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Faessen JL, Duijsings ESR, Boerma EG, Broos PPHL, van Vugt R, Stoot JHMB. The first experience with the Dextile anatomical mesh in laparoscopic inguinal hernia repair. Hernia 2023; 27:1203-1208. [PMID: 37548799 DOI: 10.1007/s10029-023-02855-3] [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] [Received: 05/19/2023] [Accepted: 07/27/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND The Dextile Anatomical mesh (Medtronic) is a polypropylene heavyweight mesh and has a 3D patented anatomical shape which adapts to the contours of the extra-peritoneal inguinal region without the need for fixation, potentially reducing the risk of hernia recurrence and chronic post-operative pain. This retrospective study will be the first study to assess the outcomes of the Dextile Anatomical mesh compared to another three-dimensional mesh, the 3DMax mesh (Bard). METHODS Between 2019 and 2022, all patients who underwent an elective unilateral inguinal hernia repair were assessed. 416 patients in the Dextile Anatomical mesh group and 540 patients in the 3DMax mesh group were included. Outcomes were intra- and post-operative complications, inguinal hernia recurrence and chronic post-operative inguinal pain. RESULTS No significant differences were found between the two groups regarding intra- and post-operative complications including wound infection, antibiotic use, hematoma, seroma, urinary retention and delayed wound healing. 1-year recurrence rate was comparable for the Dextile Anatomical mesh group and the 3DMax mesh group, respectively, 3.8% and 3.0%, P = 0.45. Chronic post-operative inguinal pain was similar for the Dextile Anatomical mesh (3.4%) and the 3DMax mesh (3.0%), P = 0.72. CONCLUSION This retrospective study comparing the relatively new Dextile Anatomical mesh (Medtronic) with the 3D Max mesh (Bard) in unilateral inguinal hernia repair showed that both meshes are safe and effective to use. There were no significant differences in intra-operative outcomes, recurrence rates and chronic post-operative inguinal pain.
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Affiliation(s)
- J L Faessen
- Department Of Surgery, Zuyderland Medical Center, Sittard-Geleen and Heerlen, Dr. H. Van der Hoffplein 1, 6162 BG, Sittard-Geleen, The Netherlands.
| | - E S R Duijsings
- Department Of Surgery, Zuyderland Medical Center, Sittard-Geleen and Heerlen, Dr. H. Van der Hoffplein 1, 6162 BG, Sittard-Geleen, The Netherlands
| | - E G Boerma
- Department Of Surgery, Zuyderland Medical Center, Sittard-Geleen and Heerlen, Dr. H. Van der Hoffplein 1, 6162 BG, Sittard-Geleen, The Netherlands
| | - P P H L Broos
- Department Of Surgery, Zuyderland Medical Center, Sittard-Geleen and Heerlen, Dr. H. Van der Hoffplein 1, 6162 BG, Sittard-Geleen, The Netherlands
| | - R van Vugt
- Department Of Surgery, Zuyderland Medical Center, Sittard-Geleen and Heerlen, Dr. H. Van der Hoffplein 1, 6162 BG, Sittard-Geleen, The Netherlands
| | - J H M B Stoot
- Department Of Surgery, Zuyderland Medical Center, Sittard-Geleen and Heerlen, Dr. H. Van der Hoffplein 1, 6162 BG, Sittard-Geleen, The Netherlands
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Gram-Hanssen A, Christophersen C, Rosenberg J. Results from patient-reported outcome measures are inconsistently reported in inguinal hernia trials: a systematic review. Hernia 2022; 26:687-699. [PMID: 34480660 DOI: 10.1007/s10029-021-02492-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/26/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the use, results, and reporting of patient-reported outcome measures specific to patients undergoing inguinal hernia repair. METHODS A systematic review was performed and reported according to the PRISMA 2020 statement. A protocol was registered at PROSPERO (CRD42021243468). Systematic searches were performed in PubMed and EMBASE. We only included randomized controlled trials that involved postoperative administration of a hernia-specific patient-reported outcome measure. Risk of bias was evaluated with the Cochrane risk of bias-tool 2.0. RESULTS Twenty trials and four different instruments were included: the Carolinas Comfort Scale (nine studies), Activities Assessment Scale (six studies), Inguinal Pain Questionnaire (seven studies), and Surgical Pain Scales (one study). Included trials used patient-reported outcome measures and compared either different surgical approaches (11 studies), types of mesh/fixation (seven studies), or types of anesthesia/analgesia (two studies). Results were reported using several different methods including means, medians, or proportions of either overall results, results from subscales, or results from single questionnaire items. Seven of the 20 included studies specified a patient-reported outcome measure as a primary outcome and provided clear reporting of sample size calculation. CONCLUSION Reporting of results from patient-reported outcome measures in inguinal hernia research was characterized by heterogeneity. The results were reported using several different methods, which impedes proper evidence synthesis. Only half of the included studies applied a patient-reported outcome measure as primary outcome. Ultimately, the heterogeneity in outcome reporting is an important methodological problem obstructing the full utilization of patient-reported outcome measures in inguinal hernia research.
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Affiliation(s)
- A Gram-Hanssen
- Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
| | - C Christophersen
- Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - J Rosenberg
- Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev, Denmark
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Murphy BL, Ubl DS, Zhang J, Habermann EB, Farley DR, Paley K. Trends of inguinal hernia repairs performed for recurrence in the United States. Surgery 2018; 163:343-350. [DOI: 10.1016/j.surg.2017.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 07/16/2017] [Accepted: 08/02/2017] [Indexed: 01/08/2023]
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D'Hondt M, Nuytens F, Yoshihara E, Adriaens E, Vansteenkiste F, Pottel H. Totally extraperitoneal laparoscopic inguinal hernia repair using a self-expanding nitinol framed hernia repair device: A prospective case series. Int J Surg 2017; 40:139-144. [PMID: 28257986 DOI: 10.1016/j.ijsu.2017.02.091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 02/27/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND The use of a self-expanding nitinol framed prosthesis (ReboundHRD®) for totally extraperitoneal laparoscopic inguinal hernia repair (TEP-IHR) could solve issues of mesh shrinkage and associated pain. We prospectively evaluated the use of the ReboundHRD® mesh for TEP-IHR. MATERIALS AND METHODS All patients who underwent a TEP-IHR using the ReboundHRD® Large mesh from April 2014 till May 2015, were included. No mesh fixation was performed. Follow-up assessments were performed at the day of surgery, 1, 2, and 7 days, 1, 3, 6, and 12 months. Outcome measures include post-operative pain (visual analogue scale, VAS), operative details, complications, and recurrence rate. RESULTS In total, 69 TEP-IHR procedures were performed in 54 patients (15 bilateral hernias). No perioperative and 5 (9%) postoperative complications occurred, all graded Clavien-Dindo I-II. The median length of stay was 1 day (range 0-3), with 78% of the operations performed in an ambulatory setting. Median VAS score decreased from 3 (range 0-4) on the day of surgery to 1 (range 0-2) on day 7. Patients were completely pain-free at a median time of 5 (range 1-60) days. The majority (80.4%, 37/46) of the active patients went back to work within 2 weeks (maximum 6 weeks). At a median follow-up of 19 months (range 16-26 months), no recurrences occurred. CONCLUSION TEP-IHR using a self-expanding nitinol framed hernia repair device is a safe technique in longterm follow-up. The technique is associated with a low incidence of postoperative pain, a short hospital stay and quick return to normal activities.
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Affiliation(s)
- Mathieu D'Hondt
- Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500 Kortrijk, Belgium.
| | - Frederiek Nuytens
- Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500 Kortrijk, Belgium
| | - Emi Yoshihara
- Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500 Kortrijk, Belgium
| | - Els Adriaens
- Adriaens Consulting Bvba, Bellemdorpweg 95, 9881 Aalter, Belgium
| | - Franky Vansteenkiste
- Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500 Kortrijk, Belgium
| | - Hans Pottel
- Interdisciplinary Research Center, Katholieke Universiteit Leuven Campus Kortrijk, Etienne Sabbelaan 53, 8500 Kortrijk, Belgium
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Wennergren JE, Plymale M, Davenport D, Levy S, Hazey J, Perry KA, Stigall K, Roth JS. Quality-of-life scores in laparoscopic preperitoneal inguinal hernia repair. Surg Endosc 2015; 30:3467-73. [PMID: 26541729 DOI: 10.1007/s00464-015-4631-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 10/17/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Published support exists for using lightweight polypropylene mesh (PPM) to repair inguinal hernias with increased biocompatibility and decreased foreign body reaction and pain. However, quality of life (QOL) has not been assessed. We assess QOL in patients undergoing laparoscopic totally extraperitoneal hernia repair (TEP) with lightweight PPM. METHODS We performed an IRB-approved study of patients undergoing TEP hernia repair. Demographic information and hernia characteristics were collected perioperatively. Baseline Short Form-36 (SF-36), Carolinas Comfort Scale (CCS), and visual analog scale (VAS) for pain were performed preoperatively, and then after 1, 26, and 52 weeks. RESULTS Forty-eight patients undergoing TEP with mesh were selected. Average age was 43.2 years (SD = 13.2), and average BMI was 26.1 kg/m(2) (SD = 4.3). Procedures include bilateral hernia, right inguinal hernia, and left inguinal hernia repairs. Mean scores on the CCS(®) and VAS were low during the immediate post-op period and 1 year. SF-36 mean scores for body pain, physical function, and role physical showed decreases at the postoperative survey and then subsequent increases. Pain-associated scores increased during the immediate post-op period. CCS and SF-36 scores demonstrated improvement after 1 year. There was no significant difference in VAS. Bilateral repair patients reported more pain and reduced physical function versus unilateral repairs. Patients with larger mesh reported greater pain scores and reduced physical function scores. CONCLUSIONS Laparoscopic inguinal hernia repair is associated with initial declines in QOL in the postoperative period. Improvements appear in the long term. General health does not appear to be impacted by laparoscopic TEP. Smaller mesh and unilateral repairs are associated with improved QOL following laparoscopic TEP with PPM. Multiple metrics for QOL are required to reflect patient recovery.
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Affiliation(s)
- John E Wennergren
- Department of Surgery, University of Kentucky, Lexington, KY, 40536, USA
| | - Margaret Plymale
- Department of Surgery, University of Kentucky, Lexington, KY, 40536, USA
| | - Daniel Davenport
- Department of Surgery, University of Kentucky, Lexington, KY, 40536, USA.,University of Kentucky College of Medicine, MN273 Medical Science Building, 800 Rose Street, Lexington, KY, 40536-0298, USA
| | - Salomon Levy
- Department of Surgery, University of Kentucky, Lexington, KY, 40536, USA
| | - Jeffrey Hazey
- Division of General and Gastrointestinal Surgery, The Ohio State University, Columbus, OH, 43210, USA
| | - Kyle A Perry
- Division of General and Gastrointestinal Surgery, The Ohio State University, Columbus, OH, 43210, USA
| | - Kyle Stigall
- University of Kentucky College of Medicine, MN273 Medical Science Building, 800 Rose Street, Lexington, KY, 40536-0298, USA
| | - J Scott Roth
- Department of Surgery, University of Kentucky, Lexington, KY, 40536, USA. .,University of Kentucky College of Medicine, MN273 Medical Science Building, 800 Rose Street, Lexington, KY, 40536-0298, USA.
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