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The Surgical Treatment of Inguinal Hernia Using the Laparoscopic Totally Extra-Peritoneal (TEP) Technique.

Mihăileanu F, Chiorescu S, Grad O, Negrea V, Silaghi H, Mironiuc A - Clujul Med (2015)

Bottom Line: The average duration of hospitalization was 6.79 days.The intraoperative incidents were: 7 minimal peritoneal lesions with pneumoperitoneum and a hemorrhagic lesion of the epigastric vessels repaired endoscopically by the clipping of the lesion.The TEP technique is a safe option followed by a low rate of complications, a low recurrence rate and low intensity postoperative pain.

View Article: PubMed Central - PubMed

Affiliation: 2 Surgery Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

ABSTRACT

Unlabelled: The surgical repair of inguinal hernia represents one of the most frequent procedures used in general surgery. The new surgical techniques are simpler, with a lower morbidity and recurrence of less than 2%. The laparoscopic totally extra-peritoneal (TEP) technique is contraindicated in complicated hernias (occlusion, incarceration) and in voluminous inguino-scrotal hernias.

Purpose: The evaluation of the TEP technique, of the risk factors and of the postoperative results on the group of patients who have undergone surgery in the Surgical Clinic 2 Cluj Napoca.

Material and method: The study is prospective, on a group of 40 patients operated with the TEP technique in the Surgical Clinic 2 during the period May 2013 - July 2014. The following have been assessed: the demographic data, the risk factors, the immediate complications, the recurrence of the hernias.

Results: The average duration of hospitalization was 6.79 days. The intraoperative incidents were: 7 minimal peritoneal lesions with pneumoperitoneum and a hemorrhagic lesion of the epigastric vessels repaired endoscopically by the clipping of the lesion. There were 2 recurrences, 24 hours and 1 year after surgery, solved by the Lichtenstein technique. After 30 interventions, the average duration of the surgery was of 64 minutes, being longer in the case of bilateral hernias and being influenced by the team's learning curve.

Conclusions: The TEP technique is a safe option followed by a low rate of complications, a low recurrence rate and low intensity postoperative pain.

No MeSH data available.


Related in: MedlinePlus

Properitoneal drainage.
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f6-cm8801p58: Properitoneal drainage.

Mentions: To avoid nerve lesions, in most cases we have not chosen to anchor the mesh with clips, these being used only in one case, presenting a large parietal defect, to hinder the migration of the prosthesis. We routinely used the drainage of the properitoneal space (Fig. 6), the exsufflation of the CO2 being carried out under visual control, to certify the correct placement of the polypropylene prosthesis, the hernial bag being always maintained posterior to the mesh. The drainage was suppressed in a variable interval of 24–48 hours, and the mobilization of the patients was initiated on the same day of the surgery. All the patients followed antibiotic prophylaxis with cephalosporins until the suppression of the drainage.


The Surgical Treatment of Inguinal Hernia Using the Laparoscopic Totally Extra-Peritoneal (TEP) Technique.

Mihăileanu F, Chiorescu S, Grad O, Negrea V, Silaghi H, Mironiuc A - Clujul Med (2015)

Properitoneal drainage.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508607&req=5

f6-cm8801p58: Properitoneal drainage.
Mentions: To avoid nerve lesions, in most cases we have not chosen to anchor the mesh with clips, these being used only in one case, presenting a large parietal defect, to hinder the migration of the prosthesis. We routinely used the drainage of the properitoneal space (Fig. 6), the exsufflation of the CO2 being carried out under visual control, to certify the correct placement of the polypropylene prosthesis, the hernial bag being always maintained posterior to the mesh. The drainage was suppressed in a variable interval of 24–48 hours, and the mobilization of the patients was initiated on the same day of the surgery. All the patients followed antibiotic prophylaxis with cephalosporins until the suppression of the drainage.

Bottom Line: The average duration of hospitalization was 6.79 days.The intraoperative incidents were: 7 minimal peritoneal lesions with pneumoperitoneum and a hemorrhagic lesion of the epigastric vessels repaired endoscopically by the clipping of the lesion.The TEP technique is a safe option followed by a low rate of complications, a low recurrence rate and low intensity postoperative pain.

View Article: PubMed Central - PubMed

Affiliation: 2 Surgery Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

ABSTRACT

Unlabelled: The surgical repair of inguinal hernia represents one of the most frequent procedures used in general surgery. The new surgical techniques are simpler, with a lower morbidity and recurrence of less than 2%. The laparoscopic totally extra-peritoneal (TEP) technique is contraindicated in complicated hernias (occlusion, incarceration) and in voluminous inguino-scrotal hernias.

Purpose: The evaluation of the TEP technique, of the risk factors and of the postoperative results on the group of patients who have undergone surgery in the Surgical Clinic 2 Cluj Napoca.

Material and method: The study is prospective, on a group of 40 patients operated with the TEP technique in the Surgical Clinic 2 during the period May 2013 - July 2014. The following have been assessed: the demographic data, the risk factors, the immediate complications, the recurrence of the hernias.

Results: The average duration of hospitalization was 6.79 days. The intraoperative incidents were: 7 minimal peritoneal lesions with pneumoperitoneum and a hemorrhagic lesion of the epigastric vessels repaired endoscopically by the clipping of the lesion. There were 2 recurrences, 24 hours and 1 year after surgery, solved by the Lichtenstein technique. After 30 interventions, the average duration of the surgery was of 64 minutes, being longer in the case of bilateral hernias and being influenced by the team's learning curve.

Conclusions: The TEP technique is a safe option followed by a low rate of complications, a low recurrence rate and low intensity postoperative pain.

No MeSH data available.


Related in: MedlinePlus