Features of тарр in recurrent inguinal hernia after liechtenstein surgery

Authors

  • Ya. P. Feleshtynsky P. Shupyk National Medical Academy of Postgraduate Education, Kyiv
  • A. A. Shtaier Kyiv City Clinic Hospital No. 5,
  • V. F. Vatamaniuk Kyiv City Clinic Hospital No. 1
  • A. V. Kokhanevych Kyiv City Clinic Hospital No. 1

DOI:

https://doi.org/10.11603/2414-4533.2020.2.10757

Keywords:

recurrent inguinal hernia, ТАРР, optimization of alloplasty of recurrent hernia

Abstract

The aim of the work: to improve treatment outcomes of patients with recurrent inguinal hernia after Liechtenstein surgery.

Materials and Methods. The analysis of surgical treatment of 105 patients with recurrent inguinal hernia after the operation of Liechtenstein was performed. All the patients were men. In 31 (29.5 %) relapses occurred in 3 months after primary plastic surgery, in 6 months in 59 (52.3 %), in 12 months in 19 (18%), 26 patients (24.7 %) had concomitant pathology.

In group 1 of 52 patients, classical TAPP was performed. Under general anesthesia, carboxyperitoneun was imposed, 3 trocars were installed, the main stage of TAРP, the incision of the parietal peritoneum over the inguinal pits, and then a 10 × 12 cm mesh was inserted preperitoneally, followed by fixation of it to the ligament of Cooper and the abdomen. In group 2 of 53 patients, performed advanced TAРP. The essence of improvement was in additional mobilization of the upper flap of the parietal peritoneum 3–4 cm upper, a wider mesh of 15x15 cm was obtained. Combined fixation of the implant with a gerniostapler and adhesive fixation with glue Sulfacrylate.

Results and Discussion. In group 1, 5 patients (9.6 %) had seroma on the side of hernioplasty. At a later date, patients were observed at 6, 24, and 36 months. Thus, 4 (7.7 %) were diagnosed with chronic inguinal pain. Repeat relapse was noted in 5 (9.6 %) patients. In group 2, 6 seromas were observed in 6 (11.3 %) patients, 3 (5.6 %) patients were diagnosed with chronic inguinal pain, recurrence was in 1 (2 %) patient. The use of advanced TAPP in comparison with the classical technique, with recurrence of inguinal hernia after Liechtenstein surgery, by using a larger mesh implant 15x15 cm and its glue fixation on the lower edge, improves the results of treatment, namely, reducing the frequency of 9 % recurrence 2 %.

References

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Published

2020-01-20

How to Cite

Feleshtynsky, Y. P., Shtaier, A. A., Vatamaniuk, V. F., & Kokhanevych, A. V. (2020). Features of тарр in recurrent inguinal hernia after liechtenstein surgery. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (2), 11–14. https://doi.org/10.11603/2414-4533.2020.2.10757

Issue

No. 2 (2020)

Section

ORIGINAL INVESTIGATIONS

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