Ahmad Siddique, Aslam Raashid, Iftikhar Muhammad, Alam Muhammad
Department of General Surgery, Hayatabad Medical Complex Peshawar, Peshawar, PAK.
Cureus. 2023 Feb 28;15(2):e35567. doi: 10.7759/cureus.35567. eCollection 2023 Feb.
Background Inguinal hernia repair is one of the commonest general surgical procedures performed all over the world. The introduction of synthetic mesh and laparoscopic repair has revolutionized inguinal hernia surgery in the recent past. Laparoscopic transabdominal preperitoneal (TAPP) repair is now considered a well-established procedure with minimal complications and short hospital stay and less recurrence. The TAPP approach gives a good view of the inguinal anatomy and a better understanding of the sac contents. The learning curve associated with TAPP repair is much less as compared to total extraperitoneal (TEP) repair. The aim of this study was to assess the effectiveness of TAPP repair for inguinal hernia in terms of the duration of surgery, hospital stay, complications, and recurrence rate. Method From March 1, 2019, to February 28, 2021, a total of 60 patients with inguinal hernias between ages 25 and 70 years were included in the study. A preoperative anesthesia assessment was done, and informed written consent was taken from all patients. The TAPP procedure was performed with polypropylene mesh in all cases, and surgery was performed by a surgeon with more than five years of laparoscopic experience. Results The total number of patients included in the study was 60. All patients were male. The mean±standard deviation (SD) age of the patients was 54.6±11.4 years. Unilateral primary inguinal hernia was present in 46 (76.6%) cases, recurrent in eight (13.3%) cases, and primary bilateral in six (10%) cases. The mean±SD duration of surgery for unilateral inguinal hernia was 59.1±15.7 minutes, and for bilateral hernia, it was 83.5±12.6 minutes. The mean hospital stay was 3.6±1.5 days. Scrotal swelling was noted as a common complication in seven (11.6%) cases, surgical site infection (SSI) in three (5%), mesh infection in two (3.3%), urinary retention in two (3.3%), and chronic pain in one (1.6%). No recurrence was noted. Conclusion Transabdominal preperitoneal repair for inguinal hernia is a very effective procedure with a short learning curve and minimal complication rate. The hospital stay is less, and recurrence is very low.
腹股沟疝修补术是全球最常见的普通外科手术之一。近年来,合成补片和腹腔镜修补术的引入彻底改变了腹股沟疝手术。腹腔镜经腹腹膜前(TAPP)修补术目前被认为是一种成熟的手术,并发症少、住院时间短且复发率低。TAPP手术方式能很好地观察腹股沟区解剖结构,更好地了解疝囊内容物。与完全腹膜外(TEP)修补术相比,TAPP修补术的学习曲线要短得多。本研究的目的是从手术时间、住院时间、并发症和复发率方面评估TAPP修补术治疗腹股沟疝的有效性。
从2019年3月1日至2021年2月28日,共有60例年龄在25至70岁之间的腹股沟疝患者纳入本研究。进行了术前麻醉评估,并获得了所有患者的书面知情同意书。所有病例均采用聚丙烯补片进行TAPP手术,手术由一名有五年以上腹腔镜经验的外科医生进行。
纳入研究的患者总数为60例。所有患者均为男性。患者的平均年龄±标准差(SD)为54.6±11.4岁。46例(76.6%)为单侧原发性腹股沟疝,8例(13.3%)为复发性疝,6例(10%)为原发性双侧疝。单侧腹股沟疝的平均手术时间±SD为59.1±15.7分钟,双侧疝为83.5±12.6分钟。平均住院时间为3.6±1.5天。7例(11.6%)患者出现阴囊肿胀这一常见并发症,3例(5%)出现手术部位感染(SSI),2例(3.3%)出现补片感染,2例(3.3%)出现尿潴留,1例(1.6%)出现慢性疼痛。未发现复发情况。
腹股沟疝经腹腹膜前修补术是一种非常有效的手术,学习曲线短,并发症发生率低。住院时间短,复发率极低。