Laparoscopic inguinal hernia

Persistent post-surgical pain (PPSP) is one of the most bothersome and disabling long-term complications after inguinal hernia repair (IHR) surgery. Understanding perioperative risk factors that contribute to PPSP can help identify high-risk patients and develop risk-mitigation approaches. The objective of this study was to systematically review and meta-analyze risk factors that contribute to PPSP after IHR. The literature search resulted in 303 papers included in this review, 140 of which were used for meta-analyses...

Corona mortis (CM) is an anastomotic vessel between the inferior epigastric or external iliac vessels and the obturator or internal iliac vessels. The Latin meaning of it is 'crown of death' which corresponds to massive haemorrhage caused by injury to this vessel during surgery. The incidence of this vessel is around 50% in the hemipelvis. We are presenting an intraoperative video of a right laparoscopic totally extraperitoneal mesh hernioplasty demonstrating a CM artery in the right hemipelvis. Care was taken to prevent injury to this vessel...

PURPOSE: The safety of laparoscopic inguinal-hernia repair must be carefully evaluated in elderly patients. Very little is known regarding the safety of the laparoscopic approach in elderly patients under surgical and medical co-management (SMC). Therefore, this study evaluated the safety of the laparoscopic approach in elderly patients, especially patients with multiple comorbidities under SMC. METHODS: From January 2012 to December 2021, patients aged ≥ 65 years who underwent open or laparoscopic inguinal-hernia repair during hospitalization were consecutively enrolled...

BACKGROUND: The article describes our initial experience using CMR Versius platform for several procedures in general surgery. METHODS: Between September 2022 and April 2023, seventy patients underwent robotic surgery in a multi-robotic referral center (San Paolo University Hospital, Milan, Italy). Three surgeons with only laparoscopic experience performed 24 cholecystectomies, 13 inguinal hernia repairs, 9 ventral hernia repairs, 7 right hemicolectomies, 11 left hemicolectomies, 1 sigmoidectomy, 1 ileocecal resection, 1 ventral rectopexy, 1 Nissen fundoplication, 1 total splenectomy, and 1 exploration with multiple biopsies...

AIM: To evaluate the practice patterns of European Pediatric Surgeons Association (EUPSA) members regarding the timing of inguinal hernia (IH) repair in premature infants. METHODS: Online survey containing 29 questions distributed to EUPSA members during January 2023. RESULTS: A total of 180 responds were received.. Overall, IH repair prior to discharge was favored by 60% of respondents when there was a history of incarceration and 56% when there was not...

BACKGROUND: Amyand's hernia (AH) is an appendix (with or without acute inflammation) trapped within an inguinal hernia. Most AH with acute appendicitis had a preexisting appendix within the hernia sac. We herein report a variant of AH that has never been described before. An inflamed appendix that was managed conservatively was found to have migrated and trapped in the sac of a previously unrecognized right inguinal hernia 6 weeks after the index admission, resulting in a secondary Amyand's hernia...

Amyand's hernia (AH) describes the rare instance of a vermiform appendix within an inguinal hernia. Primary appendiceal neoplasms are also rare with the majority of cases being found incidentally during routine histopathology. This case reports the management of a 15-year-old male, who presented to the emergency department with acute appendicitis located within an indirect right inguinal hernia, which was ultimately secondary to a neuroendocrine tumor (NET) with serosal involvement. Intraoperative findings included macroscopic appendicitis with no evidence of perforation...

A direct sliding inguinal hernia descends through the superficial inguinal ring and encroaches on nearby organ structures, such as the bladder. This type of hernia is rare with a 2-5% incidence and occurs due to a weakness within the lower abdominal wall, usually associated with advancing age, that permits the distal colon to descend into the inguinal canal. Direct sliding inguinal hernias are a rare subset of inguinal hernias that require meticulous dissection due to their incorporation of nearby organs such as the bladder or colon...

Reduction en masse is the reduction of the hernial sac into the preperitoneal space, with a loop of bowel remaining trapped at the neck of the hernial sac. This complication is rare, usually associated with inguinal hernias, and is characterized by the absence of a noticeable bulge in the groin. The patient was a 2-month-old male infant and presented with a nonreducible bulge in his left groin, and incarceration of the left inguinal hernia was diagnosed. Manual reduction was performed, and the hernia bulge became less noticeable...

INTRODUCTION AND IMPORTANCE: Amyand's hernia is a rare type of inguinal hernia which contains vermiform appendix in the inguinal sac, seldom complicated by acute appendicitis. It is usually repaired by open inguinal approach, but laparoscopic technique has been increasingly described in literature; nevertheless, standard of care is far from being defined. Here we report the case of Amyand's hernia complicated by acute appendicitis and simultaneous symptomatic left inguinal hernia, both repaired by laparoscopic technique...

Background: Laparoscopic sac disconnection and peritoneal closure represents an alternative to open pediatric hernia repair. We performed a retrospective review of our data to evaluate this alternative method. Materials and Methods: With REB approval, a retrospective chart review of all patients who underwent laparoscopic indirect inguinal hernia repair between June 2013 and July 2016 was conducted. Primary outcome was the recurrence rate. Secondary outcomes included length of surgery, postoperative hydrocele, and perioperative complications...

PURPOSE: Laparoscopic groin hernia repair has evolved and gained popularity and laparoscopic transabdominal preperitoneal (TAPP) procedure provides an opportunity to evaluate the peritoneal cavity and both inguinal areas without the need for additional dissection. There is still a paucity of evidence to support TAPP repair in the emergency setting. In this systematic review, we aim to evaluate the feasibility and safety of TAPP repair for incarcerated and strangulated groin hernias. METHODS: PRISMA guidelines were followed for literature search and established inclusion and exclusion criteria were applied...

PURPOSE: Metachronous contralateral inguinal hernia (MCIH) may occur after unilateral inguinal hernia (IH) repair, potentially as a result of occult IH (OIH). Contralateral OIH can be checked for during laparoscopic transabdominal hernioplasty for the treatment of unilateral IH. This study aims to assess the efficacy of laparoscopic iliopubic tract repair (IPTR) in treating contralateral OIH to reduce MCIH. METHODS: The medical charts of 3165 patients aged > 18 years who underwent laparoscopic transabdominal hernioplasty for unilateral IH from January 2013 to December 2021 were retrospectively reviewed...

PURPOSE: International guidelines exist for surgical treatment of either ventral or inguinal hernias repair (VHR; IHR). However, approach for managing both of them remains unestablished and is further complicated by newly developed surgical techniques and modalities (namely, robotic). This highlights the need for a tailored, algorithmic strategy to streamline surgical management. METHODS: An algorithm was developed by the directors of the NYU Langone Abdominal Core Health program of which four treatment groups were described: Group 1: open VHR and either laparoscopic or robotic IHR; Group 2: robotic transabdominal pre-peritoneal (TAPP) approach for both VHR and IHR; Group 3: robotic retro-muscular VHR and IHR; and Group 4: open repair for both...

INTRODUCTION: There has been a rapid proliferation of the robotic approach to inguinal hernia, mainly in the United States, as it has shown similar outcomes to the laparoscopic approach but with a significant increase in associated costs. Our objective is to conduct a cost analysis in our setting (Spanish National Health System). MATERIALS AND METHODS: A retrospective single-center comparative study on inguinal hernia repair using a robotic approach versus laparoscopic approach...

BACKGROUND: Inguinal herniation of the urinary bladder is uncommon and those descending into the scrotum are even rarer. Although open anterior repair has been used for inguinal bladder hernia, the efficacy of laparoscopic herniorrhaphy has been reported in recent years. CASE PRESENTATION: A 63-year-old man presented with an irreducible right groin and scrotal bulge associated with voiding difficulty. Abdominal ultrasonography showed a dislocation of the urinary bladder descending into the right scrotum...

Various surgical approaches for inguinal hernia repair have been outlined in medical literature. In most cases, these lesions are repaired by general surgeons. A variety of surgical techniques for the treatment of inguinal hernias have been documented in the medical literature. In 2018, the European Hernia Society (EHS) recommended laparo-endoscopic repair as a preferred approach for adults. This method involves a combination of laparoscopic and endoscopic techniques for hernia repair. The goal of this systematic review is to conduct a thorough examination of the total extraperitoneal vs...

Inguinal hernias, although a common occurrence, pose a significant threat to the surgical community on account of their complexity and socioeconomic consequences. Bilateral inguinal hernias, which are a rare subtype of inguinal hernias, in particular, are problematic since there are no existing definitive international guidelines for their repair. It is estimated that between 8% and 30% of inguinal hernia patients have bilateral hernias, but there is still no clarity as to whether a bilateral hernia represents a special type of inguinal hernia or two different hernias in one patient...

PURPOSE: This study aimed to determine the occurrence of incidental obturator hernia and clinical risk factors of their appearance in patients undergoing totally extraperitoneal (TEP) inguinal hernioplasty. METHODS: Data were collected retrospectively from patients who underwent TEP inguinal hernioplasty between June 2020 and December 2022. RESULTS: A total of 251 patients were included in the study. Obturator hernias were found in 21 patients (8...

BACKGROUND: Repair of an umbilical hernia is most often considered the less important condition when concomitant with other abdominal surgery. Despite this, the evidence for a concomitant umbilical hernia repair is sparse. The aim of this nationwide cohort study is to compare the short- and long-term outcomes of primary umbilical hernia repair and umbilical hernia repair concomitant with other abdominal surgery. METHOD: Data from the Danish Hernia Database and the National Patients Registry from January 2007 to December 2018 was merged, resulting in identification of patients receiving umbilical hernia concomitant to another abdominal surgery (laparoscopic inguinal hernia repair, laparoscopic cholecystectomy, and laparoscopic appendectomy)...