Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
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Κυριακή 5 Μαρτίου 2017

Totally extraperitoneal laparoscopic inguinal hernia repair using a self-expanding nitinol framed hernia repair device. Single centre prospective evaluation with one year follow-up. (case series).

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Totally extraperitoneal laparoscopic inguinal hernia repair using a self-expanding nitinol framed hernia repair device. Single centre prospective evaluation with one year follow-up. (case series).

Int J Surg. 2017 Feb 28;:

Authors: D'Hondt M, Nuytens F, Yoshihara E, Adriaens E, Vansteenkiste F, Pottel H

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.

PMID: 28257986 [PubMed - as supplied by publisher]



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