Inguinal hernia repair is performed over 20 million times yearly, with techniques evolving from tension-based to tension-free methods that lower recurrence rates. A narrative review delves into minimally invasive approaches, including laparoscopic methods like TAPP and TEP, and various mesh types and fixation strategies. While advancements such as drug-loaded meshes show promise, a definitive solution […]
Category: Hernia
Laparoscopic repair outperforms open surgery for parastomal hernias
Minimally invasive laparoscopic techniques demonstrate significant benefits over traditional open surgery in parastomal hernia repairs. This comprehensive meta-analysis reveals that laparoscopic approaches reduce hospital stays by an average of four days and lower complication rates, including a striking decrease in mortality. While robotic-assisted methods show promise for quicker operative times, the evidence remains limited. These […]
Prophylactic mesh reduces incisional hernia rates in surgeries
Prophylactic mesh reinforcement during elective abdominal surgeries significantly decreased the incidence of incisional hernias (IH) and the need for reoperations. In a meta-analysis of 15 randomized controlled trials involving 2,233 patients, mesh use demonstrated a notable reduction of IH at various follow-up points: 12 months (risk ratio 0.35), 24 months (0.28), and 36 months (0.62). […]
Non-penetrative fixation methods reduce hernia reoperation rates
A study involving 49,029 transabdominal pre-peritoneal hernia repairs revealed that non-penetrative fixation and self-fixating meshes significantly reduce reoperation rates for recurrence. Tack fixation, the most commonly used method, had the highest rate at 5.3% after five years. In contrast, glue fixation, self-fixating meshes, and no fixation showed much lower adjusted hazard ratios for reoperation: 0.25, […]
Prosthetic or bioprosthetic mesh in retromuscular plane minimizes hernias.
A recent meta-analysis involving 2,148 patients revealed that using prosthetic or bioprosthetic mesh in the retromuscular position significantly reduces the risk of incisional hernias following stoma closure. The study highlighted that both types of mesh led to lower hernia rates compared to non-use. However, no significant differences in surgical site infection rates were noted among […]
Dementia linked to worse surgical outcomes in older patients
In emergent hernia repair, patients with dementia, constituting 8.2% of 137,755 analyzed, face significantly higher risks. Older individuals with dementia experience increased in-hospital mortality (odds ratio 1.29), greater perioperative complications (1.41), and are more likely to be discharged non-home (2.98) compared to those without dementia. Additionally, readmission rates rise (1.11) for this vulnerable population. The […]
ETEP technique shows safety and low recurrence for ventral hernias
A study involving 163 patients undergoing the enhanced-view totally extraperitoneal (ETEP) technique for ventral hernia repair revealed promising results. The average operative time was 137.2 minutes, with a low conversion rate to open surgery (2.5%). Postoperative complications included seromas (6.7%) and wound infections (3.1%), while the long-term recurrence rate stood at just 0.6%. Notably, proficiency […]
RROM technique achieves low recurrence and minimal complications
The retro-rectus onlay mesh (RROM) technique for ventral hernia repair demonstrates notable long-term effectiveness. In a follow-up of over four years, a mere 0.38% recurrence rate was observed among 191 patients, alongside minimal complications, including four superficial infections. The method shows promise as a safe and cost-effective alternative to the standard intraperitoneal onlay mesh (IPOM) […]
TEP repairs present higher reoperation risks for men
Findings indicate that while reoperation rates for groin hernia repair are generally low, those who underwent totally extraperitoneal (TEP) repairs had a significantly higher risk of recurrence compared to transabdominal preperitoneal (TAPP) and Lichtenstein techniques in males. Specifically, TEP was associated with increased reoperation hazards (HR 1.38 vs. TAPP; HR 1.44 vs. Lichtenstein). Conversely, in […]
Long-acting resorbable meshes outperform other types in hernia repairs
Long-acting resorbable meshes exhibited the best long-term performance in ventral hernia repairs, with a median time-to-recurrence of 166.4 months, significantly longer than synthetic (132.1 months) and biologic meshes (80 months). Recurrence rates within five years were highest for biologic meshes (41%), dropping to 22% for long-acting resorbable meshes. The findings also suggest tailored follow-up schedules, […]