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Sapiyeva ST, Abatov NT, Aliyakparov MT, Badyrov RM, Yoshihiro N, Brizitskaya LV, Yesniyazov DK, Yukhnevich YA. Non-mesh inguinal hernia repair: Review. Asian J Surg 2024:S1015-9584(24)01272-7. [PMID: 38960759 DOI: 10.1016/j.asjsur.2024.06.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/13/2024] [Accepted: 06/19/2024] [Indexed: 07/05/2024] Open
Abstract
Hernioplasty stands as one of the most common abdominal surgical interventions. The "gold standard" treatment for inguinal hernias remains Lichtenstein mesh hernioplasty. Nonetheless, clinical practice continues to grapple with issues concerning complications such as recurrence, chronic postoperative pain, and infection. The myriad types of surgery lead to conflicting opinions regarding the superiority and drawbacks of inguinal canal plastic surgery methods. This article presents current data on the surgical treatment of non-mesh inguinal hernias, delineating the most prevalent techniques while exploring their respective advantages and disadvantages. Additionally, the researchers' experiences are analyzed in detail.
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Affiliation(s)
- S T Sapiyeva
- Department of Surgery, Non-commercial Joint-stock Company "Karaganda Medical University", Karaganda, 100000, Kazakhstan
| | - N T Abatov
- Department of Surgery, Non-commercial Joint-stock Company "Karaganda Medical University", Karaganda, 100000, Kazakhstan
| | - M T Aliyakparov
- Department of Surgery, Non-commercial Joint-stock Company "Karaganda Medical University", Karaganda, 100000, Kazakhstan
| | - R M Badyrov
- Department of Surgery, Non-commercial Joint-stock Company "Karaganda Medical University", Karaganda, 100000, Kazakhstan
| | - N Yoshihiro
- Department of Surgery, Non-commercial Joint-stock Company "Karaganda Medical University", Karaganda, 100000, Kazakhstan
| | - L V Brizitskaya
- Department of Surgery, Non-commercial Joint-stock Company "Karaganda Medical University", Karaganda, 100000, Kazakhstan
| | - D K Yesniyazov
- Department of Surgery, Non-commercial Joint-stock Company "Karaganda Medical University", Karaganda, 100000, Kazakhstan
| | - Y A Yukhnevich
- Department of Surgery, Non-commercial Joint-stock Company "Karaganda Medical University", Karaganda, 100000, Kazakhstan.
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Agarwal D, Sinyard RD, Ott L, Reinhorn M. Primary Tissue Repair for Inguinal Hernias: The Shouldice Repair Technique and Patient Selection. Surg Clin North Am 2023; 103:859-873. [PMID: 37709392 DOI: 10.1016/j.suc.2023.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
It is estimated that approximately one in four men and one in 20 women will develop an inguinal hernia over the course of their lifetime. A non-mesh inguinal hernia repair via the Shouldice technique is a unique approach that necessitates dissection of the entire groin region as well as careful assessment for any secondary hernias. Subsequently, a pure tissue laminated closure allows the repair to be performed without tension. Herein, the authors describe a brief overview of inguinal hernias and discuss the relevant patient evaluation, operative steps of the Shouldice procedure, and postoperative considerations.
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Affiliation(s)
- Divyansh Agarwal
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. https://twitter.com/divyansh_aga
| | - Robert D Sinyard
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Lauren Ott
- Mass General Brigham, Newton-Wellesley Hospital, Boston Hernia, Tufts University School of Medicine, Boston, MA, USA
| | - Michael Reinhorn
- Mass General Brigham, Newton-Wellesley Hospital, Boston Hernia, Tufts University School of Medicine, Boston, MA, USA.
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Yerxa J, Wang H, Pappas TN. A "New" Nonmesh Technique for Inguinal Hernia Repair: Revisiting E. Wyllys Andrews and His Imbricating Operation. ANNALS OF SURGERY OPEN 2023; 4:e310. [PMID: 37746612 PMCID: PMC10513125 DOI: 10.1097/as9.0000000000000310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 06/01/2023] [Indexed: 09/26/2023] Open
Abstract
The use of prosthetic mesh to repair inguinal hernias has been common practice at surgical centers around the world for more than 30 years. Open tissue repairs are the alternative for patients who cannot have, do not want, or are not offered mesh. Open tissue repairs are troubled by inferior recurrence rates in most clinical trials. In this article, we will review a long-forgotten tissue repair described by Andrews in 1895. In addition, we report on our early experience with the Andrews technique for primary inguinal hernia tissue repair.
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Affiliation(s)
- John Yerxa
- From the Trauma and Acute Care Surgery, University of Miami/Jackson Health System, Miami, FL
| | - Hanghang Wang
- Division of Thoracic Surgery, Johns Hopkins University Medical Center, Baltimore, MD
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Zhang K, Zhu L. Transversalis fascia suture reinforcement may facilitate the performance of electrospun P(LLA-CL) nanoscale fibrinogen mesh in inguinal hernia repair: a prospective single-center cohort study. Sci Rep 2023; 13:12132. [PMID: 37495644 PMCID: PMC10372066 DOI: 10.1038/s41598-023-39391-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 07/25/2023] [Indexed: 07/28/2023] Open
Abstract
The aim of this study was to evaluate a new electrospun P(LLA-CL) nanoscale fibrinogen mesh performance in real-world clinical practice. A prospective, single-center evaluation of Lichtenstein inguinal hernia repair using electrospun P(LLA-CL) nanoscale fibrinogen mesh in elderly patients with comorbid diseases was conducted between 2020 and 2022. A suture reinforcement of transversalis fascia was applied before mesh implantation. Hernia recurrence, pain score and overall complication rate were measured. A total of 52 inguinal hernias in 48 patients were included. The age of patients ranged from 33 to 95 years, with a median of 78 years. Comorbid conditions included cardiopulmonary disease, organ dysfunction, anticoagulant use, diabetes and smoking. By optimizing the physical condition perioperatively, all patients finished treatment successfully. Four cases recurred secondary to direct hernias or combined hernias and were diagnosed in the first 24 case cohort during follow-up. With surgical procedural modification involving strengthening the posterior inguinal floor by reef-up suturing of the transversalis fascia and the inferior edge of mesh slit to accommodate the spermatic cord, no further recurrence was diagnosed. Postoperative pain was mild and the pain score decreased three months after surgery compared to 1 week after surgery (p = 0.0099). No severe complications occurred, while seroma occurred in six cases. Electrospun P(LLA-CL) nanoscale fibrinogen mesh is safe and effective in repairing inguinal hernias in elderly patients with comorbid disease. A strengthening of the transversalis fascia by suturing may enhance the performance of this mesh.
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Affiliation(s)
- Kewei Zhang
- Department of General Surgery, Shanghai Tongren Hospital, JiaoTong University School of Medicine, 1111 Xianxia Road, Shanghai, 200336, China
| | - Leiming Zhu
- Department of General Surgery, Shanghai Tongren Hospital, JiaoTong University School of Medicine, 1111 Xianxia Road, Shanghai, 200336, China.
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Martín Duce A. It’s time to re-acknowledge the differences: author’s reply. Hernia 2022; 26:681. [DOI: 10.1007/s10029-021-02514-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 09/03/2021] [Indexed: 11/30/2022]
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Abstract
Inguinal hernias represent one of the most common pathologic conditions presenting to the general surgeon. In surgical practice, several controversies persist: when to operate, the utility of a laparoscopic versus open approach, the applicability of robotic surgery, the approach to bilateral hernias, management of athletic-related groin pain ("sports hernia"), and the role of tissue-based repairs in modern hernia surgery. Ideally, surgeons should approach each patient individually and tailor their approach based on patient factors and preferences. The informed consent process is critical, especially given increasing recognition of the risk of long-term chronic pain following hernia repair.
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Affiliation(s)
- Veeshal H Patel
- Department of Surgery, University of Washington Medical School, 1959 Northeast Pacific Street Box 356410, Seattle, WA 98195, USA
| | - Andrew S Wright
- Department of Surgery, University of Washington Medical School, 1959 Northeast Pacific Street Box 356410, Seattle, WA 98195, USA; Center for VideoEndoscopic Surgery Endowed Professor, University of Washington.
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Tripoloni DE, Canaro García MI, Cassani F, Zanni M. It's time to re-acknowledge the differences. Hernia 2021; 26:679. [PMID: 34591215 DOI: 10.1007/s10029-021-02500-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 08/24/2021] [Indexed: 11/29/2022]
Affiliation(s)
- D E Tripoloni
- División Emergencias, División Cirugía General, Sanatorio "Dr. Julio Méndez", Avellaneda 551, Ciudad Autónoma de Buenos Aires, República Argentina.
| | - M I Canaro García
- División Emergencias, División Cirugía General, Sanatorio "Dr. Julio Méndez", Avellaneda 551, Ciudad Autónoma de Buenos Aires, República Argentina
| | - F Cassani
- División Emergencias, División Cirugía General, Sanatorio "Dr. Julio Méndez", Avellaneda 551, Ciudad Autónoma de Buenos Aires, República Argentina
| | - M Zanni
- División Emergencias, División Cirugía General, Sanatorio "Dr. Julio Méndez", Avellaneda 551, Ciudad Autónoma de Buenos Aires, República Argentina
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