Peranbu, L (2023) A Comparative Clinical study on Open Versus Laparoscopic (TEP/TAPP) Inguinal Hernia Repair Techniques. Masters thesis, Madras Medical College, Chennai.
Full text not available from this repository.Abstract
INTRODUCTION: Hernia is defined as a protrusion of a viscus or a part of a viscus through an abnormal opening in the walls of its containing cavity. It is derived from the latin word 'hernios' meaning rupture. Most commonly seen in the inguinal region followed by paraumbilical/incisional hernia. Inguinal hernia occurs in about 15% of adult population and inguinal hernia repair is one of the mostc ommonly performed surgical procedure. In the era of minimal invasive surgery, hernia repair has seen a paradigm shift from open to laparoscopic technique. Evolution in the treatment of inguinal hernias has equalled to the technological developments in this field. The most significant advances to impact inguinal hernia repair have been the addition of prosthetic materials to conventional tissue repairs. The laparoscopic inguinal hernia repair includes Totally Extraperitoneal approach (TEP)/Trans Abdominal Preperitonealapproach (TAPP). Over 60 randomized trials have compared laparoscopic surgery with Lichenstein repair. Following introduction of mesh for hernia repair, newer measures focus on post hernioplasty pain syndrome, quality of life and return to normal activities. They show although laparoscopic operation takes longer to perform, proven advantages are reduced pain both following surgery, more rapid return to full activity and reduced chance of wound complications. A repair that results in an asymptomatic recurrence will not as clinically significant as a repair that imparts a significant amount of chronic pain, but does not lead to recurrence. AIM OF THE STUDY: The aim of this study is to prospectively compare the results of open mesh technique and laparoscopic repair for inguinal hernia and to compare operative time, post operative pain, length of hospital stay, return to normal activities and its complications. MATERIALS AND METHODS: STUDY DESIGN: Prospective study. STUDY POPULATION: Patients – male and female presenting with inguinal hernia. SAMPLE SIZE: In this prospective study a total of 50 patients with inguinal hernia were enrolled into two comparative groups ,namely Lichtenstein’s and laparoscopichernia repair. INCLUSION CRITERIA: • All male and female patients with inguinal hernia consented for inguinal hernia repair. • Incomplete hernia. • Recurrent hernia. EXCLUSION CRITERIA: • Age >80 years. • Age<12 years. • Pregnancy. • Scrotal abdomen. • Obstructed hernia. • Medically unfit patients (chronic asthma, COPD, Cardiac diseases). CONCLUSION: Laparoscopic hernia repair is safe and provide less postoperative morbidity in experienced hands and definitely had many advantages over open repair such as early resumption of daily activities and work, better subjective and objective cosmetic results with some limitations like more operative time.For bilateral and recurrent inguinal hernias laparoscopic approach is recommended. From the results of this study we find the outcomes of laparoscopic inguinal hernia are comparable with open repair. Laparoscopic repair has an advantage of less post operative pain, decreased hospital stay, faster recovery and improved cosmesis. It may soon become the procedure of choice not only for bilateral and recurrent hernias but also for primary, unilateral hernias. The open repair has a definite advantage over laparoscopic repairfinancially; however the decreased hospital stay and faster recovery mayreduce the economic burden of laparoscopic surgery to some extent. The openrepair remains a good option especially for older, high risk patients and easy toperform, inexpensive and can be done under local anesthesia. However, the trend in surgery today is of minimally invasive surgery and rightfullyso as our study proves.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 220120100514 |
| Uncontrolled Keywords: | Open, Laparoscopic (TEP/TAPP) Inguinal Hernia Repair Techniques. |
| Subjects: | MEDICAL > General Surgery > MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 15 Jan 2024 06:59 |
| Last Modified: | 19 Jan 2024 16:58 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/21304 |
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