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1.
Purpose
Long-term outcomes after obturator hernia surgery remain unclear.Methods
Between 1979 and 2012, 80 consecutive operations for obturator hernia were performed for 70 patients at our hospital. Their charts were retrospectively reviewed, and the patients were contacted by telephone to check for the presence of an episode of recurrence. Including bilateral cases, a total of 104 obturator hernia repairs were divided by type into either mesh repair (n = 29) or non-mesh repair (n = 75). Recurrence rate was then calculated and compared between groups.Results
Median age at the time of initial surgery was 84 years. Postoperative complications occurred in 31 operations (39 %), including four in-hospital deaths (5 %). After the initial obturator hernia surgery, the 2- and 5-year survival rates were 74 and 55 %, respectively. Seventeen recurrences were detected, all after non-mesh repairs. Recurrence rates at 3 years after obturator hernia repair were 0 % for mesh repair and 22 % for non-mesh repair (P = 0.048).Conclusions
Once patients recover from an incarcerated obturator hernia, they may still enjoy their super-aged lives. To prevent the recurrence, mesh repair is preferable if no contraindications are present. 相似文献2.
Background
The optimal technique to cure strangulated inguinal hernia remains controversial. The use of mesh in cases of strangulated hernia is still debated due to the potential risk of infection.Objective
This systematic review aimed to determine whether or not the mesh repair technique is associated with a higher risk of surgical site infection than non-mesh techniques for strangulated inguinal hernias in adults.Methods
An electronic search of the relevant literature was performed on 15 December 2012 using the following databases: MEDLINE, the Cochrane Library, Scopus, Embase, and the Web of Science. Articles reporting a comparison between the mesh repair technique and a non-mesh technique to treat strangulated inguinal hernias in adults, and published in the English or French language in a peer-reviewed journal, were considered for analysis. The quality of randomized controlled trials (RCTs) was assessed using the Jadad scoring system. To assess the quality of non-randomized trials, we used the Methodological Index for Non-Randomized Studies (MINORS).Results
A total of 232 papers was found in the initial search; nine were included in the meta-analysis. The wound infection rate in the mesh repair technique group was lower than in the control group, with a trend towards significance (odds ratio [OR] 0.46, 95 % confidence interval [CI] 0.20–1.07; p = 0.07). The hernia recurrence rate was lower in the mesh repair group (OR 0.2, 95 % CI 0.05–0.78; p = 0.02).Conclusion
The mesh repair technique is a good option for the treatment of strangulated inguinal hernias in adults, giving an acceptable wound infection rate and fewer recurrences than non-mesh repair. Our study does not allow us to recommend the use of mesh in cases of bowel resection. We emphasize that, except the two RCTs, the results are predicated on patient selection bias by careful surgeons. Further RCTs are required to obtain more powerful evidence-based data. 相似文献3.
D. Symeonidis M. Efthimiou G. Koukoulis I. Mamaloudis M. Ioannou G. Tzovaras 《Hernia》2013,17(6):791-794
Purpose
Our group tried to test the hypothesis of using a totally absorbable material for open inguinal hernia repair. However, the increased incidence of recurrences alleviated our initial enthusiasm regarding the technique. The purpose of the present study was to attain both gross and microscopic data that could at least in part justify the hernia repair failure from a patient included in our initial pilot study and was re-operated for recurrence.Methods
A 65-year-old male patient was diagnosed clinically with a recurrence 24 months after open inguinal hernia repair with the use of polyglycolic acid/trimethylene carbonate mesh. The patient was operated for the recurrence upon our group on July 2012. The gross appearance of the inguinal area as well as the degree of chronic inflammation provoked by the used mesh as depicted by the pathologic analysis of specimens obtained intraoperatively were assessed.Results
An open tension-free repair with the use of a non-absorbable mesh under spinal anesthetic was undertaken. Intraoperatively, after the division of the external oblique aponeurosis, only minor fibrotic reaction was observed a finding that was additionally confirmed pathologically.Conclusion
Polyglycolic acid/trimethylene carbonate mesh used for inguinal hernia repair was associated with a minimal inflammatory host reaction in the inguinal area at 3 years verified both grossly and microscopically. 相似文献4.
Purpose
A prospective, multicentre, observational study was undertaken to assess Tisseel® fibrin sealant for atraumatic mesh fixation in inguinal hernia repair throughout France.Methods
Surgeons recorded data on patients undergoing tension-free inguinal hernioplasty with mesh fixation with Tisseel®, regardless of the hernioplasty technique used. Assessments were made at 2 days and 1 month after surgery. Data on local complications, operation times and ease of product use were collected.Results
In total, 1,201 patients were recruited (90% men, mean age 57 years), among which 526 procedures were performed using open techniques and 675 using laparoscopic repairs. Local complications occurred in 4.7% of patients: 3.0% haematoma, 1.4% seroma, 0.3% recurrence. The mean visual analogue scale (VAS)-rated pain scores were 3.2 pre-operatively, 2.3 immediately after surgery and 1.8 at 1 month. Surgeons rated the product as very easy to use.Conclusions
Tisseel® fibrin sealant appears to be a well-tolerated and easy-to-use alternative to traditional, tissue-penetrating devices for mesh fixation in hernia repair techniques. 相似文献5.
Purpose
Mesh fixation is essential in laparoscopic total extraperitoneal (TEP) repair of inguinal hernia; however, fixation sometimes causes post-operative pain. This study investigated a novel method of laparoscopic TEP repair without mesh fixation.Methods
This study reviewed data from about two-hundred and forty-one laparoscopic TEP repairs on 219 patients, which were performed between December 2004 and October 2005.Results
There were no statistically significant differences in the recurrence rate, seroma formation, and hospital stay. However, the mean operation time was shorter in the internal plug mesh group than the fixation group (p = 0.009), and post-operative pain only occurred in 4 cases in the internal plug mesh group in comparison to 29 cases in the mesh fixation group (p = 0.014).Conclusions
An internal plug mesh without fixation might reduce post-operative pain after laparoscopic TEP repair of an inguinal hernia. Internal plug mesh without fixation may be an alternative method in laparoscopic TEP repair, especially for those involving indirect hernias. 相似文献6.
Motohito Nakagawa Takeshi Nagase Tomotaka Akatsu Shun Imai Naoki Fujimura Tatsuo Asagoe Toshio Kanai 《Surgery today》2013,43(10):1109-1115
Purpose
The use of mesh in the surgical repair of adult indirect inguinal hernias is widely recommended in Western countries, but no randomized controlled trials have so far been reported in Japan. The purpose of the present randomized prospective trial was to compare a mesh method with non-mesh method for surgical repair of primary adult indirect inguinal hernias in which the diameter of the internal inguinal ring was up to 3.0 cm (I-1 or I-2 of Japanese Hernia Society Classification).Methods
Patients with a primary unilateral inguinal hernia and I-1 or I-2 surgical findings were randomized to undergo either Marcy repair or Prolene Hernia System® repair. Primary endpoints were recurrence, infection, and pain, with follow-up continued for 3 years postoperatively.Results
Ninety-one of 479 patients with an inguinal hernia during the study period did not meet the exclusion criteria, and 46 were allocated to Marcy repair and 45 were allocated to Prolene Hernia System® repair. No recurrence was observed in either group, and no significant differences were identified between the groups in any of the primary endpoints.Conclusion
This randomized prospective trial of I-1 and I-2 inguinal hernias suggests that Marcy repair is not inferior to PHS repair. A large-scale randomized controlled trial appears warranted to confirm whether to use mesh for Japanese adult I-1 and I-2 hernias. 相似文献7.
8.
Ivana Štula Nikica Družijanić Ada Sapunar Zdravko Perko Nada Bošnjak Damir Kraljević 《Surgical endoscopy》2014,28(12):3413-3420
Background
Testicular flow studies after hernia mesh repair mostly showed different outcomes. The reason of infertility in some men after hernia repair is immunological factors. Aim of the study was to investigate the influence of mesh hernia repair on antisperm antibodies production and testicular blood flow and a connection among these parameters.Materials and methods
A prospective interventional longitudinal cohort study was made on 82 male patients without exclusion criteria who had an inguinal hernia. Patients underwent laparoscopic TAPP or open tension-free hernia repair. Vascular ultrasound and antisperm antibodies were measured in the preoperative and postoperative periods. Main outcome measures were resistive index (RI), peak systolic velocity (PSV) cm/s, and end-diastolic velocity (EDV) cm/s in testicular blood flow measurement and the quantitative value of antisperm antibodies (ASA) in serum (IU/ml).Results
ASA significantly increased postoperatively only in patients who underwent open tension-free hernia repair (p < 0.001). ASA stayed in normal range in all patients except the one with postoperative complication. Friedman analysis showed significant change of the RI only on intratesticular (p < 0.001) and capsular artery level (0.02) in patients who underwent laparoscopic technique. PSV significantly changed on intratesticular (p < 0.001) and capsular artery level (p = 0.015) in the laparoscopic hernia repair. PSV showed significant change on intratesticular (p < 0.001) and testicular artery levels (p < 0.001) in the open tension-free hernia repair. EDV showed significant change only on testicular artery level (p = 0.032) in the patients who had open tension-free hernia repair. These blood flow parameters significantly increased in the early postoperative period and returned on basal value in the late postoperative period. Parameters of flow did not show any significant correlation with ASA.Conclusion
Mesh hernia repairs without complication caused only a transitory change in testicular blood flow and no clinical significant autoimmune reaction. 相似文献9.
Purpose
Inguinal hernia repair is a common surgical procedure, and the majority of operations worldwide are performed ad modum Lichtenstein (open tension-free mesh repair). Until now, no suitable surgical training model has been available for this procedure. We propose an experimental surgical training model for Lichtenstein’s procedure on the male and female pig.Methods
In the pig, an incision is made 1 cm cranially to the inguinal sulcus where a string of subcutaneous lymph nodes is located and extends toward the pubic tubercle. The spermatic cord is located in a narrow sulcus in the pig, thus complicating the procedure if operation should be done in the inguinal canal. The chain of lymph nodes resembles the human spermatic cord and can be used to perform Lichtenstein’s hernia repair.Results
This experimental surgical model has been tested on two adult male pigs and three adult female pigs, and a total of 55 surgeons have been educated to perform Lichtenstein’s hernia repair in these animals.Conclusions
This new experimental surgical model for training Lichtenstein’s hernia repair mimics the human inguinal anatomy enough to make it suitable as a training model. The operation facilitates the training in the positioning and fixation of the mesh and can be performed numerous times on the same pig. It is therefore a useful training method for inexperienced surgeons to obtain experience in aspects of the Lichtenstein procedure. 相似文献10.
Purpose
Endoscopic repair of inguinal hernia can decrease the incidence of chronic groin pain. Staple mesh fixation is the surgical technique preferentially used but may also cause residual pain. Although a substantial number of specialists advocate no mesh fixations, concerns are that this could lead to an increase in recurrence rates. This study aimed to assess the safety and the effectiveness of fibrin sealant, as an alternative technique to staple mesh fixation after totally extraperitoneal (TEP) inguinal hernia repair.Methods
A total of 472 patients underwent elective TEP inguinal hernia repair between February 2005 and July 2011. Mesh fixation was achieved using fibrin sealant. Patients were reviewed postoperatively at Week 2, Week 6, and Month 6. Patient satisfaction was assessed in a subgroup of 116 patients using a comprehensive scoring system designed for hernia repairs, and pain was assessed using a standard Visual Analog pain Scale.Results
No conversion to open surgery was observed. There were two cases of major morbidities and no mortality. Three months after surgery, only three patients (0.6 %) experienced chronic groin or testicular discomfort. At Week 6, 98.9 % of the patients were either satisfied or very satisfied with their outcome, and 96.8 % denied any residual pain. Finally, only six hernia recurrences (0.9 %) were reported, of which five occurred during the first months of the study.Conclusions
Fibrin sealant is safe and reliable for mesh fixation of inguinal hernia during TEP repair with a very high satisfaction index and limited risk of developing chronic pain. 相似文献11.
D. Symeonidis M. Efthimiou G. Koukoulis E. Athanasiou I. Mamaloudis G. Tzovaras 《Hernia》2013,17(1):85-87
Purpose
Our group evaluated on a pilot basis open inguinal hernia repair with the use of a fully absorbable mesh aiming to take mesh inguinal hernia repair one step forward. The purpose of the present study was to assess the long-term results of the proposed technique.Methods
Patients that were included in our previous report were followed up at 3 years after the initial operation.Results
Ten patients underwent open inguinal hernia repair with the use of an absorbable polyglycolic acid/trimethylene carbonate mesh. 3 years after the procedure, from the total of ten patients, two were lost to follow-up (20 %). Three patients (37.5 %), one with direct and two with indirect hernia, were diagnosed clinically with a recurrence at the follow-up of 3 years. Recurrences were developed nearly 2 years—median 24 months (range 18–30)—after the initial operation. Among patients without recurrence none complained about chronic pain, foreign body sensation or numbness. On the other hand, chronic pain was a constant complain in the recurrence patient group.Conclusions
The results of the 3-year follow-up in the given patient sample alleviate the initial enthusiasm regarding the use of an absorbable mesh for inguinal hernia repair as an attractive alternative and causes skepticism about the generalized use of the procedure in its certain form. 相似文献12.
Background
The reported recurrence rates after laparoscopic inguinal hernia repair are 0–4 %. It is unclear which technique could best be offered to a patient with a recurrent hernia after a previous posterior repair. The purpose of this retrospective study was to determine the safety, feasibility, and reliability of a repeated laparoscopic repair (TAPP) for a recurrent hernia after a previous posterior inguinal hernia repair.Methods
The study group contains 2,594 consecutive transabdominal inguinal hernia repairs (TAPP). Of these, 53 repairs were attempted in 51 patients for recurrent hernias after a previous posterior repair. During the follow-up period, patients were examined for recurrences and for presence of a port-site hernia. Pain was scored by the visual analogue pain scale (VAS).Results
Fifty-one patients underwent a TAPP repair for a recurrent inguinal hernia after previous posterior hernia repair. Two patients presented a bilateral recurrent inguinal hernia. In two thirds of the patients, the recurrence was located caudally or medially from the previously placed mesh. Two attempted repairs had to be converted to an open technique due to severe adhesions. One intraoperative complication was encountered when the vas deferens was ligated during surgery due to adhesions of the previous placed mesh. Nine patients encountered an adverse event postoperatively, but none of them were serious events. No mesh infections were reported. The mean follow-up was 70 (range, 1–198) months. At follow-up, no recurrences were found at physical examination. Four patients developed a port-site hernia. Four patients had complaints of postoperative pain and were restricted in daily activities due to groin pain. The mean VAS score (scale 0–100), including the four patients with persistent pain, was 5.7 (range, 0–61).Conclusions
It is concluded that repeated laparoscopic hernia repair (TAPP) is a definite repair for recurrent inguinal hernias. The procedure is feasible, safe, and reliable. 相似文献13.
Purpose
Total extraperitoneal preperitoneal (TEP) repair is widely used for inguinal, femoral, or obturator hernia treatment. However, mesh repair is not often used for strangulated hernia treatment if intestinal resection is required because of the risk of postoperative mesh infection. Complete mesh repair is required for hernia treatment to prevent postoperative recurrence, particularly in patients with femoral or obturator hernia.Cases
We treated four patients with inguinocrural and obturator hernias (a 72-year-old male with a right indirect inguinal hernia; an 83-year-old female with a right obturator hernia; and 86- and 82-year-old females with femoral hernias) via a two-stage laparoscopic surgery. All patients were diagnosed with intestinal obstruction due to strangulated hernia. First, the incarcerated small intestine was released and then laparoscopically resected. Further, 8–24 days after the first surgery, bilateral TEP repairs were performed in all patients; the postoperative course was uneventful in all patients, and they were discharged 5–10 days after TEP repair. At present, no hernia recurrence has been reported in any patient.Conclusion
The two-stage laparoscopic treatment is safe for treatment of strangulated inguinal, femoral, and obturator hernias, and complete mesh repair via the TEP method can be performed in elderly patients to minimize the occurrence of mesh infection.14.
P. Chastan 《Hernia》2009,13(2):137-142
Background
Lichtenstein tension-free mesh repair is the most commonly used technique for the open treatment of inguinal hernia. Mesh fixation and the potential risk of associated pain are always a surgical concern. The aim of this study was to report the initial clinical experience using an innovative, partly resorbable mesh with self-gripping properties.Methods
Fifty-two patients (70 hernias) underwent open Lichtenstein hernia repair with Parietene® Progrip (Sofradim Production, Trévoux, France—Group Covidien). Patient pain as measured by a visual analogue scale (VAS) was the primary study endpoint. Clinical evaluation, with careful attention to the identification of hernia recurrence, was performed at 1 month and 1 year. The evaluation of fixation precision, quality of fixation and ease of use was assessed by the primary surgeon.Results
The mean patient pain was 1.3 (±1.4) at discharge, 0.1 (±0.4) at 1 month and 0.0 (±0.1) (one patient with VAS 1/10) at 1 year, respectively. The mean operative time was 19 ± 4 min. There was one minor cutaneous infection and no documented recurrence. The quality of the gripping effect was rated very good in 51 (98.1%) of the cases performed.Conclusion
The use of a novel low-density, macroporous mesh with semi-resorbable self-fixing properties during tension-free repair may be a satisfactory solution to the clinical problems of pain and recurrence following inguinal herniorrhaphy. 相似文献15.
Christopher Nahm Jason Free Sivakumar Gananadha Thomas J. Hugh Jaswinder S. Samra 《Surgical endoscopy》2013,27(11):4360-4363
Introduction
Inadequate peritoneal dissection from retroperitoneal structures may account for a large number of hernia recurrences amongst surgeons and trainees who are new to totally extraperitoneal (TEP) laparoscopic inguinal hernia repair. In this paper, we describe a simple dynamic test that allows surgeons to better appreciate the peritoneal edge during the initial dissection phase of TEP inguinal hernia repair, allowing for more adequate dissection of the peritoneum from retroperitoneal structures before placement of mesh.Methods
Data from a single surgeon was collected on 113 consecutive patients who underwent laparoscopic TEP inguinal hernia repair at the Royal North Shore Hospital in Sydney. The data was retrospectively reviewed to determine the number of cases in which the suction test led to further peritoneal dissection prior to mesh placement.Operative Technique
After balloon dissection of the pre-peritoneal space and initial dissection of peritoneum and sac from retroperitoneal structures, a laparoscopic suction device is used to aspirate the insufflated gas from the pre-peritoneal space to cause the peritoneum to bulge anteriorly, thus demonstrating the edge of the peritoneal reflection. Further dissection is performed if deemed necessary at this point, and the mesh is placed over the hernia defect.Results
136 TEP hernia repairs were performed in 113 patients. In 26 (23 %) of patients, the abovementioned technique was of particular value resulting in further dissection of peritoneum prior to mesh placement. There were no complications as a direct result of the test.Conclusion
This dynamic suction test is a risk-free and useful operative tool for surgeons and trainees who are new to TEP inguinal hernia repair, and provides a definitive way of identifying the peritoneal reflection to ensure the peritoneum has been dissected adequately prior to mesh placement. 相似文献16.
I. Sucullu A. I. Filiz B. Sen Y. Ozdemir E. Yucel H. Sinan H. Sen O. Dandin Y. Kurt B. Gulec M. Ozyurt 《Hernia》2010,14(2):165-169
Purpose
The two most common procedures for open tension-free groin hernia repair with prosthetic mesh are the Lichtenstein operation and the mesh plug (Rutkow–Robbins) technique. Our study evaluated these two techniques on testicular blood flow and volume, and sperm function in young adults.Methods
We randomized operation types with a systematic sampling method, and handled consecutive patients of age 20–30 years having unilateral inguinal hernia repair at our institution from March to August 2008. The study subjects were divided into the Lichtenstein group (LG) and the mesh plug group (MPG). All subjects received color Doppler ultrasonography to determine testicular volume and resistive index (RI) the day before surgery and 3 months postoperatively by a physician blinded for the type of planned or performed operation. Spermiograms done preoperatively and at 3 months postoperatively measured sperm concentration and the rate of progressive motility.Results
Sixty-four patients met the study criteria, with 32 patients each in the LG and MPG. RI levels were elevated postoperatively in both the LG (P = 0.027) and MPG (P = 0.012); there was no significant alteration in terms of testicular volume and spermiogram in the LG and MPG.Conclusion
The Lichtenstein and mesh plug techniques in unilateral inguinal hernia increase the RI level significantly in the early postoperative period, but do not have a significant effect on sperm concentration and the rate of progressive motility. 相似文献17.
Purpose
The primary objective was to describe 30-day outcomes after primary inguinal paediatric hernia repair.Methods
Prospectively collected data from the National Patient Registry covering a 2-year study period 1 January 2005 to 31 December 2006 were collected. Unexpected outcomes were defined as either/or hospital stay for >1 day (i.e. 2 nights at hospital or more), readmission within 30 days, reoperations within 12 months after repair including repair for recurrence, and death within 30 days after repair.Results
The study cohort comprised 2,476 patients, and unexpected outcome was found in 267 patients/repairs (10.8 %). Prolonged hospital stay was by far the most prevalent indicator of unexpected outcome. Prolonged hospital stay was in 8.2 %, readmission in 2.1 %, reoperation in 0.7 %, and complications were observed in 1.1 %. One patient died within 30 days after repair, but death was not associated with the inguinal hernia repair. The usual technique was a simple sutured plasty (96.5 %). Emergency repair was performed in 54 patients (2.2 %) mainly in children between 0 and 2 years (79.6 %). During the 1 year follow-up, reoperation for recurrent inguinal hernia was performed in 8 children after elective repair (recurrence rate 0.3 %). Paediatric repairs were for most parts performed in surgical public hospitals, and most departments performed less than 10 inguinal hernia repairs within the 2 years study period.Conclusion
These nationwide results are acceptable with low numbers of patients staying more than one night at hospital, low morbidity, and no procedure-related mortality. 相似文献18.
Yuki Hayashi Kanji Miyata Norihiro Yuasa Eiji Takeuchi Yasutomo Goto Hideo Miyake Hidemasa Nagai Yoichiro Kobayashi 《Surgery today》2014,44(12):2255-2262
Purpose
Tension-free mesh repair of adult inguinal hernias has become a standard procedure, but there have been few comparisons of the postoperative outcome after hernia repair using the Prolene Hernia System (PHS) vs. the Mesh Plug (MP) method in a large number of patients from a single institution.Methods
We reviewed the medical records of patients to investigate the short- and long-term outcomes of the different types of hernia repair. Late symptoms were evaluated by questionnaire. A total of 1,141 repairs performed from 1999 to 2008 (PHS in 957 and MP in 184 repairs) were evaluated.Results
There were 93 early postoperative complications (8.2 %). A subcutaneous hematoma was found more frequently after MP repair compared with after PHS repair (3.8 vs. 1.3 %, P = 0.013). Seven hundred and ten patients (62.2 %) could be followed up for more than 2 years. Recurrence was detected in 14 patients with PHS repair and two patients with MP repair (1.5 vs. 1.1 %, P = 0.956). Wound infections occurred in three patients (0.3 %) with PHS repair vs. none with MP repair (P > 0.999). Patients with PHS and MP repair showed no significant differences in the long-term wound pain.Conclusions
The recurrence and wound infection rates were similar after hernia repair using the PHS and MP methods. Patients undergoing PHS repair developed fewer subcutaneous hematomas. An older age (≥65 years) was a significant independent risk factor for recurrence. 相似文献19.
Uberto Fumagalli Romario Francesco Puccetti Ugo Elmore Simonetta Massaron Riccardo Rosati 《Surgical endoscopy》2013,27(5):1798-1802
Background
Transabdominal preperitoneal (TAPP) repair is widely used to treat bilateral or recurrent inguinal hernias. Recently a self-gripping mesh has been introduced into clinical practice. This mesh does not need staple fixation and thus might reduce the incidence of chronic pain. This prospective study aimed to compare two groups of patients with bilateral (BIH) or monolateral (MIH) primary or recurrent inguinal hernia treated with TAPP using either a self-gripping polyester and polylactic acid mesh (SGM) or a polypropylene and poliglecaprone mesh fixed with four titanium staples [standard technique (ST)].Methods
In this study, 96 patients (mean age, 58 years) with BIH (73 patients with primary and recurrent hernia) or MIH (22 patients with recurrent hernia) underwent a TAPP repair. For 49 patients, the repairs used SGM, and for 46 patients, ST was used. The patients were clinically evaluated 1 week and then 30 days postoperatively. After at least 6 months, a phone interview was conducted. The short-form McGill Pain Questionnaire was administered to all the patients at the 6-month follow-up visit.Results
The mean length of the procedure was 83 min in the SGM group and 77.5 min in the ST group. The mean follow-up period was 13.8 months (range 1.3–42.0 months) for the SGM group and 18.2 months (range 1.9–27.1 months) for the ST group. The recurrence rate at the last follow-up visit was 0 % in the SGM group and 2.2 % (1 patient) in the ST group. The incidence of mild chronic pain at the 6-month follow-up visit was 4.1 % in the SGM group and 9.1 % in the ST group, and the incidence of moderate or severe pain was respectively 2.1 and 6.8 %.Conclusions
The study population was not large enough to obtain statistically significant results. However, the use of SGM for TAPP repairs appeared to give good results in terms of chronic pain, and the incidence of recurrences was not higher than with ST. In our unit, SGM during TAPP repair of inguinal hernias has become the standard. 相似文献20.