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Surgical Endoscopy

Published in:

01-08-2016

Combined open and laparoscopic technique for extraperitoneal mesh repair of large sac inguinal hernias

Authors: Jinhui Zhu, Kai Yu, Yun Ji, Yan Chen, Yuedong Wang

Published in: Surgical Endoscopy | Issue 8/2016

Abstract

Background

Laparoscopic total extraperitoneal (TEP) hernia repair has been confirmed as an effective procedure in several studies but is considered technically demanding. Separating the hernial sac and spermatic cord is difficult when a large sac inguinal hernia is encountered. This study aimed to investigate the feasibility and effectiveness of a combined open and laparoscopic TEP repair of large sac inguinal hernias.

Methods

From June 2012 to May 2015, laparoscopic TEP (112 cases) and combined open and laparoscopic TEP (COL-TEP) (44 cases) were performed in patients with large sac hernia. There was no clear definition of large sac inguinal hernia; therefore, we defined a large sac as one with the sac base cranial to or over outer ring that could not be easily resected laparoscopically. Using this definition, the laparoscopic TEP group was divided into a small sac TEP (SS-TEP) group (68 cases) and a large sac TEP (LS-TEP) group (44 cases). Direct hernias were included in the SS-TEP group because the hernial sac was easily dissected laparoscopically. The patient demographics, perioperative parameters, complications, and recurrence were compared between the three groups.

Results

No significant differences were found between the groups in mean age, gender, body mass index, comorbidities, number of previous laparotomies, or recurrence rate. Compared with the LS-TEP group, both the SS-TEP and COL-TEP groups had a significantly lower surgical duration (51.4 ± 10.9 vs. 32.8 ± 13.1 and 36.2 ± 11.2 min, respectively), conversion rate (13.6 vs. 0 and 0 %, respectively), and total complication rate (27.3 vs. 13.2 and 11.3 %, respectively).

Conclusion

The combined technique was safe and effective for repair of large sac inguinal hernias. The combined technique was associated with decreased technical difficulty, surgical duration, and conversion and total complication rates.

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Title: Combined open and laparoscopic technique for extraperitoneal mesh repair of large sac inguinal hernias
Authors: Jinhui Zhu
Kai Yu
Yun Ji
Yan Chen
Yuedong Wang
Publication date: 01-08-2016
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 8/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4630-y

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Combined open and laparoscopic technique for extraperitoneal mesh repair of large sac inguinal hernias

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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