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Lozano-Carrillo LC, Meléndez-Mondragón H, Alvarez-Lozada LA, Quiroga-Garza A, Valdivia-Balderas JM. An Unusual Postoperative Complication Following Bilateral Inguinal Hernioplasty: A Pocket Hernia Case Report. Cureus 2024; 16:e61589. [PMID: 38962612 PMCID: PMC11221494 DOI: 10.7759/cureus.61589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2024] [Indexed: 07/05/2024] Open
Abstract
Inguinal hernias are the most common type of hernias in the groin, affecting 27% of the population, with a nine to 12 times higher incidence in men. The primary treatment for this condition typically involves a surgical procedure, with most surgeons opting for mesh placement through a laparoscopic approach. While this procedure is generally associated with low complication rates (primarily hematomas, seromas, and scrotal edema), there are some highly infrequent complications reported such as postoperative small bowel obstruction (SBO), estimated to occur in approximately 0.1%-0.5% of cases, most commonly during transabdominal preperitoneal (TAPP) repair. It is crucial to emphasize the importance of using skilled surgical techniques and adhering to established guidelines in postoperative patient care to minimize the risk of these complications. We describe a case of a 47-year-old male patient who underwent bilateral TAPP repair for inguinal hernias and subsequently experienced postoperative complications, including the development of a hematoma and SBO, requiring a re-intervention that evidenced a peritoneal pocket hernia.
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Affiliation(s)
- Luis Carlos Lozano-Carrillo
- Department of Human Anatomy, Clinical-Surgical Research Group (GICQx) Universidad Autonoma de Nuevo Leon, School of Medicine, Monterrey, MEX
- Department of Human Anatomy, Anatomy Research Group (GIA) Universidad Autonoma de Nuevo Leon, School of Medicine, Monterrey, MEX
| | - Humberto Meléndez-Mondragón
- Department of Human Anatomy, Anatomy Research Group (GIA) Universidad Autonoma de Nuevo Leon, School of Medicine, Monterrey, MEX
| | - Luis Adrian Alvarez-Lozada
- Department of Human Anatomy, Clinical-Surgical Research Group (GICQx) Universidad Autonoma de Nuevo Leon, School of Medicine, Monterrey, MEX
- Department of Human Anatomy, Anatomy Research Group (GIA) Universidad Autonoma de Nuevo Leon, School of Medicine, Monterrey, MEX
| | - Alejandro Quiroga-Garza
- General Surgery Division, Mexican Social Security Institute, Nuevo Leon Delegation, Monterrey, MEX
- Department of Human Anatomy, Clinical-Surgical Research Group (GICQx) Universidad Autonoma de Nuevo Leon, School of Medicine, Monterrey, MEX
- Department of Human Anatomy, Anatomy Research Group (GIA) Universidad Autonoma de Nuevo Leon, School of Medicine, Monterrey, MEX
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Dumitrescu V, Serban D, Costea DO, Dumitrescu D, Bobirca F, Geavlete B, Bratu DG, Tribus L, Serboiu C, Alius C, Tudor C, Dascalu AM, Tudosie MS, Serban B, Moga DF. Transabdominal Preperitoneal Versus Lichtenstein Procedure for Inguinal Hernia Repair in Adults: A Comparative Evaluation of the Early Postoperative Pain and Outcomes. Cureus 2023; 15:e41886. [PMID: 37581138 PMCID: PMC10423624 DOI: 10.7759/cureus.41886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2023] [Indexed: 08/16/2023] Open
Abstract
Inguinal hernia repairs are one of the most common procedures in general surgery. In addition to classical open surgery, laparoscopic techniques, such as transabdominal preperitoneal (TAPP) and total extraperitoneal (TEP) hernia repair, have gained acceptance and are increasingly used for inguinal hernia repairs, and these three techniques are the only standards for inguinal hernia repairs. This study aimed to compare the results of inguinal hernia repairs in adult patients using the TAPP patch technique and Lichtenstein techniques regarding the level of pain perceived one day after surgery and the number of days of hospitalization. A two-year study was performed on 129 patients who underwent TAPP vs. 109 patients who underwent Liechtenstein hernia repair. Our results revealed statistical significance for both variables (Tpain(233) = -7.12, p< 0.001, d=2.92; Tdays of hospitalization(233) = -31.34, p< 0.001, d=4.01). TAPP is a safe method for inguinal hernia repairs, allowing quick recovery and less postoperative pain than the classical Liechtenstein technique.
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Affiliation(s)
- Victor Dumitrescu
- Department of General Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Dragos Serban
- Department of General Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | | | - Dan Dumitrescu
- Department of General Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Florin Bobirca
- Department of General Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Bogdan Geavlete
- Department of Urology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | | | - Laura Tribus
- Department of Internal Medicine, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Crenguta Serboiu
- Department of Radiology, Oncology and Hematology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Catalin Alius
- Department of General Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Corneliu Tudor
- Department of General Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Ana Maria Dascalu
- Department of Ophthalmology, Faculty of Medicine, University of Medicine and Pharmacy Carol Davila, Bucharest, ROU
| | - Mihail Silviu Tudosie
- Department of Clinical Toxicology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Bogdan Serban
- Department of Orthopaedics, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU
| | - Doru Florian Moga
- Faculty of Medicine, "Lucian Blaga" University of Sibiu, Bucharest, ROU
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Plath L, Burger R, Bueter M, Thalheimer A. Two cases of an internal hernia after laparoscopic sigmoid resection. BMJ Case Rep 2022; 15:15/4/e249468. [PMID: 35393282 PMCID: PMC8990697 DOI: 10.1136/bcr-2022-249468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Two patients with a laparoscopic resection of the sigmoid colon in their surgical history were diagnosed with an internal hernia because of a mesenteric gap underneath the descending neocolon. While the first case demonstrated a strongly symptomatic patient with a closed-loop obstruction of the small bowel, the second case was less obvious and correct diagnosis was achieved after a few weeks by finally performing a diagnostic laparoscopy. Since internal hernias after laparoscopic sigmoid resection are a rare complication and as presented in the second case can display very unspecific symptoms, the surgeon’s awareness is not immediately raised towards it. Therefore, an asymptomatic internal hernia bears a constant risk of a life-threatening outcome allowing to recommend an initial closure of the mesenteric gap. In both cases, successful treatment was achieved by surgery and intraoperatively closing the remaining mesenteric gap. Subsequently recovery and follow-up were uneventful.
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Affiliation(s)
- Liane Plath
- Surgery, Spital Männedorf AG, Maennedorf, Switzerland
| | - Reint Burger
- Surgery, Spital Männedorf AG, Maennedorf, Switzerland
| | - Marco Bueter
- Surgery, Spital Männedorf AG, Maennedorf, Switzerland.,Visceral and Transplantation Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Andreas Thalheimer
- Surgery, Spital Männedorf AG, Maennedorf, Switzerland.,Visceral and Transplantation Surgery, University Hospital Zurich, Zurich, Switzerland
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Agapov MA, Kakotkin VV, Gallyamov EA, Kubyshkin VA. [Pain and quality of life after laparoscopic transabdominal preperitoneal hernioplasty with different ways of fixing the peritoneum. Results of early completion randomized clinical trial]. Khirurgiia (Mosk) 2022:14-20. [PMID: 36073578 DOI: 10.17116/hirurgia202209114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To compare and statistically evaluate the severity of pain syndrome and quality of life depending on the method of fixation of the parietal peritoneum during laparoscopic hernia repair (suture fixation or the use of tack fixation). METHODS A randomized clinical trial was conducted from May to June 2021 at the Lomonosov Moscow State University Medical Center. It was planned to observe patients for a year. In the first group, the fixation of the parietal peritoneum was performed using suture fixation, in the second group, the peritoneal flap was fixed using a fixation device. In the course of statistical data processing, it was planned to study the dependence of the duration of the operation, the severity of the pain syndrome in the early postoperative period, the frequency of complications, the quality of life of patients in the postoperative period on the chosen method of the fixation of the parietal peritoneum. RESULTS At the initial stage of the study, 8 patients with inguinal hernias were selected in the first group during randomization, and 6 patients were selected in the second group. Each patient of the second group in the early postoperative period had a more pronounced local pain, protective muscle tension in the projection of fixation of the parietal peritoneum with tacks, which was accompanied by negative psychoemotional reactions, an increase in the dose of analgesic drugs. Due to the revealed features of the early postoperative period in patients of second group, it was considered unethical and inappropriate to continue the study within the protocol. CONCLUSION The results obtained do not allow us to draw statistically supported conclusions. The solution of the problem of the peritoneal flap fixation method is possible in two ways: abandoning stapler fixation in favor of suture or conducting additional clinical studies with an analysis of the impact of the choice of peritoneal fixation technique not only on acute and chronic postoperative pain, but on quality of life in the early and delayed postoperative periods.
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Affiliation(s)
- M A Agapov
- Lomonosov Moscow State University, Moscow, Russian Federation
| | - V V Kakotkin
- Lomonosov Moscow State University, Moscow, Russian Federation
| | - E A Gallyamov
- Lomonosov Moscow State University, Moscow, Russian Federation
- Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - V A Kubyshkin
- Lomonosov Moscow State University, Moscow, Russian Federation
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