DOI: http://dx.doi.org/10.18203/2349-2902.isj20195109

Laparoscopic total extraperioneal mesh hernioplasty is a novel approach for inguinal hernia: our experience over 7 years

Dheer Singh Kalwaniya, Ranjith Mahadevan, Satya V. Arya, Jaspreet Singh Bajwa, Gowtham K. Gowda, Akshay Narayan, Vignesh M.

Abstract


Background: Inguinal hernia surgery is the most common performed surgery all over the world. Among them laparoscopic totally extra-peritoneal (TEP) mesh repair fulfils all the requirements with better clinical outcomes than other procedures.

Methods: Data was collected from the inpatient and out-patient records of 60 patients who underwent laparoscopic TEP for unilateral or bilateral inguinal hernia in a single unit in the Department of General Surgery during May 2012-June 2019 including the two years of follow-up. 3D mesh was used for application and was fixed with tackers. Then patients were followed up in outpatient department after 1 week, 2 week, and 3 months, 6 months and yearly up to two years. In every visit post-operative pain (assessed by visual analogue scale), local wound complication (hematoma, seroma, wound infection) and recurrence were noted. The data was collected and evaluated and the results shown.

Results: All patients were men, with average age of 36.5 years (range 32-58). On categorization 53 (88.3%) of them had unilateral inguinal hernia and 7 (11.6%) of them had bilateral inguinal hernia. Intra operatively 12 (20%) of them had direct inguinal hernia and 48 (80%) of them had indirect inguinal hernia. Haematoma was seen in 1 patients, surgical emphysema in 3, seroma in 5 and recurrence in 2 patients.

Conclusions: Laparoscopic TEP mesh repair was effective and safe tool for hernia repair, in terms of lesser postoperative painless number of hospital days, early recovery and lesser wound complications. However recurrence rates are comparable with other methods of hernia repair.

Keywords


TEP repair, Inguinal hernia (direct and indirect), Haematoma

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References


Ger R. The Management of certain abdominal hernia by intra-abdominal closure of neck. Ann R Coll Surg Engl. 1982;64:342-4.

Tamme C, Scheidbach H, Hampe C. Totally extraperitoneal endoscopic inguinal hernia repair (TEP). Surg Endosc. 2003;17:190-5.

Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R, Dunlop D, Gibbs J, et al. Open mesh versus laparoscopic mesh repair of inguinal hernia. New England J Med. 2004;350(18):1819-27.

Carter J, Duh QY. Laparoscopic repair of inguinal hernias.World J Surg. 2011;35:1519-25.

Singh K, Singhal A, Saggar V, Sharma B, Sarangi R. Subcutaneous carbon dioxide emphysema following endoscopic extraperitoneal hernia repair: possible mechanisms. J Laparoendoscopic Advan Surg Techniques. 2004;14(5):317-20.

Choi YY, Han SW, Bae SH, Kim SY, Hur KY, Kang GH. Comparision of the outcomes between laparoscopic totally extra peritoneal repair and prolene hernia system for inguinal hernia; review of one surgeon’s experience. J Korean Surg Soc. 2012;82(1):40-4.

Chauhan HR, Chheda H. A study of laparoscopic total extraperitoneal endoscopic hernioplastyin cases of inguinal hernia-an experience of a tertiary care centre. Int Surg J. 2016;3:643-8.

Shaikh AG, Soomoro MI, Shaik MS, Memon AA. Outcome of totally extra-peritoneal laparoscopic hernioplasty at a tertiary care hospital Larkana J Pak Med Assoc. 2013;63(7):850-3.

Wright D, Paterson C, Scott N, Hair A, Patrick J, O’dwyer PJ. Five year follow up of patients undergoing laparoscopic or open groin hernia repair. Ann Surg. 2000;235(3):333-7.

Pattar, Kattepura JD, Duffield S, Robert GM. Laparoscopic totally extra peritoneal inguinal hernia repair: a personal experience and learning curve. Indian J Surg. 2007;69(3):90-4.

Leim MSL, Graaf YVD, Steensel CJV, Boelhouwer RU, Clevers GJ, Meijer WS, et al. Comparison of conventional anterior surgery and laparoscopic surgery for inguinal hernia repair. N Engl J Med. 1997;336:1541-7.

Aeberhard P, Klaiber C, Meyenberg A, Osterwalder A, Tschudi J. Prospective audit of laparoscopic totally extra peritoneal inguinal hernia repair: a multicenter study of the Swiss Association for laparoscopic and thoracoscopic surgery (SALTC). Surg Endosc.1993;13(11):1115-20.