, and symptom duration.

Early complications were included in seroma with 2 and 3 patients in the S and NS groups,

Comments

Laparoscopic inguinal hernia repair was first described by Ger,13 Schultz et al,14 Corbitt,15 and Filipi et al16 in the early 1990s. Because of the increasing use of laparoscopic techniques, a greater number of general surgeons has attempted various innovative methods of laparoscopic inguinal hernia repair.17 Two basic techniques for inguinal hernia repair have evolved at this time: the TAPP and the TEPP approach. Both of these repairs involve placing a large sheet of polypropylene mesh at the

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