Inguinal Hernia Repair Operation Research Articles

Ultrasound-Guided Lumbar Erector Spinae Plane Block compared to Quadratus Lumborum Block for Postoperative Analgesia in Inguinal Hernia repair operations

Ultrasound-Guided Lumbar Erector Spinae Plane Block compared to Quadratus Lumborum Block for Postoperative Analgesia in Inguinal Hernia repair operations

The ANZ hernia repair practices study: low consensus on inguinal and small ventral hernia management and infrequent long-term follow-up.

The ANZ hernia repair practices study: low consensus on inguinal and small ventral hernia management and infrequent long-term follow-up.

Comparing Outcomes of Single-Incision Laparoscopic Herniorrhaphy in Newborns and Infants.

As surgical techniques progress, laparoscopic herniorrhaphy is now performed more often in premature babies. The aim of this study was to analyze the outcomes of newborns and infants who underwent single-incision laparoscopic herniorrhaphy (SILH) at our center. We retrospectively reviewed patients younger than 12 months old who received SILH at our department from 2016 to 2020. SILH involved a 5 mm 30-degree scope and 3 mm instruments with a 3-0 Silk purse-string intracorporeal suture for closure of the internal ring. At the time of surgery, Group 1 newborns, whose corrected age was 2 months and below, were compared to the Group 2 infants, whose age was above 2 months. We assessed the patients' characteristics, anesthesia, surgical data, and complications. A total of 197 patients were included (114 newborns in Group 1 and 83 infants in Group 2). The mean age and body weight in Group 1 were 1.2 months and 3.8 kg, respectively, whereas in Group 2, they were 3.2 months and 6.7 kg, respectively. There were no significant differences in operative time (Group 1 = 34.1 min vs. Group 2 = 32.3 min, p = 0.26), anesthetic time (Group 1 = 80.0 min vs. Group 2 = 76.3 min, p = 0.07), length of hospitalization (Group 1 = 2.3 days vs. Group 2 = 2.4 days, p = 0.88), postoperative complications including omphalitis (Group 1 = 5.3% vs. Group 2 = 1.2%, p = 0.13), wound infection (Group 1 = 0.9% vs. Group 2 = 1.2%, p = 0.81), and hydrocele (Group 1 = 0.35% vs. Group 2 = 8.4%, p = 0.14). No recurrence, testicular ascent or atrophy, or mortality was observed in either group during the 2-year follow-up period. Single-incision laparoscopic herniorrhaphy is a safe and effective operation for inguinal hernia repair in infants, even those with prematurity, lower body weight at the time of surgery, or cardiac and/or pulmonary comorbidities. Comparable results revealed no significant differences in perioperative complications despite younger ages and lower body weights.

WE3.11 Inguinal hernia repair operation; review of the consent and the supported decision-making in the out-patient department

Abstract Introduction In 2015, the ruling of the UK Supreme Court in Scotland in the case of Montgomery v Lanarkshire fundamentally changed the practice of consent. According to the Judges, doctors are no longer the sole arbiter of determining what risks are material to their patients. In this study, the RCS CONSENT: SUPPORTED DECISION-MAKING guide was used to evaluate our practice in regards to consent taking for inguinal hernia repair. Methods OPD letters to GPs were reviewed between 01/01/2019 to 30/12/2019. For risks with its percentages, alternative management exploration with the patient and whether information leaflets supplied to the patients. Results There were 63 patients. 19/63 letters had different options of treatment documented. 37/63 letters showed risks and complications documented and only 4/63 letters had percentages of the risks written. 25/63 patients signed consents in OPD. 0/63 letters indicated a signed consent copy was given to patients. Only 10 patients had been given an information leaflet. Conclusion Overall quality of letters was: 36/63 were poor, 21/63 were average and 5/63 were good. Therefore, to improve our practice leaflets shall be made easily accessible in all clinics. A prompt notification, if consent has been signed when booking a patient. workshops with feedback for middle grades.

Tension-free inguinal hernia repair with transversus abdominis plane (TAP) block in elderly high-risk patients.

Inguinal hernia repair is still being studied today because it is one of the most commonly performed surgical procedures in the world and is used in people of all ages. Although many centers use spinal anesthetic to treat inguinal hernias, complications such as hypotension from peripheral vasodilation, delayed mobilization from paralysis, urine retention and post-spinal headache might occur. Regional blocks are a significant component of multimodal anaesthesia that promotes postoperative recovery. Transversus abdominis plane (TAP) block is a regional anesthetic block technique that is effective on the parietal peritoneum, skin, and anterior abdominal wall. This study aimed to show that TAP block administration may be done safely without the use of an extra anesthetic treatment, especially in older patients who may experience complications from general or spinal anesthesia. Without either general, spinal or epidural anesthetic, we conducted a tension-free - Lichtenstein - inguinal hernia repair operation with only TAP block application. This retrospective case-control study received ethics committee approval (decision number 21-5T/108). Between September and December 2019, patients who underwent elective Lichtenstein hernia repair in our clinic were evaluated retrospectively. We think that inguinal hernia repair can be safely performed with only TAP block and that TAP block application has fewer anaesthesia-related complications such as postspinal headache and urinary retention compared with spinal anaesthesia, and that it can be used as an alternative to spinal anaesthesia in patients who cannot tolerate general anaesthesia. Even hernia surgery can be very challenging in patients with advanced age and comorbidities. We wanted to show the feasibility of the TAP block method as an alternative to anaesthesia in such patients.

Modified Halsted's operation for inguinal hernia repair: A new technique

BackgroundInguinal hernia is a frequent problem presented to surgical clinic in Iraq. Surgical treatment options for inguinal hernia are numerous, selecting the appropriate method or technique depends on different factors. Aim of studyTo find a new technique for open inguinal hernia repair with no recurrence even in recurrent cases, without major complications during or after surgery, and can be used even by new surgeons with little experience. Patients & methodsA retrospective cross sectional study conducted in the Medical City teaching hospital and Private Hospitals in Baghdad, during the period from January 1, 2000, to December 30, 2016 on convenient sample of 408 Iraqi patients with inguinal hernia. The patients were treated by modified Halsted's technique by open surgery applying polypropylene mesh. The patients were followed up through frequent visits and phone calls to assess the recurrence and complications. ResultsNo recurrence of inguinal hernia was reported after 5–10 years follow up, while 94.9% of patients reported postoperative complications commonly oedema of spermatic cord. There was a highly significant association between male gender hernia patients and post Modified Halsted operation complications (p < 0.001). A highly significant association was observed between direct hernia and post Modified Halsted operation complications (p < 0.001). The significant risk factors related to complications were anemia and collagen disease. ConclusionsThe modified Halsted's operation for inguinal hernia repair is effective in treatment of inguinal hernia with low recurrence and complications rate.

Inguinal hernia repair in preterm neonates: is there evidence that spinal or general anaesthesia is the better option regarding intraoperative and postoperative complications? A systematic review and meta-analysis

ObjectivesWhether spinal anaesthesia (SA) reduces intraoperative and postoperative complications compared with general anaesthesia (GA) was investigated.DesignThe meta-analysis was structured based on the PRISMA (Preferred Reporting Items for Systematic Reviews and...

Comparison between ultrasound-guided paravertebral nerve block and subarachnoid block for elderly male patients under unilateral-opened inguinal hernia repair operation: A randomised controlled trial.

Paravertebral block (PVB) as a sole anesthetic technique is difficult even in experienced hands. Hence, this study was undertaken to study the safety and efficacy of PVB and to compare with subarachnoid block (SAB) for inguinal hernia repair surgery (IHRS) in elderly male patients. Sixty-five male patients aged 65 to 89 scheduled for IHRS were allocated randomly by computer-generated randomisation sequence into two groups. They underwent PVB (Group PVB: 33 patients were injected with 10 ml ropivacaine 0.5% at each level from T12 to L1) or SAB (Group SAB: 32 patients were injected with 15 mg ropivacaine 0.5% at L3-L4 level). Primary outcomes were hemodynamic changes and duration of postoperative analgesia. Secondary outcomes were dosage of remedial analgesics, time to perform the block, side effects and satisfaction of patients. The hemodynamics in the Group PVB were more stable than those in the Group SAB during surgery (P < 0.05). The duration of post-operative analgesia was significantly longer in the Group PVB (P < 0.001). The total dose of fentanyl was smaller in the Group PVB in the first 24 h (P < 0.001). The time to perform the block was significantly longer in the Group PVB (P < 0.001). There was a significant difference in the visual analogue scales (VAS) scores between the two groups at 4 h, 6 h, 8 h and 10 h (P < 0.05) but not at 2 h, 12 h and 24 h (P > 0.05). The VAS scores were lowest at 2 h for both the 2 groups, highest at 12 h for Group PVB and at 8 h for Group SAB respectively. The Group PVB had fewer adverse effects (P < 0.05) and higher satisfaction of patients (P < 0.05). Ultrasound-guided PVB can ensure the anesthetic effects of unilateral-opened IHRS in elderly male patients. It has a small impact on hemodynamics, a longer postoperative analgesia time and less complications.

Evaluation of three different regional anesthetic techniques in postoperative pain control after inguinal hernia repair operations in adults patients

Evaluation of three different regional anesthetic techniques in postoperative pain control after inguinal hernia repair operations in adults patients

Clinical role of vitamin D in prognosis of otitis media with effusion

ObjectiveTo investigate the clinical role of Vitamin D in prognosis of Otitis media with effusion. MethodsThis prospective-controlled study was conducted at otolaryngology department in Duzce University, Turkey. The study group comprised children who were diagnosed with Otitis media with effusion between September 2016 and February 2017. Control group was conducted with children underwent circumcision or inguinal hernia repair operations that confirmed with ENT examination they do not have any sign of otitis media. After 3 months of follow-up without any treatment, unresolved cases who were accepted as chronic otitis media with effusion were operated under general anesthesia for ventilation tube application. Study and control groups were assessed depending on the serum 25(OH)Vitamin D levels at the end of 3 months; < 15 ng/mL was accepted as vitamin D deficiency. The results were compared with the control group in terms of vitamin D levels. Also, subgroup analysis was performed addressing to the complete recovery otitis media with effusion and chronic otitis media with effusion. ResultsOne-hundred-seventy-four children with otitis media with effusion and 80 control patients were included to the study. One-hundred-eight (62%) out of 174 patients with otitis media with effusion was completely recovered after a 3-months follow up. Of those 66 out of 174 children, they had persistent diseases, underwent ventilation tube insertion after a 3-months follow-up. The mean 25(OH)Vitamin D level was 18.98 ± 10.60 in otitis media with effusion group and 28.07 ± 14.10 in control group and the difference was statistically significant between the study and control group (p < 0.001). Vitamin D deficiency was observed in 33 out of 66 patients (50.0%) in chronic otitis media with effusion group whilst 35 out of 108 patients (32.4%) in complete recovery otitis media with effusion group (p = 0.021). The rate of 25(OH)Vitamin D deficiency was 25% in control group which was statistically different from chronic otitis media with effusion and recovery chronic otitis media with effusion groups (p = 0.006). ConclusionsThis study not only shows the relationship between Vitamin D and otitis media with effusion development, but also demonstrates the effects of Vitamin D on otitis media with effusion prognosis. There is a significant association between 25(OH)Vitamin D deficiency and follow-up outcomes of otitis media with effusion.

全麻复合硬膜外麻醉与单纯全麻用于腹腔镜下腹股沟疝修补术的比较

目的：比较全麻复合硬膜外麻醉与单纯全麻对腹腔镜下腹股沟疝修补术的临床效应的影响。方法：择期进行腹腔镜完全腹膜外疝修补术患者60例，随机分为硬膜外麻醉 + 全麻组(I组)和单纯全麻组(II组)，记录两组患者麻醉前5 min (T1)、麻醉后30 min (T2)、手术结束(T3)时血流动力学变化和动脉血pH值、血糖值，术中丙泊酚与瑞芬太尼用量、停药至苏醒时间、苏醒至拔管时间、术后躁动发生率及术后患者和术者满意度情况。结果：I组瑞芬太尼用量少于II组，I组拔管时间短于II组，差异有统计学意义(P < 0.01)，I组患者术后满意度高于II组(P < 0.05)，差异有统计学意义。结论：全麻复合硬膜外麻醉用于腹腔镜下腹股沟疝修补术可以减少术中瑞芬太尼用量，缩短拔管时间并能提高术后患者镇痛满意度。 Objective: To observe the effect of combined general-epidural anesthesia and general anesthesia in patients undergoing laparoscopic inguinal hernia repair operation. Methods: Sixty patients un-dergoing totally extraperitoneal prosthesis (TEP) operation were randomly allocated into combined general-epidural anesthesia group (group I) and general anesthesia group (group II). At the time of 5 minutes before anesthesia (T1), 30 minutes after anesthesia (T2) and operation ending (T3), hemodynamic parameters, arterial blood pH and glucose were recorded. We also record the dose use of propofol and remifentanil, the time from ending of narcotic to recovery, time from recovery to extubation, post-operative confusion rates and satisfaction rates both of patients and operators. Results: Compared with group II, usage of remifentanil and extubation time were significantly decreased in group I (P < 0.01). Patients in group I had a better post-operative satisfaction than that of group II (P < 0.05). Conclusion: Combined general-epidural anesthesia can decrease the usage of remifentanil, shorten the extubation time and provide a better satisfaction of post-operative pain management in laparoscopic inguinal hernia repair operation.

The Effect of Transversus Abdominis Block on Decreasing Pain Following Inguinal Hernia Repair

Objective: This study was to evaluate the transversus abdominis plane block for treating pain after inguinal hernia repair operations. Methods: This study included 60 patients who were allocated into 2 groups in a random manner r: group b(transversus abdominis plane block,30 patients received transversus abdominis in addition to an intravenous single-injection of morphine 5 mg) and group m (control group, 30 patients received morphine 5mg intravenously). The patients’ degrees of pain were evaluated postoperatively. Results: There were 60 patients, 30 in each group. Postoperatively, pain scores were significantly less in group b than group m. Conclusion: Transversus abdominis block given before operation improves postoperative pain after inguinal hernia.

Comparison of results of inguinal hernia repair operations carried out on geriatric patients under emergency or elective conditions

Comparison of results of inguinal hernia repair operations carried out on geriatric patients under emergency or elective conditions

Isolated Endometriosis on the Rectus Abdominis Muscle in Women without a History of Abdominal Surgery: a Rare and Intriguing Finding

We report 2 rare cases of endometriosis on the rectus abdominal muscle diagnosed incidentally during an operation for inguinal hernia repair in women with no surgical history. Two women sought medical attention for a mass found in the pubic abdominal wall. Only 1 woman reported occasional pain. At physical examination in both women, an ovoid swelling in the right pubic area was felt. One woman experienced pain on palpation, and one reported slight discomfort. Ultrasonography demonstrated a heterogeneous hypoechogenic formation with indistinct edges; diagnosis was difficult. Routine clinical and instrumental (pelvic ultrasonography) gynecologic examination in both patients performed shortly before hospitalization had not revealed any macroscopic focus of endometriosis in the pelvic region. At surgery, a lesion consistent with the diagnosis of endometriosis was found, which was confirmed at histologic analysis. These cases could represent the consolidation of different theories of endometriosis diffusion. We suggest including endometriosis in the differential diagnosis of a symptomatic mass in the abdominal wall in women with and without a surgical history.

Direct radionuclide cystography imaging in colovesical fistula due to inguinal hernia operation complication

Colovesical fistula is an abnormal connection between the enteric and urinary systems, usually sigmoid colon, caused by various conditions. One cause of colovesical fistula is iatrogenic injury, such as induced by inguinal hernia surgery. We present a case of colovesical fistula. A 57-year-old male was admitted to a local hospital with complaints of dysuria and pneumaturia. He had a past history of total extraperitoneal laparoscopic inguinal hernia repair operation 7 years previously for bilateral inguinal hernia. The case was assessed with radiologic and scintigraphic techniques. Radiologic techniques (plain abdominal radiography, intravenous pyelogram, ultrasound examination, double-contrast barium enema, CT, MRI) were inadequate to determine the colovesical fistula. The colovesical fistula was visualized with direct radionuclide voiding cystography as an alternative scintigraphic method.

Fate of the inguinal hernia following removal of infected prosthetic mesh

Open tension-free hernioplasty using a prosthetic mesh is a common operation for inguinal hernia repair because of the relative ease of the operation and low recurrence rate. Wound infection is a potential complication of all hernia repairs and deep-seated infection involving an inserted mesh may result in chronic groin sepsis which usually necessitates complete removal of mesh to produce resolution. Removal of mesh would potentially result in a weakness of the repair and subsequent hernia recurrence. We reviewed the outcome of all our patients who had mesh removal for sepsis over an 8-year period, particularly examining for hernia recurrence and chronic groin pain. This was a retrospective review of the database of patients who had mesh repair of inguinal hernias over an 8-year period. There were 2,139 inguinal hernias repaired using prosthetic mesh. All patients who had mesh removal for infection were identified and followed up. Fourteen patients had deep-seated wound infection which required mesh removal for resolution of sepsis. No peri-operative complications occurred during mesh removal. After a median follow-up of 44 months (range 5-91 months), there were two asymptomatic recurrences and none of the patients had chronic groin pain. Hernia recurrence is uncommon following mesh removal for chronic groin sepsis, suggesting that the strength of a mesh repair lies in the fibrous reaction evoked within the transversalis fascia by the prosthetic material rather than in the physical presence of the mesh itself. When there is established deep infection, there should be no unnecessary delay in removing an infected mesh in order to allow resolution of chronic groin sepsis.

Application of herniamesh type mesh in inguinal hernia repair operation

目的 探讨平底短型网塞式补片(T2)在腹股沟疝修补术中应用的可行性和临床疗效.方法使用平底短型网塞式补片(T2)行腹股沟疝无张力修补术101例次,术后随访1～12个月,总结临床资料.结果平均手术时间30 min,术后平均住院时间6.2 d,术后疼痛轻,恢复快,无腹股沟区异物感,随访1～12个月无复发.结论应用平底短型网塞式补片(T2)行腹股沟疝无张力修补,术式简单,安全有效,术后并发症少,复发率低,值得临床推广应用。

Inguinal endometriosis

Extrapelvic endometriosis is a rarely seen condition and it is occasionally presented to the general surgeons. It is often diagnosed incidentally. In this report we presented three cases of inguinal endometriosis all of which were thought to be inguinal hernia preoperatively. They were diagnosed during the operation for inguinal hernia repair and treated with simple excision of the lesions with a part of the round ligament.

A.223 Peripheral nerve block for postoperative analgesia after inguinal hernia repair operations

A.223 Peripheral nerve block for postoperative analgesia after inguinal hernia repair operations

Views on the choice of operation for inguinal hernia repair.

Views on the choice of operation for inguinal hernia repair.