Mesh hernia repair

  • 文章类型: Journal Article
    BACKGROUND: Inguinal hernia repair has evolved from open suture methods to mesh repair which is preformed either open or laparoscopically. Mesh hernia repair has improved the outcome in regards to patient care and recurrence rate but it is also associated with a number of complications. The complications of mesh hernia repair such as deep seated infections, mesh erosion and mesh perforation into nearby viscera has been scarcely reported in literature.
    METHODS: We report a 43 years old male case of diverticulosis adherent to a migrated mesh plug from previous laparoscopic inguinal hernia repair procedure.
    CONCLUSIONS: The choice of mesh material, appropriate suture placement and closure of the peritoneum after mesh repair is very crucial to avoid long term mesh complications.
    CONCLUSIONS: The aim of this case report is to present a rare complication of mesh erosion with colovesical fistula and abscess formation.
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  • 文章类型: Journal Article
    BACKGROUND: Primary fascial closure can be a challenging step during a laparoscopic intraperitoneal onlay mesh (IPOM) repair for a ventral hernia.
    METHODS: We present here a novel technique of using intravenous (IV) cannula as an alternative to suture passer for fascial closure during laparoscopic IPOM repair for a 59-year-old patient with an incisional ventral hernia. The placement of non-absorbable sutures for fascial closure was done with the help of a 14 gauge IV cannula instead of a transfascial suture passer. The rest of the procedural steps were the same as a standard laparoscopic IPOM repair. The patient\'s post-operative recovery was uneventful.
    CONCLUSIONS: Primary fascial closure during a laparoscopic IPOM hernia repair can be done either by intracorporeal or extracorporeal techniques, using interrupted or continuous sutures. We propose a novel alternative to suture passer in primary fascial closure. IV cannulas are widely available in hospital settings. The advantage of using an IV cannula instead of a suture passer is that they are widely available. Its single-use also eliminates the risk of transmissible diseases, and as it has a smaller diameter than suture passer, it requires a lower insertion force for successful placement.
    CONCLUSIONS: An IV cannula may be used as a more economical alternative to a transfascial suture passer. This technique is easily reproducible and does not violate the principles of primary fascial defect closure in laparoscopic ventral hernia repair.
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  • 文章类型: Journal Article
    目的:疝修补术是一种常见的外科手术,术后疼痛是疝气手术的必然结果。预防术后疼痛在患者舒适度和早期出院方面具有相当重要的意义。在这项研究中,我们评估了腹膜切口对术后早期疼痛的影响.
    背景:这是一项针对75例腹股沟疝修补术患者的前瞻性临床研究。
    方法:患者分为五组:第1组:斜疝,腹膜切口Lichtenstein修补术,第2组:间接疝,Lichtenstein修补术无腹膜切口,第三组:所有疝气,经腹腹膜前(TAPP)修复,第四组:所有疝气,完全腹膜外(TEP)修复,第5组:直疝,无腹膜切口的Lichtenstein修复术。比较各组在三个不同时间的术后疼痛评分和并发症。
    结果:男性62例,女性13例,平均年龄51.25岁。第2、4和5组的视觉模拟量表(VAS)评分较低,根据所有时间点评估的VAS变化,组间和组间均存在差异(p<0.05)。没有区别,根据VAS分析,开放和腹腔镜手术组之间。根据VAS变化,各组疝侧之间存在差异(p<0.001)。
    结论:腹膜切口是腹股沟疝修补术后疼痛的重要危险因素。但是,尽管开腹手术的VAS评分高于腹腔镜手术,但外科手术不是危险因素.
    OBJECTIVE: Hernia repair is a common surgical procedure, and postoperative pain is an inevitable result of hernia surgery. The prevention of postoperative pain is of considerable importance in terms of patient comfort and early discharge. In this study, we evaluated the effects of a peritoneal incision on pain in the early postoperative period.
    BACKGROUND: This was a prospective clinical study with 75 patients undergoing inguinal hernia repair.
    METHODS: Patients were divided into five groups: group 1: indirect hernia, Lichtenstein repair with peritoneal incision, group 2: indirect hernia, Lichtenstein repair without peritoneal incision, group 3: all hernias, trans-abdominal preperitoneal(TAPP) repair, group 4: all hernias, total extraperitoneal (TEP) repair, and group 5: direct hernia, Lichtenstein repair with no peritoneal incision. Groups were compared in terms of postoperative pain scores at three different times and complications.
    RESULTS: There were 62 males and 13 females; their average age was 51.25 years. The visual analog scale (VAS) scores were lower in groups 2, 4, and 5, and there were differences among groups and within each group according to VAS changes assessed at all time points (p < 0.05). There was no difference, according to VAS analysis, between open and laparoscopic surgery groups. There was a difference according to VAS changes in each group between hernia sides (p < 0.001).
    CONCLUSIONS: Peritoneal incision is a significant risk factor for postoperative pain after inguinal hernia repair. But, surgical procedure was not a risk factor although VAS scores were higher in open than laparoscopic surgery.
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