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Laparoscopic approach to incarcerated and strangulated inguinal hernias.

Deeba S, Purkayastha S, Paraskevas P, Athanasiou T, Darzi A, Zacharakis E - JSLS (2009 Jul-Sep)

Bottom Line: Forty-three articles were found, and 7 were included according to the inclusion criteria set.This resulted in 16 articles that were reviewed in full.From these 7 studies, there were 328 cases reported, 6 conversions, average operating time of 61.3 minutes (SD+/-12.3), average hospital stay of 3.8 days (SD+/-1.2), 34 complications (25 of which were reported as minor), and 17 bowel resections performed either laparoscopically or through a minilaparotomy incision guided laparoscopically.

View Article: PubMed Central - PubMed

Affiliation: Department of BioSurgery and Surgical Technology, London, United Kingdom.

ABSTRACT

Introduction: Acute inguinal hernias are a common presentation as surgical emergencies, which have been routinely managed with open surgery. In recent years, the laparoscopic approach has been described by several authors but has been controversial amongst surgeons. We describe the laparoscopic approach to incarcerated/strangulated inguinal hernias based on a review of the literature with regards to its feasibility in laparoscopically managing the acute hernia presentation.

Methods: A systematic literature search was carried out including Medline with PubMed as the search engine, and Ovid, Embase, Cochrane Collaboration, and Google Scholar databases to identify articles reporting on laparoscopic treatment, reduction, and repair of incarcerated or strangulated inguinal hernias from 1989 to 2008.

Results: Forty-three articles were found, and 7 were included according to the inclusion criteria set. Articles reporting on the use of laparoscopy for the evaluation of the hernia but not reducing and repairing it, the use of the open technique, elective hernia repairs, pediatric series, review articles, and other kinds of hernias were excluded after title and abstract review. This resulted in 16 articles that were reviewed in full. Of these 16 articles, 7 reported on the use of the laparoscopic approach exclusively. From these 7 studies, there were 328 cases reported, 6 conversions, average operating time of 61.3 minutes (SD+/-12.3), average hospital stay of 3.8 days (SD+/-1.2), 34 complications (25 of which were reported as minor), and 17 bowel resections performed either laparoscopically or through a minilaparotomy incision guided laparoscopically.

Conclusion: The laparoscopic repair is a feasible procedure with acceptable results; however, its efficacy needs to be studied further, ideally with larger multicenter randomized controlled trials.

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Related in: MedlinePlus

Flow chart of the articles identified and included.
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Figure 1: Flow chart of the articles identified and included.

Mentions: A total of 43 articles were found that sited the use of the laparoscopic approach for the management of acute hernias (Figure 1). Nine articles reported on the use of laparoscopy for the evaluation of the hernia and its contents but not reducing and repairing the hernia, 4 articles reported on the open technique for the repair, 9 articles were reports of laparoscopic elective hernia repairs, 2 were reports of pediatric series, 1 was a review article, and 2 were reports of other kinds of hernias and therefore were excluded after title and abstract review. This resulted in 16 articles that were reviewed in full.


Laparoscopic approach to incarcerated and strangulated inguinal hernias.

Deeba S, Purkayastha S, Paraskevas P, Athanasiou T, Darzi A, Zacharakis E - JSLS (2009 Jul-Sep)

Flow chart of the articles identified and included.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3015964&req=5

Figure 1: Flow chart of the articles identified and included.
Mentions: A total of 43 articles were found that sited the use of the laparoscopic approach for the management of acute hernias (Figure 1). Nine articles reported on the use of laparoscopy for the evaluation of the hernia and its contents but not reducing and repairing the hernia, 4 articles reported on the open technique for the repair, 9 articles were reports of laparoscopic elective hernia repairs, 2 were reports of pediatric series, 1 was a review article, and 2 were reports of other kinds of hernias and therefore were excluded after title and abstract review. This resulted in 16 articles that were reviewed in full.

Bottom Line: Forty-three articles were found, and 7 were included according to the inclusion criteria set.This resulted in 16 articles that were reviewed in full.From these 7 studies, there were 328 cases reported, 6 conversions, average operating time of 61.3 minutes (SD+/-12.3), average hospital stay of 3.8 days (SD+/-1.2), 34 complications (25 of which were reported as minor), and 17 bowel resections performed either laparoscopically or through a minilaparotomy incision guided laparoscopically.

View Article: PubMed Central - PubMed

Affiliation: Department of BioSurgery and Surgical Technology, London, United Kingdom.

ABSTRACT

Introduction: Acute inguinal hernias are a common presentation as surgical emergencies, which have been routinely managed with open surgery. In recent years, the laparoscopic approach has been described by several authors but has been controversial amongst surgeons. We describe the laparoscopic approach to incarcerated/strangulated inguinal hernias based on a review of the literature with regards to its feasibility in laparoscopically managing the acute hernia presentation.

Methods: A systematic literature search was carried out including Medline with PubMed as the search engine, and Ovid, Embase, Cochrane Collaboration, and Google Scholar databases to identify articles reporting on laparoscopic treatment, reduction, and repair of incarcerated or strangulated inguinal hernias from 1989 to 2008.

Results: Forty-three articles were found, and 7 were included according to the inclusion criteria set. Articles reporting on the use of laparoscopy for the evaluation of the hernia but not reducing and repairing it, the use of the open technique, elective hernia repairs, pediatric series, review articles, and other kinds of hernias were excluded after title and abstract review. This resulted in 16 articles that were reviewed in full. Of these 16 articles, 7 reported on the use of the laparoscopic approach exclusively. From these 7 studies, there were 328 cases reported, 6 conversions, average operating time of 61.3 minutes (SD+/-12.3), average hospital stay of 3.8 days (SD+/-1.2), 34 complications (25 of which were reported as minor), and 17 bowel resections performed either laparoscopically or through a minilaparotomy incision guided laparoscopically.

Conclusion: The laparoscopic repair is a feasible procedure with acceptable results; however, its efficacy needs to be studied further, ideally with larger multicenter randomized controlled trials.

Show MeSH
Related in: MedlinePlus