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Total Ekstra-Peritoneal Hernioplasti Olgularımızda Balonsuz Diseksiyon Deneyimlerimiz

Year 2024, Volume: 7 Issue: 2, 35 - 39, 11.10.2024
https://doi.org/10.33713/egetbd.1468224

Abstract

AMAÇ; Bu çalışmada, total ekstra-peritoneal herni onarımda, balon diseksiyonu yerine laparoskopik kamera diseksiyonu uygulanan olguların literatür ile karşılaştırılması amaçlanmıştır.
GEREÇ VE YÖNTEM; Yüksekova/Hakkari Devlet Hastanesi Genel Cerrahi kliniğinde 2013-2020 yılları arasında laparoskopik kamera diseksiyonu ile total ekstra-peritoneal uygulanan hastalar çalışmaya dahil edildi. Çalışmada yaş, cinsiyet, herni tipi, operasyon süreleri, komplikasyonlar, normal iş yaşantısına dönüş süreleri kaydedildi ve veriler retrospektif olarak değerlendirildi.
BULGULAR; Çalışma kohortu 85 erkek olmak üzere toplam 88 hastadan oluştu. Çalışmada laparoskopik kamera diseksiyonu ile total ekstra-peritoneal uygulanan hastalarda operasyon süresi tek taraflı inguinal hernilerde 53 ± 17,1 dk, bilateral inguinal hernilerde 82 ± 23,4 dk olarak bulundu. Postoperatif komplikasyon olarak hastaların %8'inde seroma ve bir hastada ise implant transpozisyonuna bağlı erken nüks görüldü. Hastanede kalış süresi ortalama 1,20 ± 0,40 gün olarak gerçekleşirken, hastaların günlük iş yaşantısına dönüş için gereken zaman ortalaması 9,3 ± 6,1 gün olarak bulundu. Sağ ve sol inguinal herni onarımları ile direk ve indirek herni onarımları arasında operasyon süresi ve komplikasyonlar açısından istatistiksel olarak fark yoktu. Ancak nüks herniler ile nüks olmayan herniler arasında ki fark istatistiksel olarak anlamlı bulundu. Hastalarda per-operatif dönemde mortalite görülmedi.
SONUÇ; Laparoskopik kamera diseksiyonu ile yapılan total ekstra-peritoneal herniorafiler, balon diseksiyonu yapılan geleneksel total ekstra-peritoneal yöntemlerinde olduğu kadar güvenlidir. Balon diseksiyonu kullanılmaması operasyon maliyetlerinin azalmasına katkı sağlamaktadır.

References

  • Bittner R, Montgomery MA, Arregui E, Bingener J, Bisgaard T, Buhck H, et al. Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society). SurgEndosc. 2015;29:289–321.
  • HerniaSurge Group. International guidelines for groin hernia management. Hernia. 2018;22:1–165.
  • Schmedt CG, Sauerland S, Bittner R. Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a metaanalysis of randomized controlled trials. SurgEndosc. 2005;19(2):188-199.
  • Amid PK, Shulman AG, Lichtenstein IL. An analytic comparison of laparoscopic hernia repair with open "tension-free" hernioplasty. Int Surg. 1995;80(1):9-17.
  • Gökçal F, Çallı İ, Almalı N, Akkurt G. Laparoskopik Total EkstraperitonealFıtıkOnarımı: İlk Deneyimlerimiz. Van Tıp Dergisi. 2015;22(4):256-259.
  • Meyer A, Blanc P, Balique JG, Kitamura M, Juan RT, Delacoste F, et al. Laparoscopic totally extraperitoneal inguinal hernia repair: twentyseven serious complications after 4565 consecutive operations. Rev Col Bras Cir. 2013;40(1):32-36.
  • Kuhry E, Van Veen RN, Langeveld HR, Steyerberg EW, Jeekel J, Bonjer HJ. Open or endoscopic total extraperitoneal inguinal hernia repair? A systematic review. SurgEndosc. 2007;21(2):161-166.
  • Choi YY, Han SW, Bae SH, Kim SY, Hur KY, Kang GH. Comparison of the outcomes between laparoscopic totally extraperitoneal repair and prolene hernia system for inguinal hernia; review of one surgeon's experience. J Korean Surg Soc. 2012;82(1):40-44.
  • Lal P, Kajla RK, Chander J, Saha R, Ramteke VK. Randomized controlled study of laparoscopic total extraperitoneal versus open Lichtenstein inguinal hernia repair. SurgEndosc. 2003;17(6):850-856.
  • Winslow ER, Quasebarth M, Brunt LM. Perioperative outcomes and complications of open vs laparoscopic extraperitoneal inguinal hernia repair in a mature surgical practice. SurgEndosc. 2004;18(2):221-227.
  • Farinas LP, Griffen FD. Cost containment and totally extraperitoneal laparoscopic hernioplasty. SurgEndosc. 2000;14(1):37-40.
  • Akin E, Bas E, Firat N, Ozdemir K, Capoglu R, Altintoprak F. Comparison of Balloon Trocar versus Telescopic Dissection Method for TEP Inguinal Hernia Repair. J Coll Physicians Surg Pak. 2021;30(6):623-626.
  • Kolli VS, Kumar K, Hajibandeh S, Hajibandeh S. Balloon dissection versus telescopic dissection during laparoscopic totally extraperitoneal (TEP) inguinal hernia repair: a systematic review, meta-analysis, and trial sequential analysis. Hernia. 2023;27(3):527-539.
  • Bringman S, Ek A, Haqlind E, Heikkinen TJ, Kald A, Kylberg F, et al. Is a dissection balloon beneficial in bilateral, totally extraperitoneal, endoscopic hernioplasty? A randomized, prospective, multicenter study. SurgLaparoscEndoscPercutan Tech. 2001;11(5):322-326.
  • Schouten N, Elshof JW, Simmermacher RK, van Dalen T, de Meer SG, Clevers GJ, et al. Selecting patients during the "learning curve" of endoscopic Totally Extraperitoneal (TEP) hernia repair. Hernia. 2013;17(6):737-743.
  • Tetik C, Arregui ME, Dulucq JL, Fitzgibbons RJ, Franklin ME, McKernan JB, et al. Complications and recurrences associated with laparoscopic repair of groin hernias. A multi-institutional retrospective analysis. SurgEndosc. 1994;8(11):1316-1322.
Year 2024, Volume: 7 Issue: 2, 35 - 39, 11.10.2024
https://doi.org/10.33713/egetbd.1468224

Abstract

References

  • Bittner R, Montgomery MA, Arregui E, Bingener J, Bisgaard T, Buhck H, et al. Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society). SurgEndosc. 2015;29:289–321.
  • HerniaSurge Group. International guidelines for groin hernia management. Hernia. 2018;22:1–165.
  • Schmedt CG, Sauerland S, Bittner R. Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a metaanalysis of randomized controlled trials. SurgEndosc. 2005;19(2):188-199.
  • Amid PK, Shulman AG, Lichtenstein IL. An analytic comparison of laparoscopic hernia repair with open "tension-free" hernioplasty. Int Surg. 1995;80(1):9-17.
  • Gökçal F, Çallı İ, Almalı N, Akkurt G. Laparoskopik Total EkstraperitonealFıtıkOnarımı: İlk Deneyimlerimiz. Van Tıp Dergisi. 2015;22(4):256-259.
  • Meyer A, Blanc P, Balique JG, Kitamura M, Juan RT, Delacoste F, et al. Laparoscopic totally extraperitoneal inguinal hernia repair: twentyseven serious complications after 4565 consecutive operations. Rev Col Bras Cir. 2013;40(1):32-36.
  • Kuhry E, Van Veen RN, Langeveld HR, Steyerberg EW, Jeekel J, Bonjer HJ. Open or endoscopic total extraperitoneal inguinal hernia repair? A systematic review. SurgEndosc. 2007;21(2):161-166.
  • Choi YY, Han SW, Bae SH, Kim SY, Hur KY, Kang GH. Comparison of the outcomes between laparoscopic totally extraperitoneal repair and prolene hernia system for inguinal hernia; review of one surgeon's experience. J Korean Surg Soc. 2012;82(1):40-44.
  • Lal P, Kajla RK, Chander J, Saha R, Ramteke VK. Randomized controlled study of laparoscopic total extraperitoneal versus open Lichtenstein inguinal hernia repair. SurgEndosc. 2003;17(6):850-856.
  • Winslow ER, Quasebarth M, Brunt LM. Perioperative outcomes and complications of open vs laparoscopic extraperitoneal inguinal hernia repair in a mature surgical practice. SurgEndosc. 2004;18(2):221-227.
  • Farinas LP, Griffen FD. Cost containment and totally extraperitoneal laparoscopic hernioplasty. SurgEndosc. 2000;14(1):37-40.
  • Akin E, Bas E, Firat N, Ozdemir K, Capoglu R, Altintoprak F. Comparison of Balloon Trocar versus Telescopic Dissection Method for TEP Inguinal Hernia Repair. J Coll Physicians Surg Pak. 2021;30(6):623-626.
  • Kolli VS, Kumar K, Hajibandeh S, Hajibandeh S. Balloon dissection versus telescopic dissection during laparoscopic totally extraperitoneal (TEP) inguinal hernia repair: a systematic review, meta-analysis, and trial sequential analysis. Hernia. 2023;27(3):527-539.
  • Bringman S, Ek A, Haqlind E, Heikkinen TJ, Kald A, Kylberg F, et al. Is a dissection balloon beneficial in bilateral, totally extraperitoneal, endoscopic hernioplasty? A randomized, prospective, multicenter study. SurgLaparoscEndoscPercutan Tech. 2001;11(5):322-326.
  • Schouten N, Elshof JW, Simmermacher RK, van Dalen T, de Meer SG, Clevers GJ, et al. Selecting patients during the "learning curve" of endoscopic Totally Extraperitoneal (TEP) hernia repair. Hernia. 2013;17(6):737-743.
  • Tetik C, Arregui ME, Dulucq JL, Fitzgibbons RJ, Franklin ME, McKernan JB, et al. Complications and recurrences associated with laparoscopic repair of groin hernias. A multi-institutional retrospective analysis. SurgEndosc. 1994;8(11):1316-1322.
There are 16 citations in total.

Details

Primary Language Turkish
Subjects General Surgery
Journal Section Original Investigation
Authors

Resul Nusretoğlu 0000-0002-0967-2757

Yücel Gültekin 0000-0002-1974-1242

Early Pub Date October 28, 2024
Publication Date October 11, 2024
Submission Date April 14, 2024
Acceptance Date June 7, 2024
Published in Issue Year 2024 Volume: 7 Issue: 2

Cite

EndNote Nusretoğlu R, Gültekin Y (October 1, 2024) Total Ekstra-Peritoneal Hernioplasti Olgularımızda Balonsuz Diseksiyon Deneyimlerimiz. Ege Tıp Bilimleri Dergisi 7 2 35–39.

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