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العنوان
Early Surgical Outcomes of Non Complicated laparoscopic Transabdominal Preperitoneal (TAPP) Inguinal Hernia repair Using Suture technique/
المؤلف
El Saman, Islam Mohamed Ahmed.
هيئة الاعداد
باحث / إسلام محمد أحمد السمان
مشرف / أشرف عبد المغني مصطفى
مشرف / كريم فهمي عبد المعطي
تاريخ النشر
2022.
عدد الصفحات
172 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
جراحة
تاريخ الإجازة
1/1/2022
مكان الإجازة
جامعة عين شمس - كلية الطب - الجراحة العامة
الفهرس
Only 14 pages are availabe for public view

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from 215

Abstract

Groin hernia repair is considered to be one of the most commonly performed operations by general surgeons but; there is no ”gold standard” operation for treatment of inguinal hernias. The optimal surgical approach must be selected individually for the patient, considering age, hernia size, unilaterality or bilaterally, primary or recurrent, and type of anesthesia, occupation, and leisure activities.
The revolution of laparoscopic surgery has raised a vigorous debate over the safest and most effective groin hernia repair. This debate has expanded our understanding of inguinal anatomy and hernia repair. At least, surgeons should be aware of the current indications and contraindications for laparoscopic inguinal hernia repair, because some hernias should have a laparoscopic repair. To increase effectiveness, surgeons should consider becoming skilled at both techniques, with the understanding that outcomes are optimal if one is committed to achieving fluency in laparoscopic repair.
Laparoscopic repairs also provide very good results. It results in very low postoperative pain, less wound infection, and rapid return to daily activity and working where a mesh is placed either with a total extra peritoneal technique (TEP) or a transabdominal preperitoneal approach (TAPP).
TAPP repair of inguinal hernia is considered suited to the Day Surgery Unit. It is associated with low rates of immediate post-operative complications and need for overnight stay, and can be performed in less time than is required for open repair.
Using tackers or mesh fixation by sutures techniques is the most common and applicable approach with many of surgeons
Other current surgical options for mesh fixation include self-gripping mesh fixation or fibrin or other glues. However, there is no consensus on the best surgical technique and the choice of options often depends on surgeons’ personal preference.
Based on our prospective randomized study, a few initial conclusions can be made. There was no significant difference in the operation time between patients who underwent sutures technique mesh fixation and those who underwent mesh fixation by absorbable tacks in TAPP repair.
The postoperative pain assessment at (1) week, (4) weeks and (3) months shows that no significant difference between the two groups.
We found that both surgical approaches had almost the same Postoperative Hospital stay where the mean postoperative hospital stay was 1.5 days versus 1.6 days in group A and group B, respectively and all patients returned to normal activity with mean time (7 ± 2) versus (8 ± 2)days in group A and group B respectively.
We found that no statistically difference as regard the recurrence between the use of mesh fixation by using sutuers techniques versus fixation by absorpable tacks.
In conclusion, after this comparative study, both the use of mesh fixation by using sutures techniques and fixation of mesh by absorbable tacks approaches are similarly effective in terms of operative time, the incidence of recurrence, complications and chronic pain coinciding with all the available literature .